Evaluation the long term effects on periodontal healing, serum C-reactive protein and HbA1c levels of diode laser applications in periodontal treatment of chronic periodontitis patients with poor control Diabetes mellitus

Aim: The purpose of this study was to compare the effects of nonsurgical periodontal treatment with and without diode laser (DL) applications on periodontal healing, systemic inflammatuar response and serum hemoglobin A1c (HbA1c) level in chronic periodontitis (CP) patients with type 2 diabetes mellitus (DM). Material and Methods: The study was performed randomized, single-blinded, parallel, controlled clinical trial for 6 months. The patients were recruited from the patient pool of the Faculity of Dentistry and Turgut Ozal Medical Center at the University of Inonu. The subject population was consisted of 40 (18 male/ 22 female) patients with CP and type 2 DM. Thrity-seven patients completed the study. In this study, patients were divided into two groups: Study group (n=18) was treated 1.0 W DL adjunctive to conventional periodontal therapy; and Control group (n=19) was treated with plasebo DL and only conventional periodontal therapy. Clinical examinations and gingival crevicular fluid (GCF) samples were performed before scaling&root planning (the baseline) as well as 3 month and 6 months after treatment. Also, HbA1c and C-reactive protein levels (CRP) were examined in blood samples. To determine the periodontal status, plaque index (PI), gingival index (GI), bleeding on probing (BoP), clinical attachment level (CAL) and probing depth (PD) were measured. All GCF samples were investigated in the laboratory of Biochemistry Department of Medicine Faculty in InonuUniversity to detect matrix metalloproteinase-8 (MMP-8) levels by using Enzyme Linked-Immuno-Sorbent Assay method. Results: In both groups, all clinical and laboratory parameters were seen significantly improvement in after treatment 3 and 6 months according to baseline (p<0.05). The recovery for PD, GI, BoP and GCF volume in the laser group was higher than in the control group (p<0.05). Although levels of CRP and HbA1c in serum and MMP-8 in GCF were lower after treatment in the laser group than the control group, there was not a statistically significant difference (p > 0.05). Conclusion: Within the limits of this study; we suggest that DL administration is an alternative treatment in reducing local inflammation and periodontal healing improvement when applied adjunctive to scaling&root planning in subjects with DM and CP. Additionally, DL administration may be considered to be more beneficial effects on the systemic imflammatuar response and glisemic control in the long term. However, more researches need in order to better understand the effects of diode laser application to periodontal treatment of subjects with DM. Key Words: chronic periodontitis, diode laser, hemoglobin A1c, matriks metalloproteinaz – 8, non-surgical periodontal therapy, type 2 diabetes mellitus.