Polymorphisms in risk genes of type 2 diabetes mellitus could be also markers of susceptibility to periodontitis.

OBJECTIVES: This study aimed to investigate polymorphisms in genes considered molecular biomarkers of type 2 diabetes mellitus (T2DM) to assess whether they are associated with periodontitis, and relating them to the periodontal status, glycemic and lipid profile of the subjects. DESIGN: We investigated individuals who underwent complete periodontal examination and biochemical evaluation. We categorized them into three groups: (i) periodontitis with T2DM (Periodontitis+T2DM group, n = 206); (ii) periodontitis without T2DM (Periodontitis group, n = 346); and (iii) healthy individuals without Periodontitis or T2DM (Healthy group, n = 345). We investigated three single nucleotide polymorphisms (SNPs) for AGER, RBMS1 and VEGFA genes. We applied multivariate logistic and multiple linear regression models for all groups and stratified the subjects by sex and smoking habits. RESULTS: Compared with RBMS1-rs7593730-CC+CT genotype carriers, RBMS1-rs7593730-TT carriers were more susceptible to periodontitis [odds ratio (OR) = 2.29; 95% confidence interval (CI) = 1.04-5.01; P-value = 0.033]. Among AGER-rs184003-CC carriers, never smokers had reduced risks of periodontitis and Periodontitis+T2DM than ever smokers. For either RBMS1-rs7593730-CC or VEGFA-rs9472138-CC carriers, never smokers had less susceptibility to develop periodontitis than ever smokers. Compared with AGER-rs184003-CC carriers, AGER-rs184003-AA carriers presented fewer remaining teeth. VEGFA-rs9472138-TT carriers showed a lower percentage of sites with characteristics of active periodontal disease (bleeding on pocket probing and interproximal clinical attachment level) compared with VEGFA-rs9472138-CC carriers. CONCLUSIONS: In the studied population, AGER rs184003, RBMS1 rs7593730, and VEGFA rs9472138, which are considered genetic markers for T2DM, were associated with periodontitis without T2DM or periodontitis together with T2DM.

Polymorphisms and haplotypes in the Interleukin 17 Alfa gene: potential effect of smoking habits in the association with periodontitis and type 2 diabetes mellitus.

Few studies evaluate interrelationships between periodontitis (P) and Type 2 Diabetes Mellitus (T2DM). The aim of this study is to investigate the genetic susceptibility to periodontitis alone, or concomitant with T2DM (as comorbidities), analyzing single nucleotide polymorphisms (SNPs) in the Interleukin 17 alpha (IL17A) gene, considering the biochemical profile and smoking habits on the subjects' periodontal status. We investigated 879 individuals divided into: T2DM subjects also affected by severe or moderate periodontitis (T2DM-P, n = 199); non-diabetics with severe or moderate periodontitis (PERIODONTITIS, n = 342); and healthy subjects (HEALTHY, n = 338). Subjects underwent complete periodontal examination, history of smoking habits, glycemic and lipid biochemical evaluation. DNA from buccal cells was utilized to genotype the SNPs rs2275913, rs3819024 and rs10484879. The impact of the subjects' biochemical profile was analyzed in their periodontal status. Each SNP was analyzed independently, and as haplotypes, by multiple logistic regressions, adjusted for covariates, and also stratifying the groups by age, sex and smoking habits. Independently of the periodontitis degree, poorly-controlled T2DM subjects showed worse glycemic and lipid profile. Multiple logistic regressions demonstrated that smokers and former-smokers carrying the GG genotype of rs3819024 seemed to have higher risk for T2DM-Periodontitis (OR = 6.33; 95% CI = 1.26-31.77, p = 0.02), and mainly for T2DM alone (OR = 5.11; 95% CI = 1.37-19.06, p = 0.01), than never smokers. We found the potential effect of smoking habits in the association of IL17A-rs3819024-GG with diseased phenotypes. Because the observed wide confidence intervals, further studies enrolling larger populations, and SNPs' functional evaluations are needed to better understand our findings.

Tratamento da recessão gengival pelo posicionamento coronal do retalho associado ao enxerto de tecido conjuntivo / Coronally advanced flap in association with connective tissue graft in the treatment of gingival recession

A recessão gengival (RG) é a migração apical da gengiva com exposição da superfície radicular. Sua presença e extensão aumentam com a idade e ocorrem em grande parte da população. A etiologia é multifatorial e alguns fatores predisponentes têm sido propostos, como higienização deficiente, deiscência óssea, biotipo gengival fino, inserção alterada de freio, posicionamento dentário e trauma por escovação. Suas principais consequências são exposição da raiz ao meio oral, com sequelas a nível estético e também funcional. Alguns tipos de procedimentos cirúrgicos podem ser realizados para tratar a RG. O objetivo deste trabalho é relatar a técnica de recobrimento com retalho posicionado coronalmente em associação com enxerto de tecido conjuntivo (ETC). Paciente AM, 32 anos, sem alterações sistêmicas e sem perda óssea interproximal, apresentava recessão gengival em uma área com histórico de cisto periodontal lateral. A recessão foi classificada como 1- de acordo com a nova classificação das doenças periodontais. Foi realizado o recobrimento das recessões gengivais dos dentes 11 e 12 pela técnica do retalho posicionado coronalmente em associação com ETC. A adição do ETC é relatada na literatura como um importante fator para obter um tecido mais espesso e resultado mais eficaz em médio e longo prazo quando comparado apenas ao posicionamento coronal do retalho. A técnica proposta foi capaz de tratar a alteração estética presente, recobrir a área radicular exposta e transformar o biotipo gengival em espesso para a aumentar a previsibilidade e longevidade do procedimento (AU).

Gingival recession (GR) is the apical migration of the gingiva with exposure of the root surface. Its presence and extent increase with age and occurs in most part of the population. The etiology is multifactorial and some predisposing factors have been proposed, such as deficient hygiene, bone dehiscence, thin gingival biotype, altered frenulum insertion, dental positioning, and toothbrushing trauma. Its main consequences are exposure of the root in the oral environment, with aesthetic and functional effects. Some types of surgical procedures can be performed to treat the GR. The aim of this study is to report the treatment of gingival reces-sions with coronally advanced flap in association with connective tissue graft (CTG). Patient AM, 32 years old, without systemic alterations and without interproximal bone loss, presented a gingival recession in an area with a history of a lateral periodontal cyst. The recession was classified as 1- according to the new classification of the periodontal diseases. The coverage of the recessions of teeth 11 and 12 was performed by coronally advanced flap in association with CTG. The addition of CTG is reported on the literature as an important factor to obtain a thicker tissue and obtain a more effective result in the medium and long term when compared only to the coronal placement of the flap. The proposed technique was able to treat the aesthetic alteration, to cover the exposed root area and to transform the gingival biotype into thick to increase the predictability and longevity of the procedure (AU).