The Effect of the Combination of Non-surgical and Occlusal Therapy on Diastema in Periodontal Diseased Patient with Diabetes: A Case Report

Abstract

Severe inflammation, deep periodontal pockets and multiple abscess formation often occur in diabetic patients with poor oral hygiene. Also, the distribution and severity of local irritants affect the severity of periodontal disease in diabetes.
The patient was a 63-year-old Japanese female who came to periodontics department of Nihon University Dental Hospital. Periodontal examination revealed abundant plaque accumulation, multiple abscess formation and diastema. The patient was diagnosed as having a generalized moderate to severe adult periodontitis with secondary occlusal trauma. Since the blood test showed high blood glucose level (311 mg/dl), she was referred to a physician to treat diabetes.
Comprehensive periodontal treatment was prepared to create a well-functioning dentition in a healthy periodontal environment. Non-surgical periodontal therapy including local drug (mino-cycline) delivery system was basically selected to reduce gingival inflammation considering about age and diabetes. Occlusal therapy using modified Hawley appliance was performed to correct diastema after inflammation reduction phase.
This case report was presented to demonstrate the importance of fundamental concept of periodontal therapy and suggested that the combination therapy was effectively to correct diastema in periodontal diseased patient with diabetes. Periodontal condition has been within normal limit after active therapy. Her blood glucose level has been decreased (110 mg/dl) after diabetic treatment. The patient has been in maintenance therapy to keep periodontal health.