A clinical case report of long-term follow up in severe chronic periodontitis patient with type II diabetes

Abstract

Reported here is a course of treatment and 12-year follow-up of a 63-year-old male patient with severe chronic periodontitis and type 2 diabetes. The patient presented with a chief com plaint of the mobile and swollen 7 . The blood glucose control status at the first visit was hemo globin A1c (HbA1c): 9.9, fasting blood sugar level (FBS): 140, and the mobility of 7 was Degree 3.7 was diagnosed with severe chronic periodontitis accompanied by occlusal trauma. The treat ment plan was formulated so as to first perform basic periodontal treatment along with glycemic control, aiming for preservation of the remaining teeth. Treatment progress and results: 7 was extracted as deemed hopeless. Blood glucose control remained poor, so the insulin therapy was started but in vain, and the patient was then hospitalized and periodontal treatment was inter rupted. After discharge, blood glucose control improved, but the periodontal condition of the remaining teeth gradually deteriorated, and the maxilla was fitted with a partial denture. After shifting to supportive periodontal therapy (SPT), the glycemic control was stable, but the destruc tion of the maxillary periodontal tissue continued to progress, resulting in the major decrease in the number of remaining teeth from 11 teeth at the first visit down to 2 teeth. Conclusion: Previous reports suggest that there is a correlation between effect of periodontal treatment and improvement of blood glucose levels. As in this case, however, when blood glucose control is very poor at the onset of periodontal treatment, progression of periodontal tissue destruction might continue even after improvement of the blood glucose level, in turn resulting in loss of teeth.