Periodontal treatment needs in diabetic and non-diabetic individuals: A case-control study.

Aim: Diabetes mellitus is a chronic metabolic disorder of the carbohydrate, protein and fat metabolism, resulting in increased blood glucose levels. Various complications of diabetes have been described with periodontitis being added as the sixth complication of diabetes mellitus. The aim of this study was to assess periodontal status and treatment needs (TN) in diabetic patients and to compare the findings between diabetic and non-diabetic individuals using community periodontal index (CPI). Materials and Methods: We evaluated the periodontal status and periodontal TN in diabetic and non-diabetic individuals in Guwahati, Assam. A total of 459 (223 diabetic and 236 non-diabetic) individuals were assessed. A person was considered to be diabetic when his blood glucose levels were above 140 mg/dl under fasting condition and 200 mg/dl 2 hours postprandially. Periodontal status was assessed using CPI. Results: Periodontal destruction was found to be increased in diabetic individuals, with periodontal destruction increasing with increased blood glucose levels. The necessity of complex periodontal treatment also increased with increasing blood glucose levels. Conclusions: Individuals with diabetes are more prone to periodontal destruction, and hence, regular periodontal screening and treatment is essential in these individuals.

Failures in periodontal therapy.

Studies have shown that modern periodontal therapies are effective in maintaining a healthy natural dentition as well as controlling periodontal disease. Numerous treatment strategies and various techniques have been designed & described to treat periodontal disease. Most of these procedures had drawbacks which were identified, leading to the modifications of the original techniques which lead to better treatment options, but still very less emphasis has been laid on failures. Without a regular program of clinical reevaluation, plaque control, oral hygiene instructions, and reassessment of biomechanical factors the benefits of treatment are often lost and inflammatory disease in the form of recurrent periodontitis may result. So, this review describes the most common failures noticed in periodontal therapies and also discusses the possible solutions to reduce the incidence of failures in periodontal therapy.

Role of antibiotics in periodontal therapy.

Loeshe in 1976 propounded the ‘Specific Plaque Hypothesis’ and efforts have been done since, to formulate a periodontal treatment regimen based on targeting of specific microorganisms. Antibiotics have gained importance as an arsenal in the treatment of periodontitis. This review takes a concise view on the role of antibiotics in periodontics. This review puts importance of antibiotics in a nutshell as a quick reference for the general practitioners in treating periodontal diseases. The selection and indication for the use of antibiotics is given with a note on resistance