The present study was undertaken in order to determine the possible alterations in whole saliva and the periodontal status in patients with diabetes mellitus (DM), and was conducted on 17 patients with DM and 17 systemically and periodontally healthy subjects. When the subjects were evaluated clinically, significantly increased probing depths were noticed in the DM group when compared with the healthy subjects. In whole saliva samples, sodium, potassium, total protein, amylase, thiocyanate, and secretory IgA levels were determined in both groups. Difference between the two groups regarding the mean salivary potassium levels were found to be statistically significant since the mean salivary potassium levels in the DM and the control groups were 2.470 +/- 9.04 mmol/L and 14.30 +/- 8.88 mmol/L, respectively. The mean salivary total protein, amylase and secretory IgA levels in the DM group were 2.41 +/- 1.0 mg/mL, 124.2 +/- 79.7 U/mL and 6.86 +/- 3.50 mg/L, all being significantly higher than the control group. However, no significant differences could be shown for the salivary sodium and thiocyanate levels. Nor was there any difference between non-insulin dependent diabetes mellitus (NIDDM) and insulin-dependent diabetes mellitus (IDDM). The findings of the present study suggest that, besides the clinical examinations, the determination of the possible alterations in the composition of whole saliva might also be helpful in understanding the increased severity of periodontal disease in diabetic patients.

Cytokines are believed to play an important role in the pathogenesis of periodontal diseases. In the present study, gingival crevicular fluid (GCF) levels of two important cytokines, interleukin 1-beta (IL-1 beta) and tumour necrosis factor-alpha (TNF-alpha) and, in addition, serum IL-1 beta levels, were determined in patients with severe and rapid periodontal breakdown by use of ELISA. While IL-1 beta was detected in all of the GCF samples studied, TNF-alpha could only be detected in about half the samples. The mean GCF IL-1 beta level was 38.45 +/- 13.99 pg/mL, and the mean TNF-alpha level was 3.20 +/- 1.39 pg/mL, respectively. The GCF IL-1 beta levels also presented a strong positive correlation with the mean pocket depths. Although weak, both of the cytokines also presented correlations with the presence of bleeding on probing. Additionally GCF samples contained increased IL-1 beta levels when compared with the serum samples suggesting local production mechanisms. The findings of the present study suggest that these cytokines may be involved in the pathogenesis of periodontal diseases (IL-1 beta being more significant), and also may help in defining the active phase of periodontal breakdown.

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