Surgical and non‐surgical therapy with systemic antimicrobials for residual pockets in type 2 diabetics with chronic periodontitis: a pilot study

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Abstract
Aim: This study evaluated the effects of surgical (SD) and non-surgical (NSD) debridements, associated with systemic antimicrobials, on clinical and immunological outcomes of residual pockets [ RP; probing depth (PD) >= 5 mm with bleeding on probing] in type 2 diabetics. Material and Methods: A split-mouth, randomized controlled trial was conducted in 21 subjects presenting at least two RP per contralateral quadrant. Subjects received metronidazole plus amoxicillin for 10 days and, contralateral quadrants were assigned to receive SD or NSD. Clinical parameters and local levels of interferon- c, interleukin (IL)-17, IL-23 and IL-4 were assessed at baseline, 3 and 6 months post-therapies. Results: Overall, the mean number, PD and clinical attachment level (CAL) of RP improved significantly after therapies (p < 0.05), without differences between groups at any time-point (p > 0.05). At quadrant level, only SD produced significant reductions in the mean CAL. Also, SD promoted higher reduction in PD from baseline to 6 months than NSD (p < 0.05). Levels of all cytokines were increased after SD compared with NSD (p < 0.05). Conclusion: SD and NSD associated with systemic antimicrobials did not differ in terms of clinical benefits for RP in diabetics up to 6 months post-therapies. RP treated by SD presented increased levels of cytokines.

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