Evaluation of mechanical-chemical gingival therapy of diabetic, obese or obese diabetic subjects: quantitative and qualitative analysis of local and systemic aspects.

Abstract

The present study hypothesized that some systemic conditions such as, diabetes and obesity, could affect negatively the response to gingival treatment. Aims: this interventional study will evaluate if diabetes, obesity or its association interfere in the host response to mechanical-chemical treatment of gingivitis. Also, to evaluate the relation between oral health and either quality of life or daily performance of systemically compromised subjects. Methods: 240 gingivitis subjects will be selected and divided in 4 groups: diabetes (n=60), obesity (n=60), diabetes+obesity (n=60) and control (systemically healthy, n=60), in addition to a negative control group (systemic and gingival health, n=60). All groups will receive professional prophylaxis (ultrasonic and/or rubber cup and prophylaxis paste, according to their gingival status) and oral hygiene instructions. Subsequently, subjects from each group will be randomly allocated in test (Listerine total care; n=30) or placebo (n=30). The parameters that will be measured at baseline and 90 days are: clinical - plaque índex, gingival índex and probing depth; microbiological: quantification (qPCR) of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tanerella forsythia, Treponema denticola, and Streptococcus oralis in gingival samples; imune: volume and composition of gingival crevicular fluid (ELISA detection of cytokines); salivary: flow and composition (total protein level); halitosis: organoleptic analysis and halitometry; questionnaires focusing on relation between oral status and quality of life (OHQOL - Oral Health and Quality of Life questionnaire) and daily performances (OIDP - Oral Impacts on Daily Performances questionnaire). Intra-group (baseline vs. 90 days) and inter-groups (at each experimental time) comparisons will be performed using the software Bio Estat 5.0 and SPSS 14.0. Expected results: to determine the efficacy of the mechanical-chemical therapy in subjects diagnosed with diabetes, obesity or diabetes + obesity. Also, to determine if these systemic conditions influence the response to periodontal treatment. Finally, it could be analyzed if these systemic conditions as well as the proposed therapy influence the self-detected quality of life and volunteers' daily performance. (AU)