Short-term comparison between clinical and microbial profiles in diabetic and non-diabetic patients with chronic periodontitis after non-surgical periodontal therapy
DOI:
https://doi.org/10.33448/rsd-v11i4.27270Keywords:
Periodontitis; Periodontal disease; Candida; Glycemic control; Type 2 diabetes mellitus.Abstract
Aim: To compare clinical and microbial profiles in type 2 diabetic (DM) and non-diabetic (NDM) patients with chronic periodontitis after non-surgical periodontal therapy. Methods: 30 subjects with periodontitis were separated into two groups: 15 DM and 15 NDM. Blood parameters and clinical parameters were assessed. Subgingival biofilm samples were collected from periodontal pockets (PD > 5mm) and ckecked by the presence of Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Prevotella intermedia (Pi), Campylobacter rectus (Cr), Candida albicans (Ca), Candida glabrata (Cg), Candida tropicalis (Ct), Candida dublinienses (Cd) by Polymerase Chain Reaction. Data were statistically analyzed, considering p < 0.05. Results: PI, PD, and CAL significantly reduced after 3 months of periodontal therapy in both groups. Only levels of HbA1c reduced in the DM group after 3 months. Comparisons between baseline and 3 months after periodontal therapy revealed a reduction of Aa, Pg, Tf, Pi, Ct and Cd for the NDM group and Aa, Pg, Tf, and Ca for the DM group. Conclusions: The periodontal therapy was effective in reducing clinical parameters and microbial levels, regardless the presence of the diabetes mellitus. However, high levels of Candida ssp. remained in periodontal pockets of diabetic patients even after therapy.
References
Acharya, A., Thakur, S., Muddapur, M., & Kulkarni, R. (2018). Systemic cytokines in type 2 diabetes mellitus and chronic periodontitis. Curr Diabetes Rev, 14: 182–188. 10.2174/1573399812666161220144011.
Al Mubarak, S., Robert, A. A., Baskaradoss, J. K., Al-Zoman, K., Al Sohail, A., Alsuwyed, A. et al (2013). The prevalence of oral Candida infections in periodontitis patients with type 2 diabetes mellitus. J Infect Public Health, 6(4): 296-301. 10.1016/j.jiph.2012.12.007.
American Diabetes Association (1997). Reported of the Expert Committee on Diagnosis and Classification of Diabetes Mellitus. Diabetes Care, 20:1183-1197.
American Diabetes Association (2006). Position Statement. Diagnosis and Classification of diabetes Mellitus. Diabetes Care, 29 Suppl 1:S43-48.
American Diabetes Association (2014). Standards of medical care in diabetes-2014. Diabetes Care, 37 Suppl 1:S14-80. 10.2337/dc14-S014.
Bastos, M. F., Tucci, M. A., de Siqueira, A., de Faveri, M., Figueiredo, L. C., Vallim, P. C. et al (2017). Diabetes may affect the expression of matrix metalloproteinases and their inhibitors more than smoking in chronic periodontitis. J Periodontal Res, 52(2): 292-299. 10.1111/jre.12394.
Campus, G., Salem, A., Uzzau, S., Baldoni, E., & Tonolo, G. (2005). Diabetes and periodontal disease: a case-control study. J Periodontol, 76(3): 418–425. 10.1902/jop.2005.76.3.418.
Ebersole, J. L., Holt, S. C., Hansard, R., & Novak, M. J. (2008). Microbiologic and immunologic characteristics of periodontal disease in Hispanic Americans with type 2 diabetes. J Periodontol, 79(4): 637–646. 10.1902/jop.2008.070455.
Gomes, C., Guimarães, L. S., Pinto, L. S., Da Cruz, G. A., Valente, M. I., & Sarquis, M. I. (2017). Investigations of the prevalence and virulence of Candida albicans in periodontal and endodontic lesions in diabetic and normoglycemic patients. J Appl Oral Sci, 25(3): 274-281. doi.org/10.1590/1678-7757-2016-0432
Graziani, F., Gennai, S., Solini, A., & Petrini, M. (2018). A systematic review and meta-analysis of observational epidemiological evidence on the effect of periodontitis on diabetes an update of the EFP-AAP review. J Clin Periodontol, 45 (2): 167–187. 10.1111 / jcpe.12837.
Hintao, J., Teanpaisan, R., Chongsuvivatwong, V., Ratarasan, C., & Dahlen, G. (2007). The microbiological profiles of saliva, supragingival and subgingival plaque and dental caries in adults with and without type 2 diabetes mellitus. Oral Microbiol Immunol, 22(3): 175–181. 10.1111/j.1399-302X.2007.00341.x.
Jepsen, S., Caton, J. G., Albandar, J. M., Bissada, N. F., Bouchard, P., Cortellini, P. et al (2018). Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Periodontol, 89 Suppl 1:S237-S248. 10.1002/JPER.17-0733.
Joseph, B., Janam, P., Narayanan, S., & Anil, S. (2017). Is Antimicrobial Photodynamic Therapy Effective as an Adjunct to Scaling and Root Planing in Patients with Chronic Periodontitis? A Systematic Review. Biomolecules, 7(4): 79. 10.3390/biom7040079.
Kocak, E., Sağlam, M., Arslan, U., Kayis, S.A., Kebapcilar, L., Loos, B.G. et al (2020). Effect of diode laser application as an adjunct to nonsurgical periodontal therapy on the reduction of red complex microorganisms in type 2 diabetics with chronic periodontitis. Lasers Med Sci, 35(6): 1403–1410. 10.1007/s10103-020-02997-1.
Klein, M. I. & Gonçalves, R. B. (2003). Detection of Tannerella forsythensis (Bacteroides forsythus) and porphyromonas gingivalis by polymerase chain reaction in subjects with different periodontal status. J Periodontol, 74(6): 798-802. 10.1902/jop.2003.74.6.798.
Kocher, T., König, J., Borgnakke, W.S., Pink, C., & Meisel, P. (2018). Periodontal complications of hyperglycemia/diabetes mellitus: Epidemiologic complexity and clinical challenge. Periodontol 2000, 78(1): 59-97. 10.1111/prd.12235.
Lalla, E., Kaplan, S., Yang, J., Roth, G. A., Papapanou, P. N., & Greenberg, S. (2007). Effects of periodontal therapy on serum C-reactive protein, sE-selectin, and tumor necrosis factor alpha secretion by peripheral blood-derived macrophages in diabetes. A pilot study. J Periodontal Res, 42 (3): 274–282.
Lee, C. Y., Kuan, Y. H., Tsai, Y. F., Tai, C. J., Tsai, T. H., & Huang, K. H. (2019). Correlation between diabetes mellitus and periodontitis in Taiwan: A nationwide cohort study. Diabetes Res Clin Pract, 150: 245-252. 10.1016/j.diabres.2019.03.019.
Lee, J. Y., Choi, Y. Y., Choi, Y., & Jin, B. H. (2020). Efficacy of non-surgical treatment accompanied by professional toothbrushing in the treatment of chronic periodontitis in patients with type 2 diabetes mellitus: a randomized controlled clinical trial. J Periodontal Implant Sci, 50(2): 83-96. 10.5051/jpis.2020.50.2.83.
Lydia Rajakumari, M., & Saravana Kumari, P. (2016). Prevalence of Candida species in the buccal cavity of diabetic and non-diabetic individuals in and around Pondicherry. J Mycol Med, 26(4): 359-367. 10.1016/j.mycmed.2016.08.002.
Makiura, N., Ojima, M., Kou, Y., Furuta, N., Okahashi, N., Shizukuishi, S. et al (2008). Relationship of Porphyromonas gingivalis with glycemic level in patients with type 2 diabetes following periodontal treatment. Oral Microbiol Immunol, 23(4): 348–351. 10.1111/j.1399-302X.2007.00426.x.
Matic Petrovic, S., Radunovic, M., Barac, M., Kuzmanovic Pficer, J., Pavlica, D., Arsic Arsenijevic, V. et al (2019). Subgingival areas as potential reservoirs of different Candida spp in type 2 diabetes patients and healthy subjects. PLoS One, 14(1): e0210527. 10.1371/journal.pone.0210527. PM
Mealey, B. L. & O’Campo, G. L. (2007). Diabetes mellitus and periodontal disease. Periodontol 2000, 44:127-153. 10.1111/j.1600-0757.2006.00193.x.
Mealey, B. L. & Rose, L. F. (2008). Diabetes mellitus and inflammatory periodontal diseases. Curr Opin Endocrinol Diabetes Obes, 15: 135–41 . 10.1097 / MED.0b013e3282f824b7.
Navarro-Sanchez, A. B., Faria-Almeida, R., & Bascones-Martinez, A. (2007). Effect of non-surgical periodontal therapy on clinical and immunological response and glycaemic control in type 2 diabetic patients with moderate periodontitis. J Clin Periodontol, 34(10): 835-843. 10.1111/j.1600-051X.2007.01127.x.
Negrini, T. C., Carlos, I. Z., Duque, C., Caiaffa, K. S., & Arthur, R. A. (2021). Interaction between the Oral Microbiome, Oral Cavity Conditions, Host Immune Response, Diabetes Mellitus and Its Associated Risk Factors - An Overview. Front Oral Health, 2: 697428. 10.3389 / froh.2021.697428.
Pérez-Losada, F. L., Jané-Salas, E., Sabater-Recolons, M. M., Estrugo-Devesa, A., Segura-Egea, J. J., & López-López, J. (2016). Correlation between periodontal disease management and metabolic control of type 2 diabetes mellitus. A systematic literature review. Med Oral Patol Oral Cir Bucal, 21(4): e440-e446. 10.4317/medoral.21048.
Premkumar, J., Ramani, P., Chandrasekar, T., Natesan, A., & Premkumar, P. (2014). Detection of species diversity in oral Candida colonization and anti-fungal susceptibility among non-oral habit adult diabetic patients. J Nat Sci Biol Med, 5(1): 148-154. 10.4103/0976-9668.127315.
Raman, R. P., Taiyeb-Ali, T. B., Chan, S. P., Chinna, K., & Vaithilingam, R. D. (2014). Effect of nonsurgical periodontal therapy verses oral hygiene instructions on type 2 diabetes subjects with chronic periodontitis: a randomized clinical trial. BMC Oral Health, 14:79. 10.1186/1472-6831-14-79.
Roden, M. (2016). Diabetes mellitus - Definition, Klassifikation und Diagnose. Wien Klin Wochenschr, 128 Suppl 2: S37-40. 10.1007/s00508-015-0931-3.
Rodrigues, C. F., Rodrigues, M. E., & Henriques, M. (2019). Candida sp. infections in patients with diabetes mellitus. J Clin Med, 8(1): 76. 10.3390/jcm8010076.
Sardi, J. C. O., Duque, C., Höfling, J. F., & Gonçalves, R. B. (2012). Genetic and phenotypic evaluation of Candida albicans strains isolated from subgingival biofilm of diabetic patients with chronic periodontitis. Med. Mycol, 50: 467-475. 10.3109/13693786.2011.633233.
Sbordone, L., Ramaglia, L., Guletta, E., & Iacono, V. (1990). Recolonization of the subgingival microflora after scaling and root planing in human periodontitis. J Periodontol, 61(9): 579-584. 10.1902/jop.1990.61.9.579.
Wu, C. Z., Yuan, Y. H., Liu, H. H., Li, S. S., Zhang, B. W., Chen, W. et al (2020). Epidemiologic relationship between periodontitis and type 2 diabetes mellitus. BMC Oral Health, 20(1): 204. 10.1186/s12903-020-01180-w.
Yun, F., Firkova, E. I., Jun-Qi, L., & Xun, H. (2007). Effect of non-surgical periodontal therapy on patients with type 2 diabetes mellitus. Folia Med (Plovdiv), 49(1-2):32-6.
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