Influence of glycemic control on the levels of subgingival periodontal pathogens in patients with generalized chronic periodontitis and type 2 diabetes

Abstract

Objective This study evaluated the influence of glycemic control on the levels and frequency of subgingival periodontal pathogens in patients with type 2 diabetes mellitus (DM) and generalized chronic periodontitis (ChP).Material and Methods Fifty-six patients with generalized ChP and type 2 DM were assigned according to the levels of glycated hemoglobin (HbA1c) into one of the following groups: HbA1c<8% (n=28) or HbA1c≥8% (n=28). Three subgingival biofilm samples from sites with probing depth (PD)<5 mm and three samples from sites with PD≥5 mm were analyzed by quantitative Polymerase Chain Reaction (PCR) for the presence and levels of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Eubacterium nodatum, Parvimona micra, Fusobacterium nucleatum ssp. and Prevotella intermedia.Results The mean counts of F. nucleatum ssp. were statistically significantly higher in the sites with PD≥5 mm of the HbA1c≥8% group (p<0.05). Frequencies of detection of T. forsythia, E. nodatum, P. micra and F. nucleatum ssp. were all higher in the sites with PD≥5 mm of the patients with HbA1c≥8%, compared with those of patients with HbA1c<8% (p<0.05). Frequency of detection of P. intermedia was higher in the sites with PD<5 mm of the patients with HbA1c≥8% than those of the patients with HbA1c<8% (p<0.05).Conclusions Poor glycemic control, as indicated by HbA1c≥8%, is associated with increased levels and frequencies of periodontal pathogens in the subgingival biofilm of subjects with type 2 DM and ChP.

25-Hydroxyvitamin D₃ Alleviates Experimental Periodontitis via Promoting Expression of Cathelicidin in Mice with Type 2 Diabetic Mellitus

“…If activated, its intracellular domain adapts to the adaptor and leads to further activation of downstream proinflammatory proteins (25). Diabetic mellitus and its representative vessel inflammation exacerbate microcirculation disturbances (26); as a consequence, periodontal tissue becomes easily infected which is even more serious than for those without diabetes (27). In this case, an alternative and economical method that can both enhance resistance to infection and alleviate periodontal destruction is of crucial significance.…”

Crestal Bone Loss Around Submerged and Non-Submerged Dental Implants in Individuals with Type-2 Diabetes Mellitus: A 7-Year Prospective Clinical Study

“…Numerous studies have showed that peri-implant bacteria and their byproducts enter systemic circulation from periodontal/peri-implant pockets that may in turn worsen insulin resistance by potentially augmenting low-grade inflammation [29-31]. Similarly, research indicates that increased blood HbA1c levels have an overall impact on the subgingival bacterial load [32-34]. This suggests that the systemic load of peri-implant bacteria and their products is higher in individuals with persistent hyperglycemia compared to patients with well-controlled glycemic levels.…”

Marcadores salivares para a periodontite crônica no diabético tipo 2

“…Vários mecanismos, incluindo alterações a resposta do hospedeiro e na composição do microbiota subgengival, foram propostas para explicar uma maior susceptibilidade dos sujeitos com DM à degradação periodontal 8 . A periodontite crônica é um desfecho comum do DM2 e sua prevalência está ligada diretamente com o grau de estabilidade glicose-insulina, uma vez que esta é influenciada pelo grau de inflamação acometido pela periodontite crônica implicando na resistência hormônio-receptor 9 .…”