Recent reports show that hemoglobin A1c (HbA1c) can be lowered by improving chronic inflammation in periodontal patients with diabetes mellitus and that full-mouth scaling and root planing (FM-SRP), in combination with azithromycin (AZM) treatment, can reduce early periodontal inflammation. However, the association of FM-SRP and AZM with periodontitis and HbA1c in patients with diabetes is largely unknown. This study investigated periodontitis and HbA1c in patients with diabetes after receiving FM-SRP and AZM to evaluate which clinical parameters most reflect the diabetic condition. Fifty-one periodontal patients with diabetes mellitus were included in this study. In total, 25 patients were assigned to the FM-SRP group in which patients were treated with FM-SRP in combination with AZM, and 26 patients were assigned to the control group in which only supragingival calculus removal was performed along with the provision of oral hygiene instructions. We evaluated periodontal parameters (probing pocket depth, periodontal inflamed surface area (PISA), bleeding on probing), and periodontal bacteria and biochemical parameters (HbA1c, high-sensitive C-reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and monocyte chemoattractant protein-1 (MCP-1)) at baseline (BL) and 1, 3, 6, and 9 months after treatment. Compared with BL values, the FM-SRP group showed improved clinical parameters, reduced periodontal pathogens, and significantly lower HbA1c. Inflammatory cytokines (hs-CRP, TNF-α, IL-6) were significantly reduced one month after treatment and remained low thereafter. MCP-1 did not change significantly during the experimental period. PISA showed a strong correlation with HbA1c, hs-CRP, and TNF-α. FM-SRP, in combination with AZM, produced clinical, microbiological, and HbA1c improvements in periodontal patients with previously diagnosed diabetes mellitus. Additionally, PISA was shown to be a useful index for assessing the diabetic status of patients with periodontal disease.

中文翻译：

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阿奇霉素一期全口洁治和牙根平整对糖尿病和牙周病的影响：一项随机对照试验

最近的报告表明，通过改善糖尿病牙周患者的慢性炎症，可以降低血红蛋白 A1c (HbA1c)，并且全口洁治和根面平整 (FM-SRP) 与阿奇霉素 (AZM) 治疗相结合，可以减少早期牙周炎。然而，在糖尿病患者中，FM-SRP 和 AZM 与牙周炎和 HbA1c 的关联在很大程度上是未知的。本研究调查了糖尿病患者接受 FM-SRP 和 AZM 后的牙周炎和 HbA1c，以评估哪些临床参数最能反映糖尿病状况。本研究纳入了 51 名患有糖尿病的牙周病患者。共有 25 名患者被分配到 FM-SRP 组，其中患者接受 FM-SRP 联合 AZM 治疗，26 名患者被分配到对照组，其中仅进行龈上牙石去除并提供口腔卫生指导。我们评估了牙周参数（探诊袋深度、牙周发炎表面积（PISA）、探诊出血）以及牙周细菌和生化参数（HbA1c、高敏 C 反应蛋白（hs-CRP）、肿瘤坏死因子-α（ TNF-α)、白细胞介素 6 (IL-6) 和单核细胞趋化蛋白 1 (MCP-1)) 在基线 (BL) 和治疗后 1、3、6 和 9 个月。与 BL 值相比，FM-SRP 组的临床参数有所改善，牙周病原体减少，HbA1c 显着降低。炎性细胞因子（hs-CRP、TNF-α、IL-6）在治疗一个月后显着降低，此后仍保持在较低水平。MCP-1 在实验期间没有显着变化。PISA 与 HbA1c、hs-CRP 和 TNF-α 有很强的相关性。FM-SRP 与 AZM 相结合，在先前诊断为糖尿病的牙周患者中产生了临床、微生物学和 HbA1c 改善。此外，PISA 被证明是评估牙周病患者糖尿病状况的有用指标。