Porphyromonas gingivalis; prevalence and quantitation by pcr and clinical assessment of periodontal diseases in type I diabetes mellitus

The aim of this study is to assess the prevalence of periodontal diseases as well as dental caries in a group of diabetic children and adolescents and to study the subgingival microflora, Porphyromonas gingivalis [P.gingivalis]. The study was conducted on 70 type I diabetic patients, 20 healthy age-matched children and adolescents were included as a control group. Both patients and controls were subjected to periodontal examination and subgingival plaque samples for detection and quantitation of Porphyromonas gingivalis using PCR technique. Thirty eight among the seventy studied patients [54%] have been diagnosed as gingivitis [inflammation confined to the gingival], 9/70 [13%] as periodontitis [progressive destruction of periodontal ligament and alveolar bone with pocket formation], and the remaining 23 [33%] were periodontally healthy diabetics. A significantly higher percentage of Porphyromonas gingivalis positive PCR and higher DNA copies/ml were detected in periodontitis and gingivitis compared to periodontically healthy diabetics and healthy controls [P<0.05]. On comparing periodontitis and gingivitis groups, a statistically significant difference was detected [P<0.05] while periodontically healthy diabetics did not show any significant difference neither in positive PCR nor in DNA copies/ml compared to healthy controls [P<0.05]. Assessment of caries condition showed higher caries scores among diabetics than controls but this increase was statistically non significant [P>0.05]. A statistically significant difference was detected between age of the patient, disease duration, poor metabolic control and the development of periodontal disease. Periodontal diseases exist in a significant percentage of diabetic children and adolescents; higher age of the patient, longer duration of DM, and poor diabetic control are risk factors for the development of periodontitis and gingivitis; Porphyromonas gingivalis may be implicated in the development of periodontal disease. Detection and Quantitative analysis of this organism is important for the evaluation of periodontai diseases

Can dental implants survive in diabetic patients?

Statement of the problem: Quite often, the diabetic patients suffer from unfavorable oral con-ditions. As these diabetic population increases, it will be necessary to learn how to achieve elective rehabilitation for these patients with dental implants

Purpose: Studying the prognosis of implant supported overdenture prosthesis in controlled diabetic versus non diabetics

Materials and methods: The study groups consisted of 15 patients [Spatients have type I controlled diabetes, Spatients have type II controlled diabetes, 5 patients were healthy individuals]. They received overdentures supported by two interforaminal implants. Clinical peri-implant tissues evaluation, periotest measurements, and loss of marginal bone height were investigated for one year.

Results: After loading of the implants with the prosthesis, neither clinical peri-implantitis nor implant instability was observed. Resorption of bone less than [1mm] was radiographically registered. These results denoted successful implantation in both types of diabetes.

Conclusion: The use of dental implants in controlled diabetes mellitus is satisfactory and encouraging. Further investigations and clinical trials over a longer period of time are needed to determine the long-term survival of implants in diabetic patients