Microbiological changes after periodontal therapy in diabetic patients with inadequate metabolic control

Abstract

Microbiological changes after periodontal therapy in diabetic patients with inadequate metabolic control abstract: The present study investigated the effect of non-surgical periodontal treatment (SRP) on the composition of the subgingival microbiota of chronic periodontitis (CP) in individuals with type 2 diabetes (DM2) with inadequate metabolic control and in systemically healthy (SH) individuals. Forty individuals (20 DM2 and 20 SH) with CP underwent full-mouth periodontal examination. Subgingival plaque was sampled from 4 deep sites of each individual and tested for mean prevalence and counts of 45 bacterial taxa by the checkerboard method. Clinical and microbiological assessments were performed before and 3 months after SRP. At baseline, those in the DM2 group presented a significantly higher percentage of sites with visible plaque and bleeding on probing compared with those in the SH group (p < 0.01). Those in the DM2 group presented significantly higher levels of C. rectus and P. gingivalis, and lower prevalence of P. micra and S. anginosus, compared with those in the SH group (p ≤ 0.001). At the 3-month visit, both groups showed a significant improvement in all clinical parameters (p < 0.01). Those in the DM2 group showed significantly higher prevalence and/ or levels of A. gerencseriae, A. naeslundii I, A. oris, A. odontolyticus, C. sputigena, F. periodonticum, and G. morbillorum compared with those in the SH group (p ≤ 0.001). However, those in the DM2 group showed a significant reduction in the levels of P. intermedia, P. gingivalis, T. forsythia, and T. denticola (p ≤ 0.001) over time. Those in the SRP group showed improved periodontal status and reduced levels of putative periodontal pathogens at 3 months' evaluation compared with those in the DM2 group with inadequate metabolic control.

Association between metabolic syndrome and periodontitis: The role of lipids, inflammatory cytokines, altered host response, and the microbiome

“…194,208,209 Some studies found that the levels of Tr. denticola were higher in patients with type 2 diabetes compared with normoglycemic controls, 203,204,210 while no difference was observed in other studies. 206,208 When type 2 diabetes and periodontitis were evaluated in individuals who smoke, the subgingival microbiome of smokers with type 2 diabetes had lower diversity, higher levels of gram-negative facultative anaerobes, and lower levels of gram-negative obligate anaerobes.…”

“…Scaling and root planing led to improvement in clinical parameters and a reduction in the pathogenic bacteria in both groups, but the reduction in the type 2 diabetes group was not as significant as that observed in the normoglycemic group. Regarding the findings of Silva‐Boghossian et al, 210 it is worth noting that the patients with type 2 diabetes had more severe periodontitis compared with the normoglycemic individuals. Therefore, based on the data presented above, it appears that periodontitis treatment leads to a less pathogenic bacterial profile; however, the shift is not as prominent in type 2 diabetes and is even less significant in patients with poorer glycemic control.…”

Impact of diabetes on clinical periodontal outcomes following non‐surgical periodontal therapy

“…excluded articles). Twelve studies enrolling 491 participants were finally selected (Camargo et al., ; Cirano et al., ; da Cruz et al., ; Dag, Firat, Arikan, Kadiroglu, & Kaplan, ; Dogan et al., ; Kara, Cifcibasi, Karsidag, & Cintan, ; Kardesler, Buduneli, Cetinkalp, & Kinane, ; Mirnic et al., ; Navarro‐Sanchez, Faria‐Almeida, & Bascones‐Martinez, ; Shen, Yin, & Shu, ; Silva‐Boghossian, Orrico, Goncalves, Correa, & Colombo, ; Wei, Chang, Pan, Yu, & Zhao, ) and fifteen data sets were included in the analyses because three studies had groups of patients with DM at different levels of glycaemic control (Dag et al., ; Kardesler et al., ; Mirnic et al., ).…”

Oral Plaque from Type 2 Diabetic Patients Reduces the Clonogenic Capacity of Dental Pulp-Derived Mesenchymal Stem Cells

“…Accordingly, DPSCs represent the responsible population for periodontal homeostasis, able to actively respond to different damages, by enhancing the repairing process [15]. Notably, periodontal therapy (especially the intensive kind) in diabetic patients in combination with glycaemia control is able to successfully restore a suitable periodontal microenvironment [33, 37, 38], therefore confirming the reversible epigenetic nature of T2D. Thus, it is also plausible that hyperglycaemia consequent to insulin resistance (the hallmark of T2D patients) may represent the key stimulus to change both the composition of the oral plaque and the biological features of DPSCs.…”