EFFECT OF ORAL AZITHROMYCIN AND METRONIDAZOLE AS AN ADJUNCT TO SCALING AND ROOT PLANING ON GLYCEMIC CONTROL IN TYPE II DIABETIC PATIENTS WITH CHRONIC PERIODONTITIS
DOI:
https://doi.org/10.22159/ajpcr.2017.v10i3.16500Abstract
ABSTRACT
Objective: Periodontitis, a chronic inflammatory disease characterized by destruction of the periodontal ligament and alveolar bone is the sixth
complication of diabetes mellitus. Periodontal treatment that reduces gingival inflammation aids in the control of hyperglycemia. Therefore, the
present study was designed to determine the effect of treating chronic periodontitis with oral antibiotics azithromycin and metronidazole on the level
of serum glycated hemoglobin in type-II diabetic patients.
Methods: This prospective observational study was carried out in the dental department of a tertiary care hospital for 9 months. Clinical and
biochemistry reports of 90 patients were collected in designed case report forms. All statistical analyses were performed using IBM Statistical Package
for Social Sciences 17 and Graph Pad Prism 7.0.
Results: Significant reduction in all the clinical and dental parameters was comparatively higher in patients who received azithromycin than in
patients who received metronidazole and scaling and root planning alone.
Conclusion: Periodontal therapy with oral azithromycin can be employed as a supportive strategy for the management of diabetes mellitus.
Henceforth, prevention and control of periodontal disease along with antibiotics must be considered an integral part of glycemic control. However,
due to the lesser sample size in this study, further investigations are required to confirm the effect of periodontal therapy on systemic diseases.
Keywords: Periodontitis, Azithromycin, Metronidazole, Glycemic control, Diabetes mellitus.
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REFERENCES
Sreeja CN, Mable SJ, Anoop KR. Etiopathogenesis of chronic inflammatory periodontitis. J Pharm Pharm Sci 2012;4:43-9.
Marchetti E, Monaco A, Procaccini L, Mummolo S, Gatto R, Tete S, et al. Periodontal disease: The influence of metabolic syndrome. Nutr Metab (Lond) 2012;9:88.
Loe H. Periodontal disease: The sixth complication of diabetes mellitus. Diabetes Care 1993;16:329-34.
Berezow AB, Darveau RP. Microbial shift and periodontitis. Periodontol 2000 2011;20055(1):36-47.
Kumar PS, Griffen AL, Barton JA, Paster BJ, Moeschberger ML, Leys EJ. New bacterial species associated with chronic periodontitis. J Dent Res 2003;82(5):338-44.
Negrato CA, Tarzia O, Jovanovic L, Chinellato LE. Periodontal disease and diabetes mellitus. J Appl Oral Sci 2013;21(1):1-12.
Shlossman M, Knowler WC, Pettitt DJ, Genco RJ. Type 2 diabetes mellitus and periodontal disease. J Am Dent Assoc 1990;121(4):532-6.
Fernando L, Santiago AH, Raul C. Relationship between diabetes and periodontal infection. World J Diabetes 2015;6:927-35.
Preshaw PM, Alba AL, Herrera D, Jepsen S, Konstantinidis A, Makrilakis K, et al. Periodontitis and diabetes: A two-way relationship. Diabetoloqia 2012;55(1):21-31.
Stanko P, Izakovicova HL. Bidirectional association between diabetes mellitus and inflammatory periodontal disease. A review. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2014;158(1):35-8.
Patil V, Mali R, Mali A. Systemic anti‑microbial agents used in periodontal therapy. J Indian Soc Periodontol 2013;17(2):162-8.
Gladue RP, Bright GM, Isaacson RE, Newborg MF. In vitro and in vivo uptake of azithromycin (CP 62993) by phagocytic cells possible mechanism of delivery and release at sites of infection. Antimicrob Agents Chemother 1989;33(3):277-82.
Girard AE, Girard D, English AR, Gootz TD, Cimochowski CR, Faiella JA, et al. Pharamacokinetic and in vivo studies with azithromycin (CP-62,993), a new macrolide with extended half-life and excellent tissue distribution. Antimicrob Agents Chemother 1987;31(12):1948-54.
Blandizzi C, Malizia T, Lupetti A, Pesce D, Gabriele M, Giuca MR, et al. Periodontal tissue disposition of azithromycin in patients affected by chronic inflammatory periodontal diseases. J Periodontol 1999;70(9):960-6.
Arvind V, Jaiganesh R. Local drug delivery systems in the treatment of periodontitis - An overview. Int J Pharm Pharm Sci 2012;4(1):30-7.
Noyan U, Yilmaz S, Kuru B, Kadir T, Acar O, Buget E. A clinical and microbiological evaluation of systemic and local metronidazole delivery in adult periodontitis patients. J Clin Periodontol 1997;24(3):158-65.
Feier I, Onisei D, Onisei D. The plurivalence of the interpretation of correlation between plaque score and bleeding score. Int J Med Dent 2009;13(1):45-8.
Dodwad V, Ahuja S, Kukreja BJ. Effect of locally delivered tetracycline hydrochloride as an adjunct to scaling and root planing on Hba1c, C-reactive protein, and lipid profile in type 2 diabetes: A clinico-biochemical study. Contemp Clin Dent 2012;3(2):150-4.
Shaddox LM, Walker CB. Treating chronic periodontitis: Current status, challenges, and future directions. Clin Cosmet Investig Dent 2010;2:79-91.
Goodson JM. Antimicrobial strategies for treatment of periodontal diseases. Periodontol 2000 1994;5:142-68.
Dastoor SF, Travan S, Neiva RF, Rayburn LA, Giannobile WV, Wang HL. Effect of adjunctive systemic azithromycin with periodontal surgery in the treatment of chronic periodontitis in smokers: A pilot
Asian J Pharm Clin Res, Vol 10, Issue 3, 2017, 449-453
Dhivya et al.
study. J Periodontol 2007;78(10):1887-96.
Lai PC, Ho W, Jain N, Walters JD. Azithromycin concentrations in blood and gingival crevicular fluid after systemic administration. J Periodontol 2011;82(11):1582-6.
Hanes PJ, Krishna R. Characteristics of inflammation common to both diabetes and periodontitis: Are predictive diagnosis and targeted preventive measures possible? EPMA J 2010;1(1):101-16.
Stewart JE, Wager KA, Friedlander AH, Zadeh HH. The effect of periodontal treatment on glycemic control in patients with type 2 diabetes mellitus. J Clin Periodontol 2001;28(4):306-10.
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