Effects of Non-surgical Periodontal Therapy on Porphyromonas gingivalis and Filifactor alocis in Chronic Periodontitis Patients With Type 2 Diabetes Mellitus: A Clinico-Microbiological Study.

BACKGROUND

Periodontitis is a multifactorial and polymicrobial disease associated with microbial dysbiosis. Diabetes mellitus can modify the onset and course of periodontitis and has a bidirectional relationship with chronic periodontitis. Porphyromonas gingivalis is considered to be a key pathogen in the progression of periodontitis, and Filifactor alocis  is a relevant pathobiont in diabetic individuals. The present study was designed to evaluate non-surgical periodontal therapy (NSPT) on the prevalence of P. gingivalis and F. alocis in type 2 diabetes mellitus (T2DM) patients with chronic periodontitis.

OBJECTIVE

To evaluate the effect of NSPT on subgingival detection of P. gingivalis and F. alocis by polymerase chain reaction (PCR) and on clinical parameters (probing pocket depth (PPD) and clinical attachment level (CAL)) in adults with T2DM and chronic periodontitis at baseline, three months, and six months. The secondary objective is to explore associations between microbial detection and glycated hemoglobin (HbA1c).

METHODS

A total of 30 T2DM patients aged between 30 and 70 years with chronic periodontitis (PPD ≥5 mm, CAL ≥3 mm) voluntarily participated in this study. Clinical parameters like PPD and CAL were recorded at baseline, three months, and six months post-NSPT. Plaque samples from subgingival sites were collected from the deepest pockets and analysed for P. gingivalis and F. alocis using PCR.

RESULTS

NSPT resulted in improvements that are statistically significant in PPD and CAL measurements (p < 0.05) over the six months. PCR analysis revealed a statistically significant percentage reduction of P. gingivalis and F. alocis after therapy. The decrease in P. gingivalis level was more consistent compared to F. alocis, indicating possible microbial resistance to NSPT.

CONCLUSION

NSPT was associated with improved clinical periodontal status and reduced microbial presence of key periodontal pathogens in T2DM patients. The findings of the present study suggest that NSPT contributes significantly to the improvement of periodontal health in diabetic patients.