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Journal of Peking University (Health Sciences) ›› 2022, Vol. 54 ›› Issue (1): 48-53. doi: 10.19723/j.issn.1671-167X.2022.01.008

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Comparison of initial periodontal therapy and its correlation with white blood cell level in periodontitis patients with or without diabetes mellitus

XU Xin-ran,HUO Peng-cheng,HE Lu(),MENG Huan-xin,ZHU Yun-xuan,JIN Dong-si-qi   

  1. Department of Periodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2021-10-10 Online:2022-02-18 Published:2022-02-21
  • Contact: Lu HE E-mail:helubj@tom.com

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Abstract:

Objective: To compare the clinical efficacy of initial periodontal therapy in periodontitis patients with or without type 2 diabetes mellitus and its correlation with white blood cell counts. Methods: In this study, 32 chronic periodontitis patients without systemic disease (CP group) and 27 chronic periodontitis patients with type 2 diabetes mellitus (CP+DM group) were enrolled. At admission, all the patients went through periodontal examination and fasting blood examination(baseline). Probing depth (PD), attachment loss (AL), bleeding index (BI), plaque index (PLI), white blood cells (WBC) counts and fasting blood glucose (FBG) were recorded respectively, while hemoglobin A1c (HbA1c) was recorded only in CP+DM group. After that, initial periodontal therapy was performed. All the tests were repeated 3 and 6 months after treatment. The changes of periodontal clinical indexes and WBC levels were compared between the two groups before and after treatment, and the correlation between WBC and periodontal clinical indexes and glucose metabolism indexes were analyzed by generalized linear mixed model. Results: At baseline, the periodontal inflammation and destruction were similar in CP and CP+DM group, but the WBC level was significantly higher in CP+DM groups [(6.01±1.26)×109/L vs. (7.14±1.99)×10 9/L, P=0.01]. After 3 and 6 months of initial periodontal therapy, the mean PD, AL, BI, and PLI in CP+DM and CP groups were significantly lower than the baseline, and the PD in CP+DM group was further decreased by 6 months compared with 3 months [(3.33±0.62) mm vs. (3.61±0.60) mm, P<0.05]. However, none of these periodontal indexes showed significant difference between the two groups by 3 or 6 months. In CP+DM group, HbA1c at 3 months and 6 months were significantly lower than the baseline [(7.09±0.79)% vs. (7.64±1.16)%, P<0.05; (7.06±0.78)% vs. (7.64±1.16)%, P<0.05], and FBG was significantly lower than the baseline by 6 months [(7.35±1.14) mmol/L vs. (8.40±1.43) mmol/L, P<0.05]. The WBC level in CP group was significantly lower than the baseline level by 3 months [(5.35±1.37)×10 9/L vs. (6.01±1.26)×10 9/L, P<0.05], while that in CP+DM group was significantly lower than the baseline level by 6 months [(6.00±1.37)×10 9/L vs. (7.14±1.99)×10 9/L, P<0.05]. The analysis of genera-lized linear mixed model showed that WBC level was significantly positively correlated with PD and FBG (P<0.05). Conclusion: Initial periodontal therapy can effectively improve the periodontal clinical status of patients with or without type 2 diabetes mellitus, and have benefits on glycemic control in diabetic patients. However, the response of periodontal indexes and WBC level to initial therapy were relatively delayed in diabetic patients. WBC plays an important role in the correlation between diabetes mellitus and periodontitis.

Key words: Periodontitis, Diabetes mellitus, type 2, Dental scaling, Periodontal index

CLC Number: 

  • R781.4

Table 1

General characteristic and clinical indexes at baseline of patients in CP and CP+DM groups"

Items CP group
(n=32)		 CP+DM group
(n=27)		 P
Age/years 47.16±5.35 54.22±7.87 <0.001
Male 13 (40.6) 18 (66.7) 0.046
BMI/(kg/m2) 23.48±2.11 24.25±2.26 0.182
WHR 0.88±0.06 0.88±0.03 0.614
PD/mm 4.68±0.59 4.63±0.95 0.821
AL/mm 4.43±1.20 4.56±0.99 0.669
BI 3.20±0.63 2.90±0.73 0.089
PLI 2.97±0.12 2.85±0.21 0.009
WBC/(×109/L) 6.01±1.26 7.14±1.99 0.010
FBG/(mmol/L) 5.20±0.35 8.40±1.43 <0.001
HbA1c/% - 7.64±1.16

Table 2

Influence of initial periodontal therapy on periodontal indexes, glycemic parameters and WBC levels"

Items Baseline 3 months 6 months Δ3 months Δ6 months
PD/mm
CP group 4.68±0.59 3.62±0.64* 3.47±0.57* 1.07±0.63 1.20±0.68
CP+DM group 4.63±0.95 3.61±0.60* 3.33±0.62*§ 1.02±0.86 1.30±0.84
AL/mm
CP group 4.43±1.20 3.87±1.07* 3.58±0.81*§ 0.56±0.66 0.85±0.66
CP+DM group 4.56±0.99 3.79±0.83* 3.76±0.86* 0.77±0.85 0.80±0.62
BI
CP group 3.20±0.63 2.09±0.61* 2.03±0.55* 1.12±0.82 1.18±0.82
CP+DM group 2.90±0.73 1.97±0.56* 1.84±0.42* 0.93±0.85 1.06±0.68
PLI
CP group 3.00±0.22 2.59±0.57* 1.85±0.75*§ 0.41±0.52 1.15±0.73
CP+DM group 2.85±0.21# 2.42±0.58* 2.03±0.65*§ 0.43±0.52 0.81±0.65
WBC/(×109/L)
CP group 6.01±1.26 5.35±1.37* 5.51±1.51 0.66±1.11 0.50±1.18
CP+DM group 7.14±1.99# 6.57±1.68 6.00±1.37* 0.57±2.20 1.14±1.80
FBG/(mmol/L)
CP group 5.20±0.35 5.20±0.32 5.33±0.42 0.00±0.31 -0.13±0.47
CP+DM group 8.40±1.43# 7.72±1.40# 7.35±1.14*# 0.68±1.52# 1.05±1.59#
HbA1c/%
CP group - - - - -
CP+DM group 7.64±1.16 7.09±0.79* 7.06±0.78* 0.55±0.78 0.58±0.83

Table 3

GLMM analysis of WBC with clinical periodontal parameters and FBG"

Parameter β SE t/Z P 95%CI
Model 1
Intercept 3.19 0.77 4.12 <0.001 1.66 to 4.71
PD 0.57 0.22 2.56 0.011 0.13 to 1.00
FBG 0.28 0.09 3.25 0.001 0.11 to 0.45
Model 2
Intercept 3.37 0.99 3.39 0.001 1.41 to 5.33
PD 0.55 0.22 2.48 0.014 0.11 to 0.99
FBG 0.27 0.09 2.98 0.003 0.09 to 0.44
Model 3
Intercept 4.10 2.34 1.75 0.082 -0.52 to 8.72
PD 0.53 0.22 2.36 0.019 0.09 to 0.96
FBG 0.29 0.09 3.33 0.001 0.12 to 0.46
Model 4
Intercept 4.73 2.47 1.91 0.058 -0.16 to 9.61
PD 0.45 0.23 1.98 0.050 0.001 to 0.90
FBG 0.26 0.09 2.94 0.004 0.09 to 0.44
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