The effect of type 2 diabetes mellitus and smoking on periodontal parameters and salivary matrix metalloproteinase-8 levels

Abstract

The present study was carried out to evaluate the effect of type 2 diabetes mellitus (DM) and smoking on periodontal parameters and on the levels of salivary matrix metalloproteinase (MMP-8). One hundred and twenty five subjects were divided into five groups: group 1, systemically and periodontally healthy subjects (n = 25); group 2, systemically healthy subjects but with chronic periodontitis (n = 25); group 3, subjects with type 2 DM and chronic periodontitis (n = 25); group 4, smokers with chronic periodontitis (n = 25); group 5, diabetic-smokers with chronic periodontitis (n = 25). MMP-8 level in saliva was estimated by enzyme linked immunosorbent assay (ELISA) using Quantikine human total MMP-8 immunoassay kit. The result showed that the clinical periodontal parameters and the mean levels of the salivary MMP-8 were significantly higher for diabetic-smokers than other study groups. A highly significant positive correlation (r) between MMP-8 and periodontal parameters was also observed in diabetic-smoker patients. The findings suggest that diabetic-smokers have increased periodontal breakdown and are associated with an increased extent and severity of periodontitis. (J Oral Sci 58, 1-6, 2016)

Periodontal Disease in Diabetes Mellitus: A Case–Control Study in Smokers and Non-Smokers

“…How this effect is realized goes beyond the scope of this study, but it is safe to assume that the process has both microvascular and immunological components, and it is probably the meeting of these different pathogenic pathways that gives rise to the observed massive deterioration. Some studies have addressed the issue of the effect of smoking and DM on periodontal health [ 50 – 52 ], but none of these concentrated explicitly on the interaction of the two factors. Our results are new in this respect and demonstrate another way in which smoking can do further damage to the health of patients with DM.…”

“…An obvious weakness of that study was that only patients with PD were enrolled in the study and, consequently, no comparison was made with healthy controls [ 49 ]. Gupta and colleagues investigated the relationship between T2D and smoking in patients with PD and observed that the periodontal status of these patients with PD was significantly worse in the group of smokers with DM than in the group of non-smokers with T2D [ 50 ]. Obrak and co-workers found that the periodontal status of non-smokers with T2D with and PD was better than that of their smoking counterparts [ 51 ], while Javed and co-workers found that both DM and smoking had a detrimental effect on the periodontal status of patients [ 52 ].…”

Periodontal complications of hyperglycemia/diabetes mellitus: Epidemiologic complexity and clinical challenge

“…35 Uncontrolled diabetes influences the expression of tissue-degrading enzymes in the inflamed gingiva, leading to up-regulation of the ratio between metalloproteinase and their inhibitors. 36,37 A two-way association or interaction between diabetes and periodontitis has been postulated, assuming that either condition interferes with the other. A somewhat different view may postulate the interaction as a type of vicious circle, as exemplified in Figure 2.…”

Periodontal Considerations in Adult Orthodontic Patients

“…Additionally, immune response is modified and the pathogenesis of the disease is negatively affected [8]. A similar pattern is present in patients affected by type 2 diabetes mellitus suggesting that diabetic-smoker patients have increased periodontal breakdown and are prone to a more severe periodontitis [9].…”