A Compelling Comparative Assessment of the Effectiveness of Non-Surgical Versus Surgical Periodontal Therapy in Patients with Both Controlled and Uncontrolled Type II Diabetes Mellitus, Highlighting the Significance of Tailored Treatment Approaches for Op

Abstract

Abstract

Aim: This study aims to compare the effectiveness of non-surgical versus surgical periodontal therapy in patients with both controlled and uncontrolled type II diabetes mellitus, highlighting the significance of tailored treatment approaches for optimal oral health outcomes.

Materials and Methods: This study investigated 60 patients with type II diabetes motivated to improve their periodontal health. Of these, 40 patients sought treatment for both diabetes management and periodontal therapy, with strict criteria for inclusion and exclusion. Informed consent was obtained, with detailed information provided on the study's aims and risks. Participants were divided into two groups based on glycaemic control: Group 1 had uncontrolled diabetes (HbA1c above recommended levels), and Group 2 had well-controlled diabetes (HbA1c within target range). Both groups received various periodontal therapies, including nonsurgical interventions like scaling and root planning, and surgical options such as flap surgery. Effectiveness was assessed through clinical evaluations and laboratory measurements of HbA1c and blood glucose levels, aiming to compare the outcomes of nonsurgical versus surgical therapy and highlight personalised treatment strategies for improved oral health.

Statistical Analysis and Results: This study analyzed 40 patients with periodontal disease and type II diabetes to assess the impact of diabetes control on treatment outcomes. The participants consisted of 16 males and 24 females and were divided into two groups: Group 1 included 20 individuals with uncontrolled diabetes (high HbA1c), while Group 2 had 20 with well-controlled diabetes (HbA1c within target range). All patients underwent nonsurgical treatments (scaling and root planing) and some received surgical therapies. In Group 1, nonsurgical treatment showed minimal improvement, with three patients exhibiting changes, averaging HbA1c of 6.4% and fasting blood glucose at 152 mg/dL. Surgical patients in this group also showed no significant clinical changes. Conversely, in Group 2, nonsurgical therapy had more positive lab results with 13 patients showing no significant clinical change but averaging HbA1c of 5.6% and fasting blood glucose of 116 mg/dL. Surgical outcomes in this group showed similar findings with 11 individuals not improving but maintaining average lab values of HbA1c at 5.8% and fasting glucose at 119 mg/dL. A one-way ANOVA analysis provided further insights into the effectiveness of diabetes management on periodontal treatments.

Conclusion: This study found that non-surgical therapy greatly benefits individuals with uncontrolled diabetes by improving oral health and glycemic control, as indicated by reduced HbA1c levels and periodontal inflammation. Effectiveness depends on diabetes severity. While standard treatments are effective, adjunctive therapies like antimicrobials and photodynamic therapy may offer additional benefits, although evidence for these is still emerging.