The Short-Term Effectiveness of Non-Surgical Treatment in Reducing Levels of Interleukin-1 beta and Proteases in Gingival Crevicular Fluid From Patients With Type 2 Diabetes Mellitus and Chronic Periodontitis

Background: This study aimed to compare the effectiveness of nonsurgical periodontal treatment in improving periodontal status and reducing gingival crevicular fluid (GCF) levels of interleukin (IL)-1 beta and IL-18, elastase activity, and matrix metalloproteinase (MMP)-8 and -9 in periodontitis patients with and without type 2 diabetes mellitus (T2DM).Methods: Twenty-three patients with T2DM (diabetes group) and 26 systemically healthy subjects (control group) with chronic periodontitis participated in this study. The clinical examination included visible plaque index, gingival bleeding index, probing depth, clinical attachment level, and bleeding on probing. GCF samples were collected from five or six deep sites to evaluate the levels of IL-1 beta and -18, elastase, and MMP-8 and -9. Shallow sites were analyzed for IL-1 beta and elastase. The glycemic control was analyzed by the concentration of glycated hemoglobin (HbA1c). The subjects received non-surgical periodontal treatment and were reexamined 90 days later.Results: All clinical parameters showed a significant improvement after treatment, which was accompanied by a significant reduction in IL-1 beta, elastase activity, and MMP-8 and -9 levels in deep sites. The shallow sites also showed significant reductions in IL-1 beta and elastase activity levels. Treatment did not significantly reduce HbA1c concentrations in patients with T2DM.Conclusions: Non-surgical periodontal treatment was effective in reducing the levels of IL-1 beta, elastase activity, and MMP-8 and -9 in GCF from diabetes and control groups. Patients with T2DM showed less reduction only in elastase activity in shallow sites compared to controls. This reduction was associated with improvement of the clinical periodontal status. J Periodontol 2008;79:2143-2150.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP