Periodontal parameters in prediabetes, type 2 diabetes mellitus, and non-diabetic patients

Abstract The aim of the present study was to compare the clinical and radiographic periodontal parameters in prediabetes, type 2 diabetes mellitus (T2DM), and non-diabetic patients. Forty-one patients with prediabetes (Group 1), 43 patients with T2DM (Group 2), and 41 controls (Group 3) were included. Demographic data were recorded using a questionnaire. Full-mouth clinical (plaque index [PI], bleeding on probing [BOP], probing depth [PD], clinical attachment loss [CAL], missing teeth [MT]) and radiographic (marginal bone loss [MBL]) parameters were measured on digital radiographs. In all groups, hemoglobin A1c (HbA1c) levels were also measured. P values less than 0.05 were considered statistically significant. The mean age and HbA1c levels of participants in Groups 1, 2, and 3 were 53.4±3.5, 60.1 ± 0.6, and 56.6 ± 2.5 years and 6.1%, 8.4%, and 4.8%, respectively. The mean duration of prediabetes and T2DM in patients from Groups 1 and 2 were 1.9 ± 0.3 and 3.1 ± 0.5 years, respectively. PI, BOP, PD, MT, CAL, and MBL were significantly higher in Groups 1 (p < 0.05) and 2 (p < 0.05) than in Group 3. There was no statistically significant difference in these parameters in Groups 1 and 2. Periodontal parameters were worse between prediabetes and T2DM patients compared with controls; however, these parameters were comparable between prediabetes and T2DM patients.

Is There a Relationship Between Periodontal Disease and Causes of Death? A Cross Sectional Study

The aim of this study was to evaluate whether there is any correlation between periodontal disease and mortality contributing factors, such as cardiovascular disease and diabetes mellitus in the elderly population. A dental evaluation was performed by a single examiner at Tufts University dental clinics for 284 patients. Periodontal assessments were performed by probing with a manual UNC-15 periodontal probe to measure pocket depth and clinical attachment level (CAL) at 6 sites. Causes of death abstracted from death certificate. Statistical analysis involved ANOVA, chi-square and multivariate logistic regression analysis. The demographics of the population sample indicated that, most were females (except for diabetes mellitus), white, married, completed 13 years of education and were 83 years old on average. CAL (continuous or dichotomous) and marital status attained statistical significance (p<0.05) in contingency table analysis (Chi-square for independence). Individuals with increased CAL were 2.16 times more likely (OR=2.16, 95% CI=1.47-3.17) to die due to CVD and this effect persisted even after control for age, marital status, gender, race, years of education (OR=2.03, 95% CI=1.35-3.03). CAL (continuous or dichotomous) was much higher among those who died due to diabetes mellitus or out of state of Massachusetts. However, these results were not statistically significant. The same pattern was observed with pocket depth (continuous or dichotomous), but these results were not statistically significant either. CAL seems to be more sensitive to chronic diseases than pocket depth. Among those conditions, cardiovascular disease has the strongest effect.

O objetivo deste estudo foi avaliar se existe relação entre doença periodontal e fatores de mortalidade como, por ex., doenças cardiovasculares e diabetes melitus, numa amostra de pessoas idosas. Um único examinador fez avaliação dentária em 284 pacientes. As avaliações periodontais foram feitas com sonda manual UNC-15 para medir profundidade da bolsa e nível de inserção clínica em 6 pontos. As causas dos óbitos foram obtidas das certidões. Para análise estatística utilizou-se ANOVA, teste do qui-quadrado e análise de regressão logística multivariada. Os dados demográficos indicaram que a maioria era constituída de mulheres (exceto para diabetes melitus), leucodermas, casadas, completaram 13 anos de escolaridade e média de 83 anos de idade. O nível de inserção clínica (contínuo ou dicotomizado) e estado civil tiveram significância estatística (p<0,05) na análise das tabelas de contingência (qui-quadrado para independentes). O nível de inserção clínica foi 2,16 vezes mais provável causa de óbito (OR=2,16; 95%CI 1,47-3,17) por doença cardiovascular que o grupo dos sobreviventes e este efeito persistiu mesmo depois de controlados idade, estado civil, sexo, raça e anos de escolaridade (OR=2,03, 95%CI 1.35-3.03). O nível de inserção clínica (contínuo ou dicotomizado) foi muito maior entre os que morreram por diabetes melitus ou fora do estado de Massachusetts, mas estes resultados não foram estatisticamente significantes. O mesmo ocorreu com a profundidade da bolsa gengival (contínua ou dicotomizada), mas estes resultados também não foram estatisticamente significantes. Aparentemente a inserção clínica é mais afetada pelas doenças crônicas em comparação com a profundidade da bolsa. Entre estas doenças, as cardiovasculares têm efeito mais forte.

Helicobacter pylori coinfection is a confounder, modulating mucosal inflammation in oral submucous fibrosis.

The oral cavity has been considered a potential reservoir for Helicobacter pylori (H pylori) , from where the organism causes recurrent gastric infections. Aim: With this case-control study we tried to evaluate the role of H pylori in the etiology of mucosal inflammation, a condition that compounds the morbid state associated with oral submucous fibrosis (OSF). Materials and Methods : Subjects ( n = 150) were selected following institutional regulations on sample collection and grouped into test cases and positive and negative controls based on the presence of mucosal fibrosis and inflammation. The negative controls had none of the clinical signs. All patients underwent an oral examination as well as tests to assess oral hygiene/periodontal disease status; a rapid urease test (RUT) of plaque samples was also done to estimate the H pylori bacterial load. We used univariate and mutivariate logistic regression for statistical analysis of the data and calculated the odds ratios to assess the risk posed by the different variables. Results : The RUT results differed significantly between the groups, reflecting the variations in the bacterial loads in each category. The test was positive in 52% in the positive controls (where nonspecific inflammation of oral mucosa was seen unassociated with fibrosis), in 46% of the test cases, and in 18% of the negative controls (healthy volunteers) (χ2 = 13.887; P < 0.01). A positive correlation was seen between the oral hygiene/periodontal disease indices and RUT reactivity in all the three groups. Conclusions: The contribution of the H pylori in dental plaque to mucosal inflammation and periodontal disease was significant. Logistic regression analysis showed gastrointestinal disease and poor oral hygiene as being the greatest risk factors for bacterial colonization, irrespective of the subject groups. A positive correlation exists between RUT reactivity and the frequency of mucosal inflammation.