Total antioxidant/oxidant status in chronic periodontitis patients with type II diabetes following nonsurgical periodontal therapy

Background: Diabetes and periodontitis are chronic inflammatory diseases characterized by a dysregulated inflammatory response involving oxidative stress (OS). Nonsurgical periodontal therapy (NSPT) eliminates bacterial load followed by reduction in inflammatory burden due to reduced levels of proinflammatory mediators.

Aim: The study aimed to evaluate the effect of NSPT on the OS biomarkers in the gingival crevicular fluid (GCF) of generalized chronic periodontitis (GCP) patients with Type II diabetes mellitus (DM).

Materials and Methods: Eighty participants were allotted into Group I, systemically healthy with GCP (n = 20); Group II, GCP with Type II DM (n = 20); Group III, Type II DM without chronic periodontitis (CP) (n = 20); and Group IV, periodontally and systemically healthy controls (n = 20). Plaque index, gingival index (GI), probing pocket depth (PPD), and clinical attachment loss (CAL) were recorded. GCF was evaluated for total antioxidant capacity (TAOC), total oxidant status (TOS), and OS index (OSI). Patients in group I and II received NSPT.

Results: Groups I, II, and III at baseline demonstrated significantly lower GCF TAOC and higher TOS and OSI when compared to Group IV (P < 0.001). GI in Group I at baseline negatively correlated with TAOC, whereas PPD and OSI were positively correlated (P < 0.05). Following NSPT, significant improvements were observed in the clinical parameters and in the TAOC levels in both group I and II patients (P < 0.001). In diabetics with GCP following NSPT, it was observed that OSI positively correlated (r = 0.46, P < 0.05) with CAL. In group I and II patients, TOS and OSI reduced significantly from baseline (P < 0.001).

Conclusions: Based on the study results, we infer that NSPT can positively modulate the levels of OS biomarkers by restoring the oxidative imbalance. Further, the study underscores the role of periodontal therapy in decreasing oxidative burden in diabetics with periodontal disease.