RESUMO
BACKGROUND: The underlying mechanisms for increased osteopenia and fracture rates in patients with diabetes are not well understood, but may relate to chronic systemic inflammation. We assessed the effect of treating periodontal disease (POD), a cause of chronic inflammation, on inflammatory and bone turnover markers in patients with diabetes. MATERIALS AND METHODS: Using an investigator-administered questionnaire, we screened a cross-section of patients presenting for routine outpatient diabetes care. We recruited 22 subjects with POD. Inflammatory and bone turnover markers were measured at baseline and 3 months following POD treatment (scaling, root planing and subantimicrobial dose doxycycline). RESULTS: There were nonsignificant reductions in high-sensitivity C-reactive protein (6.34-5.52mg/L, P = 0.626) and tumor necrosis factor-alpha (10.37-10.01pg/mL, P = 0.617). There were nonsignificant increases in urinary C-terminal telopeptide (85.50-90.23pg/mL, P = 0.684) and bone-specific alkaline phosphatase (7.45-8.79pg/mL, P = 0.074). Patients with >90% adherence with doxycycline were 6.4 times more likely to experience reduction in tumor necrosis factor-alpha (P = 0.021) and 2.8 times more likely to experience reductions in high-sensitivity C-reactive protein (P = 0.133). CONCLUSIONS: Treatment of POD in patients with diabetes resulted in nonsignificant lowering of inflammatory markers and nonsignificant increase in bone turnover markers. However, adherence to doxycycline therapy resulted in better treatment effects.
Assuntos
Antibacterianos/uso terapêutico , Diabetes Mellitus Tipo 1/metabolismo , Diabetes Mellitus Tipo 2/metabolismo , Doxiciclina/uso terapêutico , Doenças Periodontais/terapia , Aplainamento Radicular/métodos , Adulto , Idoso , Fosfatase Alcalina/sangue , Proteína C-Reativa/metabolismo , Colágeno Tipo I/urina , Raspagem Dentária/métodos , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 2/complicações , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Masculino , Pessoa de Meia-Idade , Peptídeos/urina , Doenças Periodontais/complicações , Doenças Periodontais/metabolismo , Projetos Piloto , Resultado do Tratamento , Fator de Necrose Tumoral alfa/sangueAssuntos
Alérgenos/imunologia , Antígenos de Plantas/imunologia , Arecaceae/imunologia , Proteínas de Ligação ao Cálcio/imunologia , Espécies Introduzidas , Profilinas/imunologia , Adolescente , Adulto , Idoso , Alérgenos/efeitos adversos , Antígenos de Plantas/efeitos adversos , Proteínas de Ligação ao Cálcio/efeitos adversos , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Profilinas/efeitos adversos , Rinite Alérgica/imunologia , Testes Cutâneos , Adulto JovemRESUMO
AIMS: There is a high prevalence of dental loss among patients with diabetes. Understanding the factors that impact dental loss in this population will aid with developing new strategies for its prevention. METHODS: Using a cross-sectional study design, diabetes patients presenting for routine clinic visit were evaluated with an investigator-administered questionnaire. Data was collected on demographics, dental history, duration, control and complications of diabetes. RESULTS: Among 202 subjects, 100 were female, mean age: 58.9 ± 13.2 years, duration of diabetes: 15.8 ± 11.0 years, and hemoglobin A1c: 7.7 ± 1.6%. Thirty-one patients (15.3%) had lost all their teeth and only 13 (6.4%) had all 32 of their natural teeth. Using multiple linear regression, older age (ß= - 0.146; 95% CI: - 0.062 to - 0.230), not flossing (ß= - 3.462; 95% CI: - 1.107 to - 5.817), and presence of diabetic retinopathy (ß= - 4.271; 95% CI: - 1.307 to - 7.236) were significant predictors of dental loss. CONCLUSIONS: Dental loss is common in patients with diabetes and is associated with older age, diabetic retinopathy and not flossing. In order to reduce dental loss among patients with diabetes, regular flossing should be emphasized as an important component of dental care.
