RESUMEN
INTRODUCTION: The aim of this study was to assess the relationship between serum glycemic levels and subgingival microbial profile alteration following periodontal treatment in patients with type 2 diabetes mellitus. METHODS: We studied 30 periodontitis patients with type 2 diabetes mellitus who received full-mouth subgingival debridement by analyzing their subgingival microbial profiles using a polymerase chain reaction method at baseline and various time-points for 12 months following treatment. Concurrently, probing pocket depth, bleeding on probing, and metabolic parameters, including glycated hemoglobin A1c (HbA1c), blood sugar level, C-reactive proteins, total cholesterol, triglyceride, and high-density and low-density lipoprotein cholesterol, were recorded. RESULTS: Periodontal conditions were significantly improved after treatment, and the occurrence rates of periodontal bacterial species, including Porphyromonas gingivalis, Tannerella forsythensis, Treponema denticola, and Prevotella intermedia, were also reduced. Interestingly, P. gingivalis was detected more frequently in subjects with increased HbA1c values after periodontal treatment than in those patients with decreased HbA1c values. Furthermore, P. gingivalis with type II fimbriae was detected only in HbA1c-increased subjects, while improvements in HbA1c values were observed only in subjects without type II clones. CONCLUSIONS: These results suggest that glycemic level in diabetes is affected by the persistence of P. gingivalis, especially clones with type II fimbriae, in periodontal pockets.
Asunto(s)
Glucemia/análisis , Diabetes Mellitus Tipo 2/sangre , Periodontitis/terapia , Porphyromonas gingivalis/aislamiento & purificación , Adulto , Anciano , Anciano de 80 o más Años , Aggregatibacter actinomycetemcomitans/aislamiento & purificación , Bacteroides/aislamiento & purificación , Proteína C-Reactiva/análisis , Colesterol/sangre , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Recuento de Colonia Microbiana , Femenino , Fimbrias Bacterianas/clasificación , Estudios de Seguimiento , Hemorragia Gingival/terapia , Hemoglobina Glucada/análisis , Humanos , Masculino , Persona de Mediana Edad , Bolsa Periodontal/terapia , Periodontitis/microbiología , Curetaje Subgingival , Treponema denticola/aislamiento & purificación , Triglicéridos/sangreRESUMEN
A 74-year-old woman with primary Sjögren's syndrome confirmed by salivary gland biopsy presented with parkinsonism. Magnetic resonance imaging (MRI) of the brain revealed multiple small high intensity lesions in the deep white matter, basal ganglia and pons on T2-weighted images. Treatment with L-dopa failed to improve the parkinsonian features. After the initiation of prednisolone 30 mg/day, the parkinsonian signs and symptoms significantly improved. Some lesions on MRI were decreased in size after corticosteroid therapy. These findings suggest that parkinsonism associated with primary Sjögren's syndrome is at least in part attributable to small vessel vasculopathy such as focal inflammation or edema.
