Relationship between markers of metabolic control and inflammation on severity of periodontal disease in patients with diabetes mellitus.

AIM: The aim of this study was to investigate the relationship between markers of metabolic control and inflammation and periodontal disease parameters in patients with diabetes. MATERIAL & METHODS: One hundred and eighty one adult patients with diabetes attending treatment at two diabetes centres were invited to participate in the study. Periodontal examination included full-mouth assessment for probing depths and bleeding on probing (BOP). Blood analyses were carried out for glycated haemoglobin, (HbA1c), high-sensitivity C reactive protein, (hsCRP) and lipid profile comprising total cholesterol, low-density lipoprotein cholesterol (LDL chol), high-density lipoprotein cholesterol (HDL chol) and triglycerides. RESULTS: Upon multivariate analysis, periodontal disease severity in terms of increased percentage of BOP and mean percentage of sites with probing depths > or = 5 mm were found to be associated with inadequate glycaemic control as measured by HbA1c (p<0.01). HsCRP was also found to be a significant predictor for mean percentage of sites with probing depths > or = 5 mm (p<0.05). After controlling for age, gender, smoking habits and number of teeth, positive correlations were found between HbA1c and percentage sites with probing depths > or = 5 mm, percentage sites BOP, total cholesterol, LDL chol and triglycerides (p<0.05). Using the adjusted differences, subjects with acceptable glycaemic control (HbA1c < 8%) showed a lower percentage of sites with BOP and probing depths > or = 5 mm (p<0.05) when compared with those having inadequate glycaemic control. There was also a trend towards lower blood cholesterol in the well-controlled group. CONCLUSION: The level of glycaemic control as measured by HbA1c emerged as the most consistent risk factor associated with the extent and severity of periodontal disease in this study cohort.

A comparison of 4 techniques for clinical detection of early plaque formed during different dietary regimes.

The purpose of this study was to evaluate the sensitivity of 4 clinical techniques used in detecting early plaque during a period of dietary sucrose restriction and during a period of sucrose supplementation. The accumulation of plaque during experimental periods of 3 h, 6 h and 18 h was recorded in a group of 38 dental personnel for the 1st part of the study, and in a group of 32 for the 2nd part. Plaque levels were assessed using a caries probe, a plaque detection probe, erythrosin and a 2-tone disclosing agent. There was a progressive increase in plaque over the period of the study, with significant variation between the detection methods used and the sites being assessed. Plaque formed more rapidly interdentially and on the posterior teeth. 3 h after the teeth had been thoroughly cleaned, plaque was detectable on over 12% of sites for the sucrose-restricted diet and on up to 23% of sites for the sucrose-supplemented diet. After 18 h of plaque formation, the proportion of plaque-covered surfaces had increased to between 52% and 73%. For minimal amounts of plaque, the disclosing solutions were found to be the most sensitive assessment techniques. However, for moderate and abundant plaque deposits, the techniques using the probes resulted in a greater degree of differentiation in the proportional measurements of plaque. Overall, the plaque probe was found to be as sensitive or better than the other techniques under most conditions and was favoured on clinical grounds, as it aided access to the interdental areas and provided a contrasting colour at the tip to enable plaque to be detected with greater ease.(ABSTRACT TRUNCATED AT 250 WORDS)