International Journal of Drug Delivery Technology
Volume 16, Issue 2s

Change in Neutrophil to Lymphocyte Ratio following Non-Surgical Periodontal Therapy in Patients with Type 2 Diabetes Mellitus and Periodontitis

Dr Mohammed Shereef MDS1*, Dr Rekha P Radhakrishnan MDS2, Dr Neethu P Reghu MDS3, Dr S Santhosh Kumar MDS4, Dr Baiju R M MDS PhD5, Dr Tony Kurien MDS6

1*Department of Periodontology, Government Dental College Kozhikode, Kerala University of Health Sciences (KUHS), Kozhikode, Kerala, India
ORCID: 0000-0002-4150-1827
2Department of Periodontology, Government Dental College Kottayam, Kerala University of Health Sciences (KUHS), Kottayam, Kerala, India
ORCID: 0000-0001-9858-4814
3Department of Periodontology, Government Dental College Kottayam, Kerala University of Health Sciences (KUHS), Kottayam, Kerala, India
ORCID: 0009-0000-3307-4784
4Department of Periodontology, Government Dental College Kottayam, Kerala University of Health Sciences (KUHS), Kottayam, Kerala, India
ORCID: 0000-0002-7707-5727
5Department of Periodontology, Government Dental College Kottayam, Kerala University of Health Sciences (KUHS), Kottayam, Kerala, India
ORCID: 0000-0002-9682-3209
6Department of Periodontology, Government Dental College Kottayam, Kerala University of Health Sciences (KUHS), Kottayam, Kerala, India

ABSTRACT

Background: Periodontitis is a chronic inflammatory disease with well-established bidirectional association with type 2 diabetes mellitus (T2DM). Systemic inflammatory burden in such patients can be assessed using simple haematological markers such as the neutrophil-to-lymphocyte ratio (NLR), which reflects the balance between innate and adaptive immune responses.

Aim: To evaluate the change in neutrophil-to-lymphocyte ratio following non-surgical periodontal therapy (NSPT) in well-controlled T2DM patients with periodontitis.

Materials and Methods: A longitudinal clinical study was conducted among 45 controlled T2DM patients (HbA1c ≤ 7%) diagnosed with periodontitis. Clinical periodontal parameters including probing pocket depth (PPD), clinical attachment level (CAL), full-mouth plaque score (FMPS), and full-mouth bleeding score (FMBS) were recorded at baseline and 8 weeks after NSPT. Peripheral blood samples were collected for complete blood count analysis, and NLR was calculated. Statistical analysis was performed using paired t-test and ANOVA, with significance set at p < 0.05.

Results: All periodontal parameters showed significant improvement following NSPT (p < 0.001). Neutrophil counts did not show a significant change (p = 0.807), whereas lymphocyte counts increased significantly post-therapy (p < 0.001). NLR demonstrated a statistically significant reduction from baseline (1.98 ± 0.30) to post-treatment (1.81 ± 0.25) (p = 0.002). Baseline NLR values increased significantly with advancing stages of periodontitis.

Conclusion: Non-surgical periodontal therapy significantly reduces systemic inflammatory burden, as reflected by decreased NLR, in well-controlled T2DM patients with periodontitis. NLR may serve as a simple and reliable adjunctive biomarker for monitoring systemic inflammation following periodontal therapy.

Keywords: periodontitis, diabetes mellitus type 2, neutrophil-lymphocyte ratio, periodontal therapy, inflammation

How to cite this article: Shereef M, Radhakrishnan RP, Reghu NP, Kumar SS, Baiju RM, Kurien T, Change in Neutrophil to Lymphocyte Ratio following Non-Surgical Periodontal Therapy in Patients with Type 2 Diabetes Mellitus and Periodontitis. Int J Drug Deliv Technol. 2026;16(2s): 825-831; DOI: 10.25258/ijddt.16.825-831