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Abstract：
Background Periodontitis, a chronic inflammatory disease, is triggered by the plaque biofilm culminating in periodontal attachment loss, bone loss, and tooth loss. Diabetes, a globally prevalent disease, causes an increased inflammatory response to the microflora associated with periodontitis. It has been observed that the link between these two diseases is bidirectional. Tissue repair is impaired in diabetic patients with periodontitis. Local drug delivery systems selectively target the inflamed sites contrary to systemic antibiotics which lead to resistance and many other adverse effects. Probiotics aid in the growth of beneficial microorganisms and have immunomodulatory effects on the host. Tetracyclines have anti-collagenase properties and reduce the bacterial load, curbing the progression of periodontitis. Interleukin (IL) 1β, a strong marker of periodontal tissue destruction, plays a pivotal role in inflammation, immune regulation, and bone resorption in periodontitis. This study evaluated and compared the benefits of probiotics and tetracycline fibers when used as adjunctive tools after scaling and root planing (SRP) on IL1β levels in type 2 diabetic patients with periodontitis. Methodology A total of 36 patients participated in this study. Group I included 12 patients with periodontitis and uncontrolled diabetes (HbA1c levels >7). After SRP, six patients received tetracycline fibers (IA), and six patients received probiotics (1B) as locally delivered agents. Group II included 12 patients with periodontitis and diabetes under control (HbA1c levels 6-7%). After SRP, six patients received tetracycline fibers (IIA), and six patients received probiotics (IIB) as locally delivered drugs (test groups). Group III, the control group, included 12 patients with periodontitis only, wherein a placebo was used as a local drug delivery (LDD) after SRP. The clinical parameters, such as plaque index, gingival index, and probing pocket depth, were recorded preoperatively and at eight and 12 weeks after non-surgical periodontal therapy. IL1β levels were assessed by enzyme-linked immunosorbent assay at baseline and six weeks after SRP. Results On intra and intergroup comparison, all groups showed improvement in both the clinical and biochemical parameters but significant results were seen in Group IIA (p < 0.01) when compared to the other groups. Conclusions Group II (well-controlled diabetics) performed significantly better than the other groups, which was followed by Group III. The use of LDDs as adjunctive tools after SRP was not beneficial in Group I (uncontrolled diabetics).
摘要：
背景牙周炎，慢性炎症性疾病,是由菌斑生物膜引发的，最终导致牙周附着丧失，骨丢失,牙齿脱落。糖尿病,一种全球流行的疾病，引起与牙周炎相关的微生物区系的炎症反应增加。已经观察到这两种疾病之间的联系是双向的。糖尿病牙周炎患者的组织修复受损。与导致耐药性和许多其他副作用的全身性抗生素相反，局部药物递送系统选择性地靶向发炎部位。益生菌有助于有益微生物的生长并对宿主具有免疫调节作用。四环素具有抗胶原酶的特性，并减少细菌负荷，抑制牙周炎的进展。白细胞介素（IL）1β，牙周组织破坏的强烈标志，在炎症中起着关键作用，免疫调节，和牙周炎中的骨吸收。这项研究评估并比较了益生菌和四环素纤维在2型糖尿病牙周炎患者的IL1β水平上的洁齿和根面平整（SRP）后作为辅助工具的益处。方法共36例患者参与本研究。第一组包括12例牙周炎和未控制的糖尿病患者（HbA1c水平>7）。SRP之后,六名患者接受四环素纤维（IA），6例患者接受了益生菌(1B)作为局部给药药物.II组包括12例牙周炎和糖尿病患者（HbA1c水平6-7％）。SRP之后,六名患者接受四环素纤维（IIA），6例患者接受益生菌(IIB)作为局部给药(试验组).第三组,对照组,仅包括12例牙周炎患者，其中安慰剂用作SRP后的局部药物递送(LDD)。临床参数，如菌斑指数，牙龈指数,探测口袋深度，在术前以及非手术牙周治疗后8周和12周进行记录。在基线和SRP后六周通过酶联免疫吸附测定评估IL1β水平。结果组内和组间比较，所有组的临床和生化指标均有改善，但与其他组相比，IIA组的结果显着（p<0.01）。结论II组（糖尿病控制良好）的表现明显优于其他组，其次是第三组。SRP后使用LDDs作为辅助工具对I组（不受控制的糖尿病患者）没有好处。
