Impacto da terapia periodontal não cirúrgica na qualidade de vida e nos desfechos clínicos periodontais em pacientes com comprometimento sistêmico

Abstract

This study aims to evaluate the impact of non-surgical periodontal therapy (NSPT) on oral health-related quality of life (OHRQoL) in patients with type II diabetes and/or hypertension and to evaluate the additional effect of the use of topical intra-pocket probiotics on periodontal clinical parameters. To this end, a randomized, triple-blind, placebo-controlled clinical trial was conducted, including 30 patients, allocated to a probiotic group (n = 15) and a placebo group (n = 15). All patients underwent quadrant- by-quadrant TPCN, followed by intra-pocket application of gel containing Lactobacillus acidophilus NCFM and Bifidobacterium lactis HN019 (2.5 × 108 CFU/g) or placebo. The primary endpoints were OHRQoL (OHIP-14), clinical probing depth (CPD), clinical attachment loss (CAL), gingival recession, dental biofilm, bleeding on probing, suppuration, and tooth mobility, and were assessed at baseline and after three months. Secondary outcomes included laboratory, hemodynamic, salivary, and halitosis parameters. The results showed a significant improvement in QVRSB after three months, with a reduction in OHIP-14 scores (p< 0.0001). The initial score (OHIP-14) and the simultaneous presence of type II diabetes and hypertension were associated with the outcome (SRQ-OHRQoL). A reduction in dental anxiety and periodontal disease severity was also observed, with no significant laboratory changes. A significant reduction in PCS A significant reduction in PCS and PCI was observed in both groups (p < 0.05), with probiotics having no additional effect on these parameters. On the other hand, the parameters of suppuration and tooth mobility showed improvement associated with the use of probiotics. Biofilm and gingival bleeding were reduced in both groups, with no difference between them. The treatment was safe in terms of hemodynamic parameters and showed high patient satisfaction. Thus, it is concluded that after three months, TPNC is effective in improving periodontal health and OHRQoL in patients with type II diabetes and/or hypertension. Probiotics did not have an additional effect on PCS and PCI, although they had a positive effect on suppuration and tooth Mobility after three months of follow-up.