A comparative evaluation of the effectiveness of scaling and root planing alone or with the adjunct therapy of laser curettage in chronic periodontitis patients diagnosed with type-2 diabetes mellitus

Periodontitis and diabetes mellitus have complex and unique bidirectional associations. The two-way relationship between the two chronic diseases is an intersection between environmental, microbiologic, genetic, and immunologic factors. Although periodontitis was understood as the sixth complication of diabetes mellitus, currently the two diseases are considered as “comorbid old friends.†in the same light, periodontal treatment reduces serum levels of inflammatory markers. A meta-analysis of clinical trials that investigated the effect of periodontal treatment on HbA1c levels found an HbA1c decrease of 0.29% at 3 months after periodontal treatment (Simpson et al. 2015). In parallel to HbA1c improvements, reductions in local periodontal inflammation, pocket depths, and low-grade systemic inflammation were observed. Non -surgical periodontal treatment resulted in a better glycemic status of type 2 diabetes patients and demonstrated the importance of oral health in their general health. Another meta-analysis indicated a mean treatment effect of -0.36% HbA1c (CI -0.54, -0.19) compared to no treatment after periodontal therapy (p < 0.0001) (Engrebetson, Kocher 2015). Diode Laser therapy benefits the periodontium directly by eliminating the pathogens and disinfecting the pockets and indirectly by reducing the hyper inflammatory status and improves the collagen formation and thus, healing will be accelerated of Diabetes Mellitus patients. DL treatment can provide improved clinical results when it is used as an adjunct to nonsurgical periodontal treatment in Chronic periodontitis patients with Diabetes Mellitus.