以菌斑控制为导向的糖尿病患者牙周基础治疗效果1例报告及文献复习

doi:10.13481/j.1671-587X.20220228

Abstract

Abstract: Objective

To analyze the role of guided biofilm therapy （GBT） in the therapy of the patient with periodontitis and diabetes mellitus， and to provide the basis for the diagnosis and treatment of periodontitis associated with systemic diseases.

Methods

The clinical materials of one periodontitis patient with type 2 diabetes mellitus （T2DM） were collected， and GBT was performed. The positive rates of bleeding on probing（BOP）， probing depth （PD）， attachment loss （AL）， the number of deep periodontal pockets （>5 mm）， and the levels of fasting blood glucose and glycated hemoglobin （HbA1c） of the patient were examined and recorded at the first visit， 1 month， 3 months， 6 months， 1 year and 2 years after GBT， respectively. The related literatures were reviewed.

Results

After GBT，the positive rates of BOP， PD， AL， the number of deep periodontal pockets， and the levels of fasting blood glucose and HbA1c were decreased in varying degrees. Two years after treatment， there was no obvious gingival inflammation in the whole mouth， the positive rate of BOP was 10%，the average PD value was 2.18 mm， the AL was reduced to 0.98 mm， the positive rate of plaque was 20%， and there was no deep periodontal pocket greater than 5 mm. The fasting blood glucose was 5.5 mmol·L^－1， and the HbA1c was 5.9%.

Conclusion

GBT is more effective in the treatment of periodontitis associated with T2DM， and it is beneficial for the long-term control of blood glucose.

Key words: Guided biofilm therapy, Diabetes mellitus，type 2, Periodontitis, Initial periodontal therapy

CLC Number:

R781

Peipei ZHANG,Donghui GAO,Yue TIAN,Hongyan LI. Effect of guided biofilm therapy for periodontitis in diabetic patient: A case report and literature review[J].Journal of Jilin University(Medicine Edition), 2022, 48(2): 493-499.

Figures/Tables 6

Fig. 3

Fig. 4

Tab.1

Tab.2

References 29

1	孟焕新. 牙周病学［M］. 5版. 北京：人民卫生出版社， 2020：34.
2	李玉超，潘亚萍. 以菌斑控制为导向的牙周治疗联合引导性组织再生术病例分析1例［J］. 口腔医学， 2019， 39（11）： 1042-1046.
3	KHUMAEDI A I， PURNAMASARI D， WIJAYA I P， et al. Association of periodontitis and arterial stiffness in type 2 diabetic patients［J］. Acta Med Indonesiana， 2018， 50（4）： 320-327.
4	PAPAPANOU P N， SANZ M， BUDUNELI N， et al. Periodontitis： consensus report of workgroup 2 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions［J］. J Periodontol， 2018， 89： S173-S182.
5	MARCHETTI E， CASALENA F， CAPESTRO A， et al. Efficacy of two mouthwashes on 3-day supragingival plaque regrowth： a randomized crossover clinical trial［J］. Int J Dent Hyg， 2017， 15（1）： 73-80.
6	WORTHINGTON H V， MACDONALD L， POKLEPOVIC PERICIC T， et al. Home use of interdental cleaning devices， in addition to toothbrushing， for preventing and controlling periodontal diseases and dental caries［J］. Cochrane Database Syst Rev， 2019， 4： CD012018.
7	LAURITANO D， NOTA A， MARTINELLI M， et al. A hydrosilver gel for plaque control in adults affected by chronic periodontitis： Effects on the ‘red complex’ bacterial load. A prospective longitudinal pilot study using polymerase chain reaction analysis［J］. Int J Immunopathol Pharmacol， 2019， 33： 2058738418825212.
8	TECCO S， GRUSOVIN M G， SCIARA S， et al. The association between three attitude-related indexes of oral hygiene and secondary implant failures： a retrospective longitudinal study［J］. Int J Dent Hyg， 2018， 16（3）： 372-379.
9	CAYGUR A， ALBABA M R， BERBEROGLU A， et al. Efficacy of glycine powder air-polishing combined with scaling and root planing in the treatment of periodontitis and halitosis： a randomised clinical study［J］. J Int Med Res， 2017， 45（3）： 1168-1174.
10	LÖE H. Periodontal disease： The sixth complication of diabetes mellitus［J］. Diabetes Care， 1993， 16（1）： 329-334.
11	WATANABE K.Periodontitis in diabetics：is collaboration between physicians and dentists needed？［J］. Dis Mon， 2011， 57（4）： 206-213.
12	BORGNAKKE W S， YLÖSTALO P V， TAYLOR G W，et al. Effect of periodontal disease on diabetes： systematic review of epidemiologic observational evidence［J］. J Clin Periodontol， 2013， 40（）： S135-S152.
13	ARTESE H P， FOZ A M， RABELO M D E S， et al. Periodontal therapy and systemic inflammation in type 2 diabetes mellitus： a meta-analysis［J］. PLoS One， 2015， 10（5）： e0128344.
14	DEMMER R T， HOLTFRETER B， DESVARIEUX M，et al. The influence of type 1 and type 2 diabetes on periodontal disease progression： prospective results from the Study of Health in Pomerania （SHIP）［J］. Diabetes Care，2012， 35（10）： 2036-2042.
15	SUNDAR C， RAMALINGAM S， MOHAN V， et al. Periodontal therapy as an adjunctive modality for HbA1c reduction in type-2 diabetic patients［J］. J Educ Health Promot， 2018， 7： 152.
16	BASTOS A S， GRAVES D T， LOUREIRO A P，et al. Lipid peroxidation is associated with the severity of periodontal disease and local inflammatory markers in patients with type 2 diabetes［J］. J Clin Endocrinol Metab， 2012， 97（8）： E1353-E1362.
17	SOUTHERLAND J H， TAYLOR G W， MOSS K，et al.Commonality in chronic inflammatory diseases： periodontitis， diabetes， and coronary artery disease［J］. Periodontol 2000， 2006， 40： 130-143.
18	ACHARYA A B， THAKUR S， Muddapur M V， et al. Cytokine ratios in chronic periodontitis and type 2 diabetes mellitus［J］. Diabetes Metab Syndr， 2017，11（4）： 277-278.
19	EVAN DYKE T. Pro-resolving mediators in the regulation of periodontal disease［J］. Mol Aspects Med， 2017， 58： 21-36.
20	ARREGUIN-CANO J A， AYERDI-NÁJERA B， TACUBA-SAAVEDRA A， et al. MMP-2 salivary activity in type 2 diabetes mellitus patients［J］. Diabetol Metab Syndr， 2019， 11： 113.
21	POLAK D， SHAPIRA L. An update on the evidence for pathogenic mechanisms that may link periodontitis and diabetes［J］. J Clin Periodontol， 2018， 45（2）： 150-166.
22	CHAPPLE I L， GENCO R， GROUPWORKING 2 OF THE JOINT EFP/AAP WORKSHOP. Diabetes and periodontal diseases： consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases［J］. J Periodontol， 2013， 84（4 ）： S106-S112.
23	中华医学会糖尿病学分会.中国2型糖尿病防治指南（2020年版）（下）［J］.中国实用内科杂志，2021，41（9）：757-784.
24	BORGNAKKE W S， YLÖSTALO P V， TAYLOR G W，et al. Effect of periodontal disease on diabetes： systematic review of epidemiologic observational evidence［J］. J Clin Periodontol， 2013， 40（）： S135-S152.
25	NIBALI L， D’AIUTO F， GRIFFITHS G， et al. Severe periodontitis is associated with systemic inflammation and a dysmetabolic status： a case–control study［J］. J Clin Periodontol， 2007， 34（11）： 931-937.
26	SHI B， LUX R， KLOKKEVOLD P， et al. The subgingival microbiome associated with periodontitis in type 2 diabetes mellitus［J］. Isme J， 2020， 14（2）： 519-530.
27	李宗泽. 2型糖尿病患者口腔微生物宏基因组学研究［D］. 西安：第四军医大学， 2017.
28	GRAVES D T， DING Z， YANG Y. The impact of diabetes on periodontal diseases［J］. Periodontol 2000， 2020， 82（1）： 214-224.
29	MIRANDA TS， FERES M， RETAMAL-VALDES B， et al. Influence of glycemic control on the levels of subgingival periodontal pathogens in patients with generalized chronic periodontitis and type 2 diabetes［J］. J Appl Oral Sci， 2017， 25（1）： 82-89.

Periodontal clinical parameter	First visit	1 month after treatment	3 months after treatment	6 months after treatment	1 year after treatment	2 years after treatment
BOP (+) site	15（89.88%）	57(33.93%)	46(27.38%)	29（17.26%）	23（13.69%）	10(5.95%)
Mean PD（l/mm）	4.12±1.29	3.35±1.06	2.93±0.83	2.55±0.638^*	2.23±0.64^*	2.18±0.77^*
PD≥5 mm sites	68（40.48%）	47（27.98%）	33（19.64%）	19（11.31%）	7（4.17%）	0（0.00%）
Mean AL（l/mm）	1.86±0.67	1.71±0.53	1.63±0.52	1.58±0.49	1.33±0.55^*	0.98±0.48^*

[1]	Feilong REN,Huanyu LUO,Shize ZHENG,Xinyi FAN,Chunxia REN,Yuan MENG,Hong ZHAO,Ce SHI,Hongchen SUN. Effects of C3a-C3aR axis on inflammatory response and tissue damage in chronic periodontitis model mice by promoting M1-type polarization of macrophages [J]. Journal of Jilin University(Medicine Edition), 2022, 48(1): 1-8.
[2]	Zhulan ZHAO,Qingyu ZHANG,Degeng XIA,Yang ZHONG,Tianyi ZHANG,Yu HUANG,Li ZHANG,Ning MA. Clinical repair effect of combined orthodontic treatment with implant prosthesis in severe invasive periodontitis：A case report and literature review [J]. Journal of Jilin University(Medicine Edition), 2021, 47(5): 1292-1297.
[3]	HUANG Yu, ZHAO Zhulan, ZHONG Yang, XU Lishuo, LIU Chenguang, MA Ning, ZHANG Li. Soft tissue augmentation and bone regeneration combined with immediate implantation of patient with severe chronic periodontitis:A case report and literature review [J]. Journal of Jilin University(Medicine Edition), 2020, 46(05): 1082-1086.
[4]	HUANG Jiangyong, LI Chanxiu, ZHENG Zhichao, WANG Hongjuan, GUO Lyuhua, WU Zhe, LUO Tao. Effect of probiotics on expression of IL-17 in periodontal tissue of estrogen-deficient mice induced by ovariectomy and its significance [J]. Journal of Jilin University(Medicine Edition), 2020, 46(04): 733-738.
[5]	CAI Rujia, GUAN Ning, LIU Yizhen, GAO Xiuqiu, WANG Linyuan. Expressions of M1 macrophage-related factors in gingiva tissue of patients with severe chronic periodontitis and their significances [J]. Journal of Jilin University(Medicine Edition), 2020, 46(02): 372-376.
[6]	LI Hongyan, WANG Lei, LIU Min, LIN Chongtao. Nifedipine-induced gingival enlargement in diabetic patient: A case report and literature review [J]. Journal of Jilin University(Medicine Edition), 2020, 46(02): 399-403.
[7]	LI Wenjing, TIAN Songbo, CHENG Dongmei, LIU Congna, CUI Zhanqin. Promotion effect of nerve growth factor on regeneration of young permanent dental pulp tissue in Beagle dogs [J]. Journal of Jilin University(Medicine Edition), 2019, 45(05): 1075-1079.
[8]	XU Lishuo, HUANG Yu, JIN Quan, LIU Chenguang, CHEN Fei, ZHANG Li, MA Ning. Evaluation on effect of compound Chinese medicine preparation of wild chrysanthemum and rhizoma drynariae combined with ornidazole in treatment of chronic periodontitis [J]. Journal of Jilin University(Medicine Edition), 2019, 45(05): 1128-1133.
[9]	LU Jingyi, WANG Lei, ZHENG Yi, REN Baijie, WANG Xiaojun. Clinical application of non-surgical treatment under periodontal endoscope in patients with moderate-to- severe periodontitisof multirooted teeth [J]. Journal of Jilin University(Medicine Edition), 2019, 45(05): 1146-1151.
[10]	JIN Quan, ZHENG Yi, XU Lishuo, HUANG Yu, MA Ning, ZHANG Li. Expression of periostin in gingival tissue of patients with chronic periodontitis and its clinical significance [J]. Journal of Jilin University(Medicine Edition), 2019, 45(03): 634-638.
[11]	YUAN Zhongzheng, LIU Yin, SHEN Yuqin, LIN Chongtao. Effect of periodontitis patient's own tissue nucleic acid on expression of NLRP3 mRNA in murine macrophages and its significance [J]. Journal of Jilin University(Medicine Edition), 2019, 45(01): 23-27.
[12]	ZHENG Taijing, BAI Yuanliang, ZHENG Jiawen, LIU Honghong, GUO Zijun, WANG Ping. Efficacies of clarithromycin and metronidazole in treatment of chronic periodontitis: A Meta-analysis [J]. Journal of Jilin University(Medicine Edition), 2019, 45(01): 130-136.
[13]	JIN Quan, XU Lishuo, HUANG Yu, JIAO Peng, CHEN Fei, CHE Hongze, MA Ning, ZHANG Li. Severe periodontitis complicated with oral lichen planus: A case report and literature review [J]. Journal of Jilin University(Medicine Edition), 2018, 44(06): 1298-1302.
[14]	CHEN Fei, SHI Jinxian, JIAO Peng, JIN Quan, XU Lishuo, ZHANG Li, MA Ning. Detection of levels of serum visfatin and PGE2 in patients with periodontitis and their relationships with activity of periodontitis [J]. Journal of Jilin University Medicine Edition, 2018, 44(03): 563-567.
[15]	JIAO Peng, CHEN Fei, JIN Quan, CHEN Nannan, ZHANG Li, MA Ning. Comprehensive treatment of anterior esthetic zone in patient with loosening and falling of teeth induced by severe periodontitis: A case reeport and literature review [J]. Journal of Jilin University Medicine Edition, 2018, 44(02): 421-424.

Effect of guided biofilm therapy for periodontitis in diabetic patient: A case report and literature review

RichHTML

PDF (PC)

Like

Knowledge

Abstract

Cite this article

share this article

Figures/Tables 6

References 29

Related Articles 15

Metrics

Comments

Recommended 0