Assessment of Wound Healing Using MMP-8 Levels in GCF of Diabetics With Chronic Periodontitis After Diode Laser Assisted Flap Surgery.

Abstract

Background: Inflammatory cytokines like Matrix Metalloproteinases (MMPs) are associated with the destruction observed in periodontal disease (3). There has been evidence of significant increases in MMP levels in patients with systemic disorders, such as Diabetes Mellitus (DM), which is associated with microvascular complications, causing increased MMP activity, directly or indirectly, due to oxidative stress. Objective: The aim of this study was conducted in order to assess wound healing using MMP-8 levels in GCF of diabetics with chronic periodontitis after diode laser assisted flap surgery.

Methods: This interventional, comparative clinical trial, was conducted after obtaining approval from the Institutional Ethics Committee (IEC), (Study protocol number: 48/2020), and registered with Clinical Trials Registry of India (CTRI/2022/07/043898). Purposive sampling technique was used to select 30 patients with chronic periodontitis (15 systemically healthy patients, and 15 diabetic patients), who visited the Department of Periodontology.

Results: Out of the 30 patients initially selected, 3 patients were lost to follow up and 1 patient was excluded from the study due to lack of compliance towards oral hygiene maintenance. Intragroup comparison of the clinical parameters at baseline and 3 months in both groups was statistically significant (p=0.000). This concludes that there was statistically significant improvement in the periodontal parameters of non-diabetic patients after diode laser assisted flap surgery. Inter-group comparison of the clinical parameters did not show statistical significance at baseline and at 3 months (p > 0.05). It can be concluded that there was comparable changes in the periodontal parameters in both groups after surgery.

Conclusion: MMP-8 could be used as a futuristic tool for assessing wound healing especially in diabetics, so that necessary treatment interventions can be undertaken prior to development of any post-op complications. Laser assisted Modified Widman flap showed noteworthy improvement in the clinical parameters in both groups. Thus, proving that laser assisted MWF surgery is a favorable treatment modality, especially in diabetics who are immunocompromised and prone to infections.