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Diabetes and periodontal disease are the most common chronic multifactorial and inflammatory diseases in humans, and there is a bidirectional relationship between type 2 diabetes and periodontitis. With the negative effects of the control of these two diseases, it results in an increase in the severity of diabetes and periodontitis, and they affect many systems together. To elucidate the role of ceramide, which is one of the possible biochemical mechanisms between diabetes and the degree of glycemic control and periodontitis, in inflammation. Aim of this study is the measurement of C1P and PGE2 in saliva and the effect of non-surgical periodontal treatment, which includes the degree of control of diabetes, oral hygiene education, tooth surface cleaning and root surface arrangement, on 3 months.
A total of 102 subjects were included. Clinical periodontal measurements, saliva samples were collected from each individual at baseline and 3 months after non-surgical periodontal treatmet in periodontitis groups. Salivary C1P and PGE2 levels were determined by enzyme-linked immunosorbent assay (ELISA) method.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1 (HH) | Active Comparator | 17 systemically healthy + periodontally healthy (normoglycemic) |
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| Group 2 (HP) | Experimental | 17 systemic healthy + grade A periodontitis |
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| Group 3 (T2D+H) | Active Comparator | 17 T2DM (HbA1c<%7) + periodontally healthy |
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| Group 4 (T2D+P) | Experimental | 17 T2DM (HbA1c<%7) + grade B periodontitis |
|
| Group 5 (T2D-H) | Active Comparator | 17 T2DM (HbA1c≥%7) + periodontally healthy |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Non-surgical periodontal treatment | Procedure | Routine non-surgical periodontal treatment will be applied to patients with periodontitis. The main aim of non-surgical periodontal treatment is to protect, heal and maintain the existing dentition. For this purpose, using manual, sonic or ultrasonic instruments, microbial dental plaque and calculus are removed by tooth surface cleaning and root surface straightening. |
| Measure | Description | Time Frame |
|---|---|---|
| PGE2 levels in saliva | Change in saliva PGE2 levels from baseline to 3 months after non-surgical periodontal treatment | baseline to 3 months after treatment |
| C1P levels in saliva | Change in saliva C1P levels from baseline to 3 months after non-surgical periodontal treatment | baseline to 3 months after treatment |
| HbA1c levels | Blood test in routine biochemistry laboratory for evaluation of the change in HbA1c levels of patients with type 2 diabetes from baseline to 3 months after non-surgical periodontal treatment | baseline to 3 months after treatment |
| Measure | Description | Time Frame |
|---|---|---|
| Plaque index (PI) | The changes in PI from baseline to 3 months after non-surgical periodontal treatment | baseline to 3 months after treatment |
| Bleeding on probing index (BOP) | The changes in BOP from baseline to 3 months after non-surgical periodontal treatment |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ondokuz Mayis University | Samsun | Turkey (Türkiye) |
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A total of 102 (n=102) individuals were included in the study and were divided into 6 groups. The control groups of our study were Group 1 (HH), which included 17 both systemically healthy and periodontally healthy normoglycemic individuals, Group 2 (HP), which included 17 systemic healthy with Grade A periodontitis. Periodontally healthy T2DM patients were divided into two groups according to their HbA1c levels, and 17 patients with HbA1c levels below 7% were grouped as Group 3 (T2D+H), and 17 patients with HbA1c above 7% and 7% were grouped as Group 5 (T2D-H). 17 patients with T2DM with Grade B periodontitis with an HbA1c below 7% in the last three months were included in Group 4 (T2D+P), and 17 patients T2DM and periodontitis with an HbA1C value above 7% were included in Group 6 (T2D-P).
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|
| Group 6 (T2D-P) | Experimental | 17 T2DM (HbA1c≥%7) + grade C periodontitis |
|
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| ELISA Test | Diagnostic Test | C1P and PGE2 levels in saliva samples obtained, and will be examined by ELISA test. |
|
| Periodontal Examination | Other | All diagnostic procedures were performed with examination instruments (periodontal probe, dental mirror, x-ray device, etc.). Periodontal clinical index measurements (PI, GI, BOP, PPD, CAL) recorded from all teeth. Routine panoramic radiographs were taken from all patients to determine alveolar bone resorption. Vertical/horizontal bone losses on the radiographs were evaluated and used in the diagnosis of periodontitis. |
|
| Saliva Sample Collection | Other | Saliva samples were collected from all subjects in the morning. Unstimulated saliva from each patient was collected by standard defined spitting method without stimulation. |
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| HbA1c Level | Diagnostic Test | Measurement of HbA1c levels from blood tests |
|
| baseline to 3 months after treatment |
| Gingival index (GI) | The changes in GI from baseline to 3 months after non-surgical periodontal treatment | baseline to 3 months after treatment |
| Probing pocket depth | The changes in probing pocket depth from baseline to 3 months after non-surgical periodontal treatment | baseline to 3 months after treatment |
| Clinical attachment level (CAL) | The changes in CAL from baseline to 3 months after non-surgical periodontal treatment | baseline to 3 months after treatment |
| ID | Term |
|---|---|
| D010518 | Periodontitis |
| D003924 | Diabetes Mellitus, Type 2 |
| ID | Term |
|---|---|
| D010510 | Periodontal Diseases |
| D009059 | Mouth Diseases |
| D009057 | Stomatognathic Diseases |
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
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| ID | Term |
|---|---|
| D014080 | Tooth Exfoliation |
| D016745 | Root Planing |
| ID | Term |
|---|---|
| D009063 | Dental Physiological Phenomena |
| D055688 | Digestive System and Oral Physiological Phenomena |
| D012534 | Dental Scaling |
| D003777 | Dental Prophylaxis |
| D010517 | Periodontics |
| D003813 | Dentistry |
| D013357 | Subgingival Curettage |
| D011313 | Preventive Dentistry |
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