Gopalakrishnan Sundaram1, Ramakrishnan Theagarajan2, Kanimozhi Gopalakrishnan3, Gnanasagar Ramesh Babu1, Gomathi Dhakshina Murthy1
1Department of Periodontics, Thai Moogambigai Dental College and Hospital, Chennai, Tamil Nadu, India.
2Department of Periodontics, Adhiparasakthi Dental College, Melmaruvathur, Tamil Nadu, India.
3Department of Periodontics, SRM Dental College and Hospital, Chennai, Tamil Nadu, India.
Aims and Objectives: The aim of this study is to compare the efficacy of metformin and fenugreek seed powder as an adjunct to scaling and root planing (SRP) with the effect achieved using SRP and metformin alone by assessing their respective effects on periodontal parameters, glycemic status, and inflammatory marker. Materials and Methods: Eighty patients were included in this study who were further divided into two groups. Each group consisted of 40 patients. Group 1 patients included chronic periodontitis with uncontrolled type 2 diabetes mellitus (DM), who received SRP and treatment with metformin. Group 2 patients included chronic periodontitis with uncontrolled type 2 DM, who received SRP, metformin plus fenugreek powder. Periodontal parameters such as plaque index (PI), gingival index, bleeding on probing, pocket depth, and clinical attachment levels were evaluated at baseline and 1 month after nonsurgical periodontal therapy. Blood samples were also collected to assess the levels of glycosylated hemoglobin (HbA1c) and inflammatory cytokine interleukin-6 (IL-6) at baseline and after 1 month of nonsurgical periodontal therapy. Results: On intragroup comparison of clinical parameters at baseline and after treatment, a statistically significant reduction was observed for both Group 1 and Group 2 patients. When intergroup comparison was done after treatment, significant reduction was observed only for PI (P < 0.0031). On intragroup comparison was done for fasting blood sugar (FBS) and HbA1c before and after nonsurgical periodontal treatment, there were statistically significant changes seen in both the groups for FBS (P < 0.001) and for HbA1c in Group 2 patients alone. The level of IL-6 also reduced after treatment compared to baseline values (P < 0.001). Conclusion: The direct effect of fenugreek on the FBS level could attribute to the changes in the PI and decrease in the inflammation. Thus, the study showed that fenugreek seeds could be used as an adjuvant in chronic periodontitis patients to control type 2 DM and inflammatory marker IL-6.
Keywords: Chronic generalized periodontitis, fenugreek seeds, glycosylated hemoglobin, interleukin-6, metformin, type 2 diabetes mellitus.