[Periodontal condition and tooth loss in diabetic patients]. / Condición periodontal y pérdida dental en pacientes diabéticos del Hospital Universitario San Vicente de Paúl.

INTRODUCTION: Diabetes is a systemic disease which affects the metabolism of glucose,and it has been associated with the development of periodontal disease. OBJECTIVE: The periodontal condition and tooth loss was evaluated in diabetic subjects. MATERIALS AND METHODS: At the San Vicente de Paúl Hospital (Medellín, Colombia), 117 subjects with type 1 and 2 diabetes mellitus were examined. Patients underwent a comprehensive periodontal evaluation, glycosylated hemoglobin analysis, oral hygiene habits and history of diabetes. A descriptive and comparative analysis between the clinical parameters, tooth loss and type of diabetes was performed. RESULTS: The prevalence of gingivitis was 27.4% and periodontitis 72.6%. The most frequent systemic complication was hypertension (51.3%). The most frequently lost teeth were molars and in general, the subjects had lost an average of 7 teeth and had a poor plaque control (55.4%). No differences were seen in clinical parameters between type 1 and 2 diabetes patients. The mean probing depth was 2.6 mm. The first and second upper and lower molars showed the highest values of PD. The mean clinical attachment loss was 3.3 mm . Maxillary teeth 17, 16, and mandibular 37, 47 showed the highest values of clinical attachment loss. CONCLUSIONS: In conclusion, the periodontal condition in diabetic patients was poor, presenting periodontitis in most cases. This can be a major cause of tooth loss in diabetic subjects and requires special attention by clinicians.

Condición periodontal y pérdida dental en pacientes diabéticos del Hospital Universitario San Vicente de Paúl / Periodontal condition and tooth loss in diabetic patients

Introducción. La diabetes es una enfermedad sistémica que afecta el metabolismo de la glucosa y se ha relacionado con el desarrollo de enfermedad periodontal. Objetivo. El objetivo de este estudio fue determinar la condición periodontal y la pérdida dental de un grupo de pacientes diabéticos del Hospital Universitario San Vicente de Paúl. Materiales y métodos. A 117 sujetos con diabetes de tipo 1 y 2 se les practicó un examen periodontal completo, determinación de valores de la hemoglobina A1C (glycosilated hemoglobin) y radiografías periapicales, y se les indagó sobre hábitos de higiene oral e historia de diabetes. Los datos se analizaron de forma descriptiva y comparativa entre los parámetros clínicos, pérdida dental y tipo de diabetes. Resultados. La prevalencia de gingivitis fue de 27,4 % y la de periodontitis de 72,6 %. La complicación sistémica más frecuente fue la hipertensión arterial (51,3 %). Los dientes más frecuentemente perdidos fueron los molares y, en promedio, los sujetos habían perdido siete dientes. El control de placa bacteriana fue pobre (55,4 %). No hubo diferencias en los parámetros clínicos entre pacientes diabéticos de tipo 1 y de tipo 2. El promedio de profundidad con sonda fue 2,62 mm, siendo los molares los dientes más afectados. El promedio de pérdida de inserción fue de 3,03 mm. Los dientes 17, 16, 27, 37 y 47 presentaron los valores más altos de pérdida de inserción. Conclusiones. En conclusión, la condición periodontal en pacientes diabéticos fue mala, y presentaban periodontitis en la mayoría de los casos. Esto puede ser una causa importante de pérdida dental en sujetos diabéticos y requiere de especial atención por parte de los odontólogos y médicos.

Introduction. Diabetes is a systemic disease which affects the metabolism of glucose,and it has been associated with the development of periodontal disease. Objective. The periodontal condition and tooth loss was evaluated in diabetic subjects. Materials and methods. At the San Vicente de Paúl Hospital (Medellín, Colombia), 117 subjects with type 1 and 2 diabetes mellitus were examined. Patients underwent a comprehensive periodontal evaluation, glycosylated hemoglobin analysis, oral hygiene habits and history of diabetes. A descriptive and comparative analysis between the clinical parameters, tooth loss and type of diabetes was performed. Results. The prevalence of gingivitis was 27.4% and periodontitis 72.6%. The most frequent systemic complication was hypertension (51.3%). The most frequently lost teeth were molars and in general, the subjects had lost an average of 7 teeth and had a poor plaque control (55.4%). No differences were seen in clinical parameters between type 1 and 2 diabetes patients. The mean probing depth was 2.6 mm. The first and second upper and lower molars showed the highest values of PD. The mean clinical attachment loss was 3.3 mm . Maxillary teeth 17, 16, and mandibular 37, 47 showed the highest values of clinical attachment loss. Conclusions. In conclusion, the periodontal condition in diabetic patients was poor, presenting periodontitis in most cases. This can be a major cause of tooth loss in diabetic subjects and requires special attention by clinicians.

Tooth and periodontal clinical attachment loss are associated with hyperglycemia in patients with diabetes.

BACKGROUND: Periodontal disease has been associated with diabetes, but there is still controversy on the relationship between periodontal clinical parameters and glycemic control. The purpose of this study is to assess the relationship between blood glucose levels and clinical parameters of periodontal disease in individuals with diabetes. METHODS: A total of 65 individuals with diabetes and 81 individuals without diabetes were included in the study. A full-mouth periodontal examination and preprandial fasting glycemia values were recorded for each individual. Glycosylated hemoglobin was only measured in patients with diabetes. A comparative analysis between groups (Mann-Whitney U test) and a correlation analysis between glycemia and periodontal parameters were performed (Spearman test). RESULTS: Patients without diabetes presented more teeth than individuals with diabetes (P <0.05). Patients with diabetes with periodontitis displayed loss of periodontal clinical attachment compared to patients without diabetes, but the highest value was observed in patients with periodontitis that reported a smoking habit. Furthermore, patients with diabetes with periodontitis presented higher glycemia and glycated hemoglobin values in contrast to patients with gingivitis. Patients with diabetes with hyperglycemia had a higher risk to develop periodontitis (odds ratio = 2.24; 95% confidence interval = 1.02 to 4.93). A positive correlation was observed between glycemia and clinical attachment loss (AL), whereas a negative correlation between glycemia and the number of teeth present was found (P <0.05). CONCLUSIONS: Tooth and periodontal AL were increased by hyperglycemia in individuals with diabetes. This study contributes additional evidence that diabetes could aggravate periodontal disease and affect the systemic health of individuals.