Type 1 diabetes and periodontitis: prevalence and periodontal destruction—a systematic review

Dicembrini, Ilaria; Serni, Lapo; Monami, Matteo; Caliri, Mariasmeralda; Barbato, Luigi; Cairo, Francesco; Mannucci, Edoardo

doi:10.1007/s00592-020-01531-7

Cited by 38 publications

(37 citation statements)

References 42 publications

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“…Conversely, no significant association of either mean PPD or mean CAL was observed with HbA1c. Although this latter result may seem at variance with prior cross-sectional studies [4], it may be argued that the mean and the variance of HbA1c in the present sample were relatively low, possibly attenuating existing correlations.…”

Section: Discussioncontrasting

confidence: 88%

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Glucose variability and periodontal disease in type 1 diabetes: a cross-sectional study—The “PAROdontopatia e DIAbete” (PARODIA) project

et al. 2021

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Aims Periodontal disease (PD) is a chronic inflammation of periodontal tissue associated with infection from specific anaerobic pathogens contained in dental plaque. Both type 1 and type 2 diabetes are associated with an increased prevalence of PDs. A two-way relationship between diabetes and periodontitis has been proposed, with diabetes increasing the risk for periodontitis, and periodontal inflammation negatively affecting glycaemic control. To date, the relationship between PD and glucose variability in type 1 diabetes has not been evaluated. To investigate the prevalence of PD in patients with type 1 diabetes and its association with glycemic control and glucose variability. Methods In this cross-sectional study, all enrolled patients were scheduled to attend both a diabetologic and a periodontal visit. HbA1c, glucose coefficient of variation (CV), loss of clinical attachment (CAL), and periodontal probing depth (PPD) were collected. Results 136 patients were included in the analysis. The prevalence of PD was 63%. A significant correlation was found between mean CAL and glucose CV (r = 0.31, p = 0.002), but not with HbA1c. Mean PPD was also associated with glucose CV (r = 0.27 and 0.044), but not with HbA1c. In a multiple linear regression model, with mean CAL as dependent variable, age, glucose CV, and smoking habit resulted significantly associated (r = 0.23, p = 0.013; r = 0.33, p = 0.001; r = 0.34, p < 0.001, respectively). Assuming mean PPD as dependent variable, multiple linear regression analysis showed a significant association with glucose CV and smoking habits only. Conclusions PD is associated with glucose variability in patients with type 1 diabetes also after adjusting for the main confounders.

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Section: Discussioncontrasting

confidence: 88%

“…The prevalence of PD in this study was higher than that reported in recently published meta-analysis of crosssectional studies [4]. This difference could be due, at least partly, to differences in assessment methods, diagnostic, and classification criteria.…”

Section: Discussioncontrasting

confidence: 87%

Glucose variability and periodontal disease in type 1 diabetes: a cross-sectional study—The “PAROdontopatia e DIAbete” (PARODIA) project

et al. 2021

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“…The pathogenesis of both diabetes and periodontitis is influenced by genetic factors and epigenetic processes 27 , 28 . Patients with diabetes show increased prevalence and severity of periodontitis 29 , 30 . Although diabetes is associated with important epigenetic changes, the exact changes implicated in the susceptibility to periodontitis remain unknown.…”

Section: Discussionmentioning

confidence: 99%

Epigenetic changes caused by diabetes and their potential role in the development of periodontitis

Xie

et al. 2021

J of Diabetes Invest

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Aims/Introduction Periodontal disease, a chronic inflammation induced by bacteria, is closely linked with diabetes mellitus. Many complications associated with diabetes are related to epigenetic changes. However, the exact epigenetic changes whereby diabetes affects periodontal disease remain largely unknown. Thus, we sought to investigate the role of diabetes‐dependent epigenetic changes of gingival tissue in the susceptibility to periodontal disease. Materials and Methods We studied the effect of streptozotocin‐induced diabetes in minipigs on gingival morphological and epigenetic tissue changes. Accordingly, we randomly divided six minipigs into two groups: streptozotocin‐induced diabetes group, n = 3; and non‐diabetes healthy control group, n = 3. After 85 days, all animals were killed, and gingival tissue was collected for histology, deoxyribonucleic acid methylation analysis and immunohistochemistry. Results A diabetes mellitus model was successfully created, as evidenced by significantly increased blood glucose levels, reduction of pancreatic insulin‐producing β‐cells and histopathological changes in the kidneys. The gingival tissues in the diabetes group presented acanthosis of both gingival squamous epithelium and sulcular/junctional epithelium, and a significant reduction in the number and length of rete pegs. Deoxyribonucleic acid methylation analysis showed a total of 1,163 affected genes, of which 599 and 564 were significantly hypermethylated and hypomethylated, respectively. Immunohistochemistry staining showed that the hypomethylated genes – tumor necrosis factor‐α and interleukin‐6 – were positively expressed under the junctional epithelium area in the diabetes group. Conclusions Diabetes mellitus induces morphological and epigenetic changes in periodontal tissue, which might contribute to the increased susceptibility of periodontal diseases in patients with diabetes.

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“…Recently, a systematic review concluded that T1D is an important risk factor for periodontitis and that the severity of periodontitis seems to vary widely between patients with optimal (HbA1c ≤7%) and suboptimal (HbA1c >7%) glycaemic control (Dicembrini et al, 2020). As proposed by Jindal et al (Jindal, Singh Parihar, Sood, Singh, & Singh, 2015), we chose a cut‐off value of 8 for the levels of HbA1c in order to assess whether a “fair” or poor glycemic control is related to the biomarkers' levels.…”

Section: Discussionmentioning

confidence: 99%

“…Less studies have examined interactions between T1D and periodontal health, yet a recent systematic review found a prevalence of periodontitis in T1D patients to be 18.5% (Dicembrini et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Gingival crevicular fluid biomarkers in type 1 diabetes mellitus: A case–control study

Sereti

Roy

Zekeridou

et al. 2020

Clinical & Exp Dental Res

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Objective The aim of the study is to compare the levels of Gingival Crevicular Fluid (GCF) interleukin 8 (IL‐8), matrix metalloproteinase 8 (MMP‐8) and advanced glycated‐end products (AGEs) in a cohort of type 1 diabetic (T1D) subjects and healthy controls. Material and methods GCF samples and periodontal examination were assessed in 50 subjects with T1D (30 males and 20 females; mean age: 35.2 years) recruited from the Diabetology Unit of the Geneva University Hospitals and in 50 control subjects matched for gender, age and smoking status. Samples were assessed for IL‐8 and MMP‐8 using a bead array multianalyte detection system and for AGEs the ELISA. The two groups were compared using the Wilcoxon signed rank test. Results The mean HbA1c differed significantly between the groups (8.3% for the T1D group vs. 5.2% for the control group, p < 0.001). T1D subjects had significantly more plaque and gingival inflammation and presented more sites with bleeding on probing compared to the controls. The GCF levels of IL‐8, MMP‐8 and AGEs did not differ significantly between the groups. Further analysis of the GCF markers in younger (<40 years) and older (≥40 years) cohorts, revealed no significant differences between younger diabetics and controls or between older diabetics and controls. When the groups were divided according to their glycemic status (HbA1c 6.1–8, and > 8%), again no significant differences could be identified for any of the biochemical markers. Conclusions T1D subjects, particularly the younger ones, exhibited more inflammation compared to the matched healthy controls. Results on the GCF expression of IL‐8, MMP‐8 and AGEs did not differ between the groups. The diabetic population of our cohort was for the most part fairly‐controlled, with little if any complications and with presence of only mild type of periodontal disease, as 68% had gingivitis.

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Type 1 diabetes and periodontitis: prevalence and periodontal destruction—a systematic review

Cited by 38 publications

References 42 publications

Glucose variability and periodontal disease in type 1 diabetes: a cross-sectional study—The “PAROdontopatia e DIAbete” (PARODIA) project

Glucose variability and periodontal disease in type 1 diabetes: a cross-sectional study—The “PAROdontopatia e DIAbete” (PARODIA) project

Epigenetic changes caused by diabetes and their potential role in the development of periodontitis

Gingival crevicular fluid biomarkers in type 1 diabetes mellitus: A case–control study

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