The Ultrastructure of Capillary Basement Membranes in the Attached Gingiva of Diabetic and Nondiabetic Patients with Periodontal Disease

Frantzis, Theodosios G.; Reeve, Charles M.; Brown, Arnold L.

doi:10.1902/jop.1971.42.7.406

Cited by 91 publications

(84 citation statements)

References 7 publications

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“…Considering the well-known oral manifestations of diabetes (11)(12)(13)(14)(15)(16), both the inflammatory processes (gingivitis, periodontitis) and the atrophic lesions (chronic cheilitis and glossitis) are possible precursors of malignant epithelial transformation. However, the epidemiological relationship between these two important diseases has not been studied until now.…”

Section: Diabetes Screening Of Oral Cancer Patientsmentioning

confidence: 99%

Diabetes and Oral Tumors in Hungary

et al. 2004

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OBJECTIVE -Numerous publications have already demonstrated that diabetes is a risk factor for the development of periodontal diseases and various inflammatory lesions in the oral mucosa. A possible correlation between diabetes and oral premalignancies and tumors was examined in this study, as no literature data are available concerning this problem.RESEARCH DESIGN AND METHODS -Stomato-oncological screening was carried out on 200 diabetic patients in the medical departments; the control group included 280 adult dentistry outpatients. The lesions found were classified into three groups: inflammatory lesions, benign tumors, and precancerous lesions. A retrospective diabetes screening of 610 inpatients with histologically confirmed oral malignancies was also performed. The control group comprised 574 complaint-and tumor-free adults. Fasting blood glucose levels were determined in both groups, and the tumor location was registered in the cancer patients.RESULTS -Benign tumors were found in 14.5% and precancerous lesions in 8% of diabetic patients. In the control group these values were significantly lower, at 6.4 and 3.2%, respectively (P Ͼ 0.01). Earlier Hungarian screening studies indicated similar frequency of these lesions in the general population. The proportion of oral cavity lesions was higher among diabetic patients compared with that of the control patients. In the oral cancer patient group, diabetes was present in 14.6% and an elevated blood glucose level in 9.7%. These values are significantly higher than those for the tumor-free control group (P Ͻ 0.01). The gingival and labial tumor location was significantly more frequent among diabetic cancer patients than in the nondiabetic group (P Ͻ 0.01). The combination of diabetes and smoking means a higher risk for oral precancerous lesions and malignancies.CONCLUSIONS -Diabetes may be a risk factor for oral premalignancies and tumors. Diabetes Care 27:770 -774, 2004C orrelations between diabetes and inflammatory oral lesions were first published in the 19th century (1). Gingivitis and destructive periodontitis with a rapid loss of the teeth were described as cardinal, pathognomic symptoms of diabetes (2,3).The discovery of insulin treatment justified a close correlation between the disorder of the carbohydrate metabolism and oral inflammatory complications (4). The adequate treatment of diabetes results in marked improvement of the gingival and periodontal lesions.Diabetes patients have further inflammatory complications of the oral mucosa. The decreased rate of saliva secretion and the low pH value result in chronic cheilitis and glossitis with progressive atrophy of the covering epithelial layer (5).The inflammation-mediated carcinogenesis is a well-known empirical fact, but the exact pathway of this transition has not been perfectly clarified until now (6 -9). Is there any correlation between diabetes and tumor genesis of the oral cavity? Surprisingly, there are no literature data concerning this problem. Accordingly, in the present study, we have attempted...

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Section: Diabetes Screening Of Oral Cancer Patientsmentioning

confidence: 99%

Diabetes and Oral Tumors in Hungary

et al. 2004

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“…Periodontitis is also more prevalent among teenagers and adults with IDDM, and may be associated with some of the often-encountered complications of diabetes, such as retinopathy and nephropathy (Glavind et al, 1968;Cianciola et al, 1982;Rylander et al, 1986). The reasons for the increased periodontal disease risk among patients with diabetes remain unclear; some but not all investigators have found differences in pathologic structure within the gingiva (e.g., capillary basement membranes; Frantzis et al, 1971) or impaired neutrophil function (Fikrig et al, 1977;Manouchehr-Pour etal, 1981).…”

Section: Multifactorial Conditionsmentioning

confidence: 99%

Genetic Influences in Caries and Periodontal Diseases

Hassell

Harris

1995

Critical Reviews in Oral Biology & Medicine

115

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Deciphering the relative roles of heredity and environmental factors ("nature vs. nurture") in the pathogenesis of dental caries and diseases of the periodontium has occupied clinical and basic researchers for decades. Success in the endeavor has come more easily in the case of caries; the complex interactions that occur between host-response mechanisms and putative microbiologic pathogens in periodontal disease have made elucidation of genetic factors in disease susceptibility more difficult. In addition, during the 30-year period between 1958 and 1987, only meager resources were targeted toward the "nature" side of the nature/nurture dipole in periodontology. In this article, we present a brief history of the development of genetic epistemology, then describe the three main research mechanisms by which questions about the hereditary component of diseases in humans can be addressed. A critical discussion of the evidence for a hereditary component in caries susceptibility is next presented, also from a historical perspective. The evolution of knowledge concerning possible genetic ("endogenous", "idiotypic") factors in the pathogenesis of inflammatory periodontal disease is initiated with an analysis of some foreign-language (primarily German) literature that is likely to be unfamiliar to the reader. We identify a turning point at about 1960, when the periodontal research community turned away from genetics in favor of microbiology research. During the past five years, investigators have re-initiated the search for the hereditary component in susceptibility to common adult periodontal disease; this small but growing body of literature is reviewed. Recent applications of in vitro methods for genetic analyses in periodontal research are presented, with an eye toward a future in which persons who are at risk-genetically predisposed-to periodontal disease may be identified and targeted for interventive strategies. Critical is the realization that genes and environment do not act independently of each other; the appearance or magnitude of heritability may differ with various environments.

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“…4 Similar changes in small vessels can be found in the oral tissues. 5,6 Periodontal disease has also been recognized as the sixth complication of diabetes. 7 All of these longterm consequences have been widely analysed in recent years, leading to improvements in prevention and therapy, thus giving patients with diabetes a better quality of life.…”

Section: Introductionmentioning

confidence: 99%

The Influence of Smoking and Non-Insulin-Dependent Diabetes Mellitus on Periodontal Disease

et al. 2002

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The periodontal health of smokers and non-smokers with non-insulin-dependent diabetes mellitus (NIDDM) and non-smokers with periodontitis who were not suffering from a systemic disease was assessed. The investigation was carried out on 60 adult subjects. Levels of blood glucose, glycosylated haemoglobin and immunoglobulins G, A and M were determined, together with the plaque index, gingival index, probing pocket depths and clinical attachment level. Periodontitis was more severe in smokers and non-smokers with NIDDM than non-smokers without NIDDM, and the periodontal condition (clinical attachment level, probing pocket depth and gingival bleeding) was better in non-smokers with NIDDM than smokers with NIDDM. The results suggest that diabetes and smoking are high-risk factors for periodontal disease.

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The Ultrastructure of Capillary Basement Membranes in the Attached Gingiva of Diabetic and Nondiabetic Patients with Periodontal Disease

Cited by 91 publications

References 7 publications

Diabetes and Oral Tumors in Hungary

Diabetes and Oral Tumors in Hungary

Genetic Influences in Caries and Periodontal Diseases

The Influence of Smoking and Non-Insulin-Dependent Diabetes Mellitus on Periodontal Disease

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