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Treatment of periodontitis reduces systemic inflammation in type 2 diabetes

Lookup NU author(s): Professor Philip Preshaw, Dr John TaylorORCiD, Dr Katrin Jaedicke, Dr Susan BissettORCiD, Paiboon Jitprasertwong, Dr Jolanta Weaver, Professor Roy Taylor, Dr Rebecca Wassall



This is the authors' accepted manuscript of an article that has been published in its final definitive form by Wiley-Blackwell Publishing Ltd., 2020.

For re-use rights please refer to the publisher's terms and conditions.


Aims: To assess the impact of periodontal treatment on systemic inflammation in type 2 diabetes. Materials and Methods: Adults with type 2 diabetes (n=83) and without diabetes (controls, n=75) were recruited, and participants with periodontitis received periodontal treatment and 12 months’ follow-up. Biomarkers for periodontal inflammation (gingival crevicular fluid interleukin-6, tumour necrosis factor-α, interleukin-1β, interferon-γ, matrix metalloproteinase-8, matrix metalloproteinase-9, adiponectin) and serum markers of inflammation and diabetes control (glycated haemoglobin, high sensitivity C-reactive protein, interleukin-6, tumour necrosis factor-α, interleukin-1β, interferon-γ, leptin, adiponectin) were measured. Structural equation modelling was used to evaluate periodontal treatment effects on oral and systemic inflammation. Results: Periodontal treatment resulted in significant improvements in clinical status and reductions in gingival crevicular fluid biomarkers from baseline to month 12. Structural equation modelling identified that, at baseline, individuals with diabetes and periodontitis had significantly higher systemic inflammation than non-diabetic controls with periodontitis (Δ=0.20, p=0.002), with no significant differences between groups for oral inflammation. There was a greater reduction in systemic inflammation following periodontal treatment in individuals with diabetes and periodontitis compared to those with periodontitis but not diabetes (Δ=-0.25, p=0.01). Conclusions: Diabetes and periodontitis together appear to increase systemic inflammation, with evidence of reductions following periodontal treatment.

Publication metadata

Author(s): Preshaw PM, Taylor JJ, Jaedicke KM, De Jager M, Bikker JW, Selten W, Bissett SM, Whall KM, van de Merwe R, Arebi A, Jitprasertwong P, Al-Shawani R, Weaver J, Taylor R, Wassall RR

Publication type: Article

Publication status: Published

Journal: Journal of Clinical Periodontology

Year: 2020

Volume: 47

Issue: 6

Pages: 737-746

Print publication date: 01/06/2020

Online publication date: 27/02/2020

Acceptance date: 24/02/2020

Date deposited: 09/03/2020

ISSN (print): 0303-6979

ISSN (electronic): 1600-051X

Publisher: Wiley-Blackwell Publishing Ltd.


DOI: 10.1111/jcpe.13274


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