The effect of non-surgical periodontal therapy on glycemic control and C1-reactive protein levels among type 2 diabetic patients with periodontitis: A clinical trial

Mohammad Moshtaghi Moghaddam, Arman Keymoradzadeh, Rashed Ghorbandoust


It suggests that non-surgical periodontal therapy without systemic antibiotic therapy may not achieve a significant improvement in glycemic control and systemic inflammation in diabetic patients. However, it is important to highlight that the decision of whether or not to use antibiotics to treat periodontitis. Thus this study aimed to evaluate over 3 months the consequence of non-surgical periodontal treatment without systemic antibiotic therapy on serum levels of HbA1c and C-reactive protein (CRP). Forty-two participants with type 2 diabetes mellitus (DM) and moderate periodontal disease were randomized into intervention (IG) and control (CG) groups. The IG received non-surgical periodontal therapy in the form of full-mouth scaling and root planing. Participants were followed up for 3 months. The CG received non-surgical periodontal therapy after 3 months. Clinical parameters, including plaque index (PI), gingival bleeding index (GBI), probing pocket depth (PPD), clinical attachment level (CAL), and HbA1c and CRP levels, of all patients were recorded at baseline and after 3 months. A p-value less than 0.05 considered significant. At the end of 3 months, IG showed improvement in all the clinical parameters compared to CG. There were no significant differences in HbA1c and CRP after 3 months when compared to the baseline level in both groups. Clinical parameters were significantly improved by the employment of non-surgical periodontal treatment without systemic antibiotic therapy, but HbA1C and CRP levels were not significantly affected.


Antibiotics; Diabetes; Non-surgical periodontal treatment; Periodontal Disease


Mirzaei M, Rahmaninan M, Mirzaei M, Nadjarzadeh A. Epidemiology of diabetes mellitus, pre-diabetes, undiagnosed and uncontrolled diabetes in Central Iran: results from Yazd health study. BMC Public Health. 2020; 20(1):166.

Thorstensson H, Hugoson A. Periodontal disease experience in adult long‐duration insulin‐dependent diabetics. J Clin Periodontol. 1993; 20(5):352-8.

Buset SL, Walter C, Friedmann A, Weiger R, Borgnakke WS, Zitzmann NU. Are periodontal diseases really silent? A systematic review of their effect on quality of life. J Clin Periodontol. 2016; 43(4):333-44.

Vaghani H, Mehta R, Desai K, Duseja S, Mehta T. Effect of Non-surgical Periodontal Therapy on Glycosylated Haemoglobin Levels in Diabetics and Non-diabetic Healthy Controls with Periodontitis. Adv Hum Biol. 2016; 6(2):95-98.

Wolff RE, Wolff LF, Michalowicz BS. A Pilot Study of Glycosylated Hemoglobin Levels in Periodontitis Cases and Healthy Controls. J Periodontol. 2009; 80(7):1057-61.

Fritoli A, Gonçalves C, Faveri M, Pérezchaparro PJ, Fermiano D, Feres M. The effect of systemic antibiotics administered during the active phase of non-surgical periodontal therapy or after the healing phase: A systematic review. J Appl Oral Sci. 2015; 23(3):249-54.

Van Winkelhoff AJ, Rams TE, Slots J. Systemic antibiotic therapy in periodontics. Periodontol 2000. 1996; 10(1):45-78.

Koromantzos PA, Makrilakis K, Dereka X, Offenbacher S, Katsilambros N, Vrotsos IA, et al. Effect of Non-Surgical Periodontal Therapy on C-Reactive Protein, Oxidative Stress, and Matrix Metalloproteinase (MMP)-9 and MMP-2 Levels in Patients With Type 2 Diabetes: A Randomized Controlled Study. J Periodontol. 2012; 83(1):3-10.

Aldridge JP, Lester V, Watts TLP, Collins A, Viberti G and Wilson RF. Single-blind studies of the effects of improved periodontal health on metabolic control in type 1 diabetes mellitus. J Clin Periodontol. 1995; 22(4):271-5.

Singh S, Kumar V, Kumar S, Subbappa A. The effect of periodontal therapy on the improvement of glycemic control in patients with type 2 diabetes mellitus: a randomized controlled clinical trial. Int J Diabetes Dev Ctries. 2008; 28(2):38-44.

Obeid PR, D’Hoore W, Bercy P. Comparative clinical responses related to the use of various periodontal instrumentation. J Clin Periodontol. 2004; 31(3):193-9.

Grossi SG, Skrepcinski FB, DeCaro T, Robertson DC, Ho AW, Dunford RG, et al. Treatment of Periodontal Disease in Diabetics Reduces Glycated Hemoglobin. J Periodontol. 1997; 68(8):713-9.

Katagiri S, Nitta H, Nagasawa T, Uchimura I, Izumiyama H, Inagaki K, et al. Multi-center intervention study on glycohemoglobin (HbA1c) and serum, high-sensitivity CRP (hs-CRP) after local anti-infectious periodontal treatment in type 2 diabetic patients with periodontal disease. Diabetes Res Clin Pract. 2009; 83(3):308-15.

Silva MP, Feres M, Oliveira Sirotto TA, Silva Soares GM, Velloso Mendes JA, Faveri M, et al. Clinical and microbiological benefits of metronidazole alone or with amoxicillin as adjuncts in the treatment of chronic periodontitis: A randomized placebo-controlled clinical trial. J Clin Periodontol. 2011; 38(9):828-37.

Miranda TS, Feres M, Perez-Chaparro PJ, Faveri M, Figueiredo LC, Tamashiro NS, et al. Metronidazole and amoxicillin as adjuncts to scaling and root planing for the treatment of type 2 diabetic subjects with periodontitis: 1-year outcomes of a randomized placebo-controlled clinical trial. J Clin Periodontol. 2014; 41(9):890-9.



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