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Periodontal regenerative therapy in patients with type 2 diabetes using minimally invasive surgical technique with enamel matrix derivative under 3‐year observation: A prospective cohort study
Author(s) -
Mizutani Koji,
Shioyama Hidehiro,
Matsuura Takanori,
Mikami Risako,
Takeda Kohei,
Izumi Yuichi,
Aoki Akira,
Iwata Takanori
Publication year - 2021
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1002/jper.20-0590
Subject(s) - enamel matrix derivative , medicine , dentistry , prospective cohort study , diabetes mellitus , type 2 diabetes , surgery , regeneration (biology) , endocrinology , biology , microbiology and biotechnology
Background Information regarding periodontal regenerative therapy in patients with diabetes mellitus (DM) is limited. This pilot study compared the regenerative outcomes of minimally invasive periodontal surgery using enamel matrix derivative (EMD) between DM and non‐DM patients. Methods This prospective study included deep intrabony defects in patients with or without type 2 DM. Minimally invasive surgical technique (MIST) or modified MIST (M‐MIST) using EMD, without bone graft materials, was performed. Periodontal examination and intraoral radiography were performed at baseline, 6 months, and 1 and 3 years after surgery. Results Ten sites of 10 subjects in the DM group, and 20 sites of 18 subjects in non‐DM group were evaluated (mean age; 67.5 ± 7.6 and 63.1 ± 9.7, respectively). Probing depth significantly decreased from 7.1 ± 1.6 and 7.0 ± 1.3 mm to 2.2 ± 0.9 and 2.3 ± 1.1 mm at the 1‐year examination in the DM and non‐DM groups, respectively. Clinical attachment level (CAL) gain and radiographical defect fill at the 3‐year examination were 3.8 ± 1.1 mm and 58.3% ± 10.4%, respectively, in the DM group, and 4.1 ± 1.1 mm and 65.5% ± 18.8%, respectively, in the non‐DM group, showing no significant differences between the groups. Multiple regression analysis showed no significant association of CAL gain with DM or age after adjustments for relevant confounders. Conclusions This is the first documented study of successful periodontal tissue regeneration in patients with DM. Minimally invasive surgery combined with EMD yielded significant clinical attachment gain and bone fill in the DM and non‐DM groups at comparable levels.