Tip 2 diyabetli hastalarda cerrahisiz periodontal tedaviye ek olarak yapılan diyod lazer dekontaminasyon uygulamasının periodontal parametreler üzerine etkisi
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Dosyalar
Tarih
2014
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Yayıncı
Selçuk Üniversitesi Sağlık Bilimleri Enstitüsü
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Bu çalışma tip 2 Diabetes Mellitus'u olan kronik periodontitis hastalarında, cerrahisiz periodontal tedaviye ileve olarak diyod lazerin, klinik periodontal parametreler, dişeti oluğu sıvısı interlökin (IL)-1β, IL-6, IL-8, ICAM and VCAM, salya IL-1β ve metabolik kontrol (HbA1c) üzerine etkisinin incelenmesi amaçlandı. Gereç ve Yöntem: Otuzu iyi kontrollü (Glikolize Hemoglobin 5.7% ≤ [HbA1c] ≤6.7 %) ve 30'u kötü kontrollü (6.8% ≤ [HbA1c] ≤8 %) tip 2 diyabetik kronik periodontitis hastası değerlendirildi. İyi kontrollü (İK) ve kötü kontrollü (KK) tip 2 diyabetik kronik periodontitis hastası bireyler kendi içerisinde 15'er kişilik rastgele 2 gruba ayrıldı. Klinik periodontal parametreler, DOS ve salya örneklemesi başlangıçta ve tedaviden sonra 1. ve 3. ayda yapıldı. HbA1c seviyelerini değerlendirmek amacı ile başlangıçta ve tedaviden sonra 3. ayda kan örnekleri alındı. Dişeti oluğu sıvısı IL-1β, IL-6, IL-8, ICAM, VCAM total miktarları ve salya IL-1β seviyeleri ELISA ile değerlendirildi. Bulgular: Tüm tedavi gruplarında tedavi sonrasında klinik ve biyokimyasal parametrelerde olumlu sonuçlar elde edildi. Cerrahisiz periodontal tedaviye lazer ilave edilen gruplarda, yalnızca cerrahisiz periodontal tedaviye göre cep derinliği ve klinik ataçman seviyelerinde daha fazla azalma elde edildi (p<0,05). Aynı zamanda lazerin ilave edildiği gruplarda, lazer uygulanmayan gruplara göre DOS IL-1β, IL-6, ICAM ve VCAM total miktarlarında lazer lehine anlamlı azalma izlendi (p<0,05). Tedavi sonrasında IL-8 seviyeleri başlangıca göre 1. ayda anlamlı şekilde azalmasına rağmen (p<0,05), 3. ayda 1. aya göre artış görüldü (p<0,05). HbA1c seviyelerinde tüm gruplarda başlangıca göre 3. ayda anlamlı azalma görüldü (p<0,05). Kötü kontrollü diyabeti olan grupta cerrahisiz periodontal tedaviye ilave olarak lazer uygulanan grupta, uygulanmayan gruba göre istatistiksel olarak anlamlı şekilde azalma görüldü (p<0,05). Biyokimyasal parametreler ve klinik parametreler arasında anlamlı korelasyon bulundu (p<0,05) Tartışma: İyi kontrollü ve kötü kontrollü tip 2 diyabeti olan kronik periodontitis hastalarında, cerrahisiz periodontal tedavinin, klinik, biyokimyasal parametrelere ve diyabetin metabolik kontrolüne ilave etkileri görüldü. Diyod lazerin ilave kullanımı ile cep derinliği ve klinik ataçman seviyelerinde anlamlı azalma gözlendi. Cerrahisiz periodontal tedaviye ilave lazer kullanımının diyabetin metabolik kontrolüne ilave etkileri olabileceği düşünülmektedir. Bu bulguyu desteklemek için iyi tasarlanmış randomize klinik çalışmalara ihtiyaç bulunmaktadır..
This study was designed to explore the effect of diode laser (DL) as an adjunct to nonsurgical treatment on clinical parameters, the levels of interleukin (IL)-1β, IL-6, IL-8, ICAM and VCAM in gingival crevicular fluid (GCF), IL-1β in saliva and metabolic control (HbA1c) in chronic periodontitis patients with type 2 diabetes mellitus (DM2). Material and Methods: Thirty well-controlled (glycated hemoglobin 5.7% ≤ [HbA1c] ≤ 6.7%) and 30 poorly controlled (6.8% ≤ [HbA1c] ≤ 8%) patients with DM2 and chronic periodontitis (CP) were enrolled.Well-controlled (W-DM) and poorly controlled (P-DM) patients with CP were randomly assigned in two groups to receive SRP alone (SRP, n=15) or SRP followed by diode laser application (SRP+DL, n=15).Clinical periodontal parameters, saliva and GCF sampling were assessed at baseline, 1 and 3 months after periodontal treatment. Blood samples were taken to evaluate HbA1c levels at baseline and 3 months post-therapy. Total amounts of IL-1β, IL-6, IL-8, ICAM and VCAM in the GCF and IL-1β in saliva were analysed by enzyme-linked immunosorbent assay (ELISA). Results: W-DM and P-DM subjects responded well after therapy,showing significant improvements in clinical and biochemical parameters. SRP+DL group provided better reductions in PD and CAL parameters compared to SRP group (P<0.05). Significant reductions were also found in the total amounts of GCF levels of IL-1, IL-6, ICAM and VCAM after treatment (P<0.05). Although,the IL-8 levels were significantly reduced at first month after treatment compared with baseline (P<0.05), it increased at 3 months after treatment compared with first month (P<0.05). HbA1c levels decreased significantly at 3 months after treatment in both P-DM and W-DM patients (P<0.05). SRP+DL group significantly reduced HbA1c levels compared to SRP group in P-DM patients (P<0.05). There were significant correlations between clinical and biochemical parameters (P<0.05). Conclusions: Non-surgical periodontal treatment appeared to improve clinical, biochemical parameters and glycemic control in both P-DM and W-DM patients with CP. The adjunctive use of diode laser significantly improved the clinical PD and CAL parameters. The combined use of DL and SRP may be beneficial in improving glycemic control for P-DM patients with CP in clinic routine. Additional well-designed randomized clinical trials are needed to confirm this finding.
This study was designed to explore the effect of diode laser (DL) as an adjunct to nonsurgical treatment on clinical parameters, the levels of interleukin (IL)-1β, IL-6, IL-8, ICAM and VCAM in gingival crevicular fluid (GCF), IL-1β in saliva and metabolic control (HbA1c) in chronic periodontitis patients with type 2 diabetes mellitus (DM2). Material and Methods: Thirty well-controlled (glycated hemoglobin 5.7% ≤ [HbA1c] ≤ 6.7%) and 30 poorly controlled (6.8% ≤ [HbA1c] ≤ 8%) patients with DM2 and chronic periodontitis (CP) were enrolled.Well-controlled (W-DM) and poorly controlled (P-DM) patients with CP were randomly assigned in two groups to receive SRP alone (SRP, n=15) or SRP followed by diode laser application (SRP+DL, n=15).Clinical periodontal parameters, saliva and GCF sampling were assessed at baseline, 1 and 3 months after periodontal treatment. Blood samples were taken to evaluate HbA1c levels at baseline and 3 months post-therapy. Total amounts of IL-1β, IL-6, IL-8, ICAM and VCAM in the GCF and IL-1β in saliva were analysed by enzyme-linked immunosorbent assay (ELISA). Results: W-DM and P-DM subjects responded well after therapy,showing significant improvements in clinical and biochemical parameters. SRP+DL group provided better reductions in PD and CAL parameters compared to SRP group (P<0.05). Significant reductions were also found in the total amounts of GCF levels of IL-1, IL-6, ICAM and VCAM after treatment (P<0.05). Although,the IL-8 levels were significantly reduced at first month after treatment compared with baseline (P<0.05), it increased at 3 months after treatment compared with first month (P<0.05). HbA1c levels decreased significantly at 3 months after treatment in both P-DM and W-DM patients (P<0.05). SRP+DL group significantly reduced HbA1c levels compared to SRP group in P-DM patients (P<0.05). There were significant correlations between clinical and biochemical parameters (P<0.05). Conclusions: Non-surgical periodontal treatment appeared to improve clinical, biochemical parameters and glycemic control in both P-DM and W-DM patients with CP. The adjunctive use of diode laser significantly improved the clinical PD and CAL parameters. The combined use of DL and SRP may be beneficial in improving glycemic control for P-DM patients with CP in clinic routine. Additional well-designed randomized clinical trials are needed to confirm this finding.
Açıklama
Anahtar Kelimeler
Diabetes mellitus-tip 2, Diabetes mellitus-type 2, Diyod lazer, Diode laser, Hemoglobin A-glikolize, Hemoglobin A-glycosylated, Lazer tedavisi, Laser therapy, Periodontal hastalıklar, Periodontal diseases
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Künye
Koçak, E. (2014). Tip 2 diyabetli hastalarda cerrahisiz periodontal tedaviye ek olarak yapılan diyod lazer dekontaminasyon uygulamasının periodontal parametreler üzerine etkisi. Selçuk Üniversitesi, Yayımlanmış doktora tezi, Konya.
