ABSTRACT
OBJECTIVES: To evaluate the effects of systemic doxycycline on clinical and microbiological parameters of diabetic subjects with chronic periodontitis. METHODS: This 9-month multi-center, randomized, parallel, single-blinded study was conducted from different hospitals in Riyadh, Saudi Arabia between April 2010 and December 2010. A total of 76 diabetic subjects with chronic periodontitis were randomized into 2 groups: control group (CG) received only scaling and root planing (SRP), and the treatment group (TG) receiving systemic doxycycline during the reevaluation visit 45 days after the completion of SRP. Probing pocket depth, clinical attachment level, gingival index, plaque index, and bleeding on probing were collected at baseline, 45 days after SRP, and one, 3, and 6 months after the use of systemic doxycycline. Microbiological analysis comprised the detection of Tannerella forsythia (Tf), Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Prevotella intermedia (Pi) by polymerase chain reaction method. RESULTS: Sixty-eight (33 CG and 35 TG) subjects completed the study. Greater reduction in the population of Tf, Pg, and Pi were observed in TG compared with CG in the first month after the administration of systemic doxycycline. The TG showed a significant improvement in gingival index scores compared with the CG (p<0.05) by the end of the first and 6 months after the administration of doxycycline. CONCLUSION: Adjunct systemic doxycycline can be associated with a reduction of Tf, Pg, and Pi in the first month after the administration of doxycycline with an improvement in the GI.
Subject(s)
Anti-Bacterial Agents/therapeutic use , Bacteroidaceae Infections/therapy , Chronic Periodontitis/therapy , DNA, Bacterial/analysis , Diabetes Mellitus, Type 2/complications , Doxycycline/therapeutic use , Pasteurellaceae Infections/therapy , Root Planing/methods , Adult , Aggregatibacter actinomycetemcomitans/genetics , Aggregatibacter actinomycetemcomitans/isolation & purification , Bacteroidaceae Infections/complications , Bacteroidetes/genetics , Bacteroidetes/isolation & purification , Chronic Periodontitis/complications , Dental Scaling/methods , Female , Humans , Male , Middle Aged , Pasteurellaceae Infections/complications , Periodontal Index , Porphyromonas gingivalis/genetics , Porphyromonas gingivalis/isolation & purification , Prevotella intermedia/genetics , Prevotella intermedia/isolation & purification , Single-Blind Method , Treatment OutcomeABSTRACT
OBJECTIVES: The purpose of this study was to determine the prevalence of Candida spp. in periodontitis patients with type 2 diabetes mellitus. METHODS: This cross-sectional study included 42 diabetic patients with periodontitis (aged 21-70 years; 18 males and 24 females). Clinical measurements included probing pocket depth (PPD), clinical attachment level (CAL) and hemoglobin A1c (HbA1c) levels. Sub-gingival samples were collected from the mesio-buccal aspect of 3 teeth for fungal analysis. Candida species, including Candida albicans, Candida dubliniensis, Candida tropicalis and Candida glabrata, were identified using Gram staining, the germ tube test, CHROMagar, Staib agar and API 20C AUX. RESULTS: The overall prevalence of Candida in diabetic patients with periodontitis observed in our study was 52%. The most common spp. of Candida identified were C. albicans (38%), followed by C. dubliniensis (9.5%), C. tropicalis (4.7%) and C. glabrata (4.7%). Compared to females, male patients were characterized by increased levels of Candida infections. Our results also indicate that individuals over the age of 40 had increased levels of Candida infections compared to patients younger than 40. Candida infections were higher among subjects with elevated blood sugar levels (HbA1c>9) compared to individuals with well-controlled blood sugar levels (HbA1c<6). Patients with PPDs≥5 had an increased risk of Candida infection compared to patients with PPDs between 3 and 4. CONCLUSION: This study indicates that the frequency of C. albicans is higher than the frequencies of C. dubliniensis, C. tropicalis and C. glabrata in diabetic patients with periodontitis. Candida infections were observed at increased frequencies among subjects with high blood sugar levels and PPDs≥5.
Subject(s)
Candida/isolation & purification , Candidiasis, Oral/epidemiology , Diabetes Mellitus, Type 2/complications , Periodontitis/complications , Adult , Aged , Candida/classification , Cross-Sectional Studies , Female , Glycated Hemoglobin/analysis , Humans , Male , Middle Aged , Periodontal Pocket/pathology , Prevalence , Young AdultABSTRACT
OBJECTIVE: To determine and analyze the frequency of periodontopathogens in microbiological monitoring of diabetic patients with periodontitis. METHODS: This cross-sectional study included 352 diabetic patients with periodontitis who were registered at Riyadh Armed Forces Hospital, King Faisal Specialist Hospital and Research Centre, King Abdul Aziz Medical City, Naval Base Hospital, and Sultan Bin Adulaziz Humanitarian City, Riyadh, Kingdom of Saudi Arabia from July 2004 to August 2008. Microbiological analysis comprised the detection of Bacteroides forsythus (Bf), Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and Prevotella intermedia (Pi) by polymerase chain reaction method. RESULTS: The mean age of patients was 54.4 +/- 0.67 (range: 21-80 years). There were 214 (61%) males and 138 (39%) females. Among the study population, 36 (10%) had type 1, and 316 (90%) patients had type 2 diabetes. The results showed that 55.6% of patients had Bf, 51.7% had Aa, 63.7% had Pg, and 6.1% had Pi. The frequencies of periodontopathogens were higher in males than females in all age groups. The risk of periodontopathogens Bf were found higher level in 41-50 age group, Aa in 51-60, Pg in 51-60, and Pi in 31-40 age groups. CONCLUSION: This study found that the frequencies of periodontal pathogens Bf, Aa, and Pg were higher than Pi in diabetic patients with periodontitis.