Periodontitis:An often-neglected complication of diabetes

The bidirectional association between type 2 diabetes mellitus(T2DM)and periodontitis is now well established,resulting in periodontal disease being considered as the 6th major complication of diabetes mellitus(DM)after cardiovascular disease,eye disease,neuropathy,nephropathy,and peripheral vascular disease.DM can worsen the virulence and invasiveness of pathogenic oral microbial flora aggravating the local inflammation and infection in those with periodontal disease.On the other hand,the chemical and immunological mediators released into the circulation as part of periodontal inflammation worsen the systemic insulin resistance with worsening of T2DM.Periodontitis if undiagnosed or left untreated can also result in eventual tooth loss.A study by Xu et al in the World Journal of Diabetes examined the predictive factors associated with periodontitis in Chinese patients with T2DM.The prevalence of periodontitis was found to be 75.7%in this study.Based on logistic regression analysis,the predictive factors for higher risk were low tooth brushing frequency[odds ratio(OR)=4.3],high triglycerides(TG;OR=3.31),high total cholesterol(TC;OR=2.87),higher glycated hemoglobin(HbA1c;OR=2.55),and higher age(OR=1.05)while higher education level was protective(OR=0.53).However,the most influential variables were HbA1c followed by age,TC,TG,low education level,brushing frequency,and sex on the random forest model(this model showed higher sensitivity for predicting the risk).A good understanding of the predictors for periodontitis in T2DM patients is important in prevention,early detection of susceptible patients,and intervention to improve periodontal health and enable long-term glycaemic control as observed by Xu et al.

Correlation of periodontal inflamed surface area with glycated hemoglobin,interleukin-6 and lipoprotein(a)in type 2 diabetes with retinopathy

BACKGROUND The two-way relationship between periodontitis and type 2 diabetes mellitus(T2DM)is well established.Prolonged hyperglycemia contributes to increased periodontal destruction and severe periodontitis,accentuating diabetic complications.An inflammatory link exists between diabetic retinopathy(DR)and periodontitis,but the studies regarding this association and the role of lipoprotein(a)[Lp(a)]and interleukin-6(IL-6)in these conditions are scarce in the literature.AIM To determine the correlation of periodontal inflamed surface area(PISA)with glycated Hb(HbA1c),serum IL-6 and Lp(a)in T2DM subjects with retinopathy.METHODS This cross-sectional study comprised 40 T2DM subjects with DR and 40 T2DM subjects without DR.All subjects were assessed for periodontal parameters[bleeding on probing(BOP),probing pocket depth,clinical attachment loss(CAL),oral hygiene index-simplified,plaque index(PI)and PISA],and systemic parameters[HbA1c,fasting plasma glucose and postprandial plasma glucose,fasting lipid profile,serum IL-6 and serum Lp(a)].RESULTS The proportion of periodontitis in T2DM with and without DR was 47.5%and 27.5%respectively.Severity of periodontitis,CAL,PISA,IL-6 and Lp(a)were higher in T2DM with DR group compared to T2DM without DR group.Significant difference was observed in the mean percentage of sites with BOP between T2DM with DR(69%)and T2DM without DR(41%),but there was no significant difference in PI(P>0.05).HbA1c was positively correlated with CAL(r=0.351,P=0.001),and PISA(r=0.393,P≤0.001)in study subjects.A positive correlation was found between PISA and IL-6(r=0.651,P<0.0001);PISA and Lp(a)(r=0.59,P<0.001);CAL and IL-6(r=0.527,P<0.0001)and CAL and Lp(a)(r=0.631,P<0.001)among study subjects.CONCLUSION Despite both groups having poor glycemic control and comparable plaque scores,the periodontal parameters were higher in DR as compared to T2DM without DR.Since a bidirectional link exists between periodontitis and DM,the presence of DR may have contributed to the severity of periodontal destruction and periodontitis may have influenced the progression of DR.

Link between periodontitis and diabetic retinopathy:Inflammatory pathways and clinical implications

The bidirectional relationship between periodontitis and type 2 diabetes mellitus has been well-established.However,the underlying molecular mechanisms remain unclear.Diabetic retinopathy(DR)is an important complication of diabetes,but there are few studies on the relationship between DR and periodontitis,especially on the intrinsic inflammatory pathway mechanism.This article reviews the latest clinical data on how diabetes promotes susceptibility to periodontitis from the epidemiological and molecular perspectives,with a special focus on the key roles of systemic inflammation and endothelial dysfunction in the interplay between DR and periodontitis.Comprehension of the intertwined pathogenesis of DR and periodontitis can better guide the development of comprehensive management strategies for glycemic control and periodontal health,with the aim of mitigating the progression of DR and enhancing overall well-being.

Establishment of models to predict factors influencing periodontitis in patients with type 2 diabetes mellitus

BACKGROUND Type 2 diabetes mellitus(T2DM)is associated with periodontitis.Currently,there are few studies proposing predictive models for periodontitis in patients with T2DM.AIM To determine the factors influencing periodontitis in patients with T2DM by constructing logistic regression and random forest models.METHODS In this a retrospective study,300 patients with T2DM who were hospitalized at the First People’s Hospital of Wenling from January 2022 to June 2022 were selected for inclusion,and their data were collected from hospital records.We used logistic regression to analyze factors associated with periodontitis in patients with T2DM,and random forest and logistic regression prediction models were established.The prediction efficiency of the models was compared using the area under the receiver operating characteristic curve(AUC).RESULTS Of 300 patients with T2DM,224 had periodontitis,with an incidence of 74.67%.Logistic regression analysis showed that age[odds ratio(OR)=1.047,95%confidence interval(CI):1.017-1.078],teeth brushing frequency(OR=4.303,95%CI:2.154-8.599),education level(OR=0.528,95%CI:0.348-0.800),glycosylated hemoglobin(HbA1c)(OR=2.545,95%CI:1.770-3.661),total cholesterol(TC)(OR=2.872,95%CI:1.725-4.781),and triglyceride(TG)(OR=3.306,95%CI:1.019-10.723)influenced the occurrence of periodontitis(P<0.05).The random forest model showed that the most influential variable was HbA1c followed by age,TC,TG, education level, brushing frequency, and sex. Comparison of the prediction effects of the two models showedthat in the training dataset, the AUC of the random forest model was higher than that of the logistic regressionmodel (AUC = 1.000 vs AUC = 0.851;P < 0.05). In the validation dataset, there was no significant difference in AUCbetween the random forest and logistic regression models (AUC = 0.946 vs AUC = 0.915;P > 0.05).CONCLUSION Both random forest and logistic regression models have good predictive value and can accurately predict the riskof periodontitis in patients with T2DM.

Periodontal disease:A silent factor in the development and progression of diabetic retinopathy

The global increase in the prevalence of type 2 diabetes mellitus(T2DM)and its complications presents significant challenges to public health.Recently,periodontal disease(PD)was recognized as a factor that is likely to influence the progression of T2DM and its complications due to its potential to exacerbate systemic inflammation and oxidative stress.In this editorial,we comment on the article published by Thazhe Poyil et al in the very recent issue of the World Journal of Diabetes in 2024,which investigated the correlation between PD and diabetic retinopathy(DR)in T2DM patients,with emphasis on the association between periodontal swollen surface area,glycated hemoglobin(HbA1c),interleukin-6(IL-6),and lipoprotein(a).The findings by Thazhe Poyil et al are significant as they demonstrate a strong link between PD and DR in T2DM patients.This correlation highlights the importance of addressing periodontal health in diabetes management to potentially reduce the risk and severity of DR,a complication of diabetes.The integration of periodontal evaluation and treatment into diabetes care protocols may lead to improved glycemic control and better overall outcomes for T2DM patients.A few studies have established an interconnection between PD and diabetic complication,specifically DR,in T2DM patients,which we aim to highlight in this editorial.Emphasis was placed on the different mechanisms that suggest a bidirectional relationship between PD and T2DM,where the presence of periodontal inflammation negatively influenced glycemic control and contributed to the development and progression of DR through shared inflammatory and vascular mechanisms.This article highlights the importance of collaboration amongst diabetes specialists,ophthalmologists,periodontists,and public health professionals to advance the prevention,early detection,and treatment of PD and DR.This will improve the health and quality of life of T2DM patients.Moreover,the editorial highlights the need for further research on the specific molecular and immunological mechanisms that underlie the link between periodontitis and DR,with identification of common inflammatory biomarkers and signaling pathways.This is expected to facilitate effective direction of therapeutic objectives,thereby improving the management of diabetes and its complications through integrated care that incorporates oral health.

Management of diabolical diabetes mellitus and periodontitis nexus: Are we doing enough?

Periodontitis is the commonest oral disease affecting population worldwide. This disease is notorious for the devastation of tooth supporting structures, ensuing in the loss of dentition. The etiology for this disease is bacterial biofilm, which accumulates on the teeth as dental plaque. In addition to the biofilm microorganisms, other factors such as environmental, systemic and genetic are also responsible in progression of periodontitis. Diabetes mellitus (DM) is metabolic disorder which has an impact on the global health. DM plays a crucial role in the pathogenesis of periodontitis. Periodontitis is declared as the &#x0201c;sixth&#x0201d; major complication of DM. Evidence based literature has depicted an enhanced incidence and severity of periodontitis in subjects with DM. A &#x0201c;two way&#x0201d; relationship has been purported between periodontitis and DM. Mutual management of both conditions is necessary. Periodontal therapy (PT) may assist to diminish the progression of DM and improve glycemic control. Various advanced technological facilities may be utilized for the purpose of patient education and disease management. The present paper clarifies the etio-pathogenesis of periodontitis, establishing it as a complication of DM and elaborating the various mechanisms involved in the pathogenesis. The role of PT in amelioration of DM and application of digital communication will be discussed. Overall, it is judicious to create an increased patient cognizance of the periodontitis-DM relationship. Conjunctive efforts must be undertaken by the medical and oral health care professionals for the management of periodontitis affected DM patients.

The influence of diabetes enhanced inflammation on cell apoptosis and periodontitis

Aim: Diabetes mellitus is a metabolic disorder leading to hyperglycemia and exhibiting altered fat and protein metabolism. Diabetes altered cellular microenvironment caused myriad untoward effects. Periodontitis is chronic inflammatory disease. Diabetes and periodontitis had higher prevalence in populations. The objective studied the relationship between diabetes and periodontitis associated with cell apoptosis and the influence of diabetes enhanced inflammation on apoptosis and periodontitis. Methods: This paper studied and analyzed the papers which published in the worldwide associated with the influence of diabetes enhanced inflammation on cell apoptosis and periodontitis, and reviewed the probably mechanism associated with apoptosis. Results: Diabetes induced hyperglycemia enhanced inflammation related to cell apoptosis. Periodontitis had a higher morbidity on diabetes patients. Periodontal intervention may be benefit to controlling the diabetes. The bidirectional efficiency happened between diabetes and periodontitis. Anti-apoptotic and anti-inflammation option can improve the therapeutic effects on diabetes and periodontitis. The finding included following several aspects. 1) Advanced glycation end products enhanced inflammatory response;2) Hyperglycemia induced cell apoptosis;3) inflammatory cytokines caused cell apoptosis;4) Mutuality between cell apoptosis and periodontitis;5) Diabetes induce periodontitis and bone loss;6) Periodontitis induced insulin resistance. 7) TNFα induce prostaglandins elicited cell apoptosis;8) periodontal therapies had effects on diabetes. Conclusion: Diabetes can enhance inflamemation leading to apoptosis and periodontitis. Effective periodontal therapy and control glucose may produce better effects on diabetes or periodontitis. Further research required to investigate the bidirectional mechanism between diabetes and periodontitis.

Relationship between diabetes and periodontal infection

Periodontal disease is a high prevalent disease.In the United States 47.2% of adults ≥ 30 years old have been diagnosed with some type of periodontitis.Longitudinal studies have demonstrated a two-way relationship between diabetes and periodontitis,with more severe periodontal tissue destruction in diabetic patients and poorer glycemic control in diabetic subjects with periodontal disease.Periodontal treatment can be successful in diabetic patients.Short term effects of periodontal treatment are similar in diabetic patients and healthy population but,more recurrence of periodontal disease can be expected in no well controlled diabetic individuals.However,effects of periodontitis and its treatment on diabetes metabolic control are not clearly defined and results of the studies remain controversial.

Effect of periodontal treatment on adipokines in type 2 diabetes

The association between adipokines and inflammatory periodontal diseases has been studied over the last two decades. This review was intended to explore the observation that periodontal therapy may lead to an improvement of adipokines in diabetic patients. In summary, substantial evidence suggests that diabetes is associated with increased prevalence, extent and severity of periodontitis. Numerous mechanisms have been elucidated to explain the impact of diabetes on the periodontium. However, current knowledge concerning the role of major adipokines indicates only some of their associations with the pathogenesis of periodontitis in type 2 diabetes. Conversely, treatment of periodontal disease and reduction of oral inflammation may have positive effects on the diabetic condition, although evidence for this remains somewhat equivocal.

Association between retinopathy,nephropathy,and periodontitis in type 2 diabetic patients:a Meta-analysis

AIM:To verify the association between retinopathy,nephropathy,and periodontitis in type 2 diabetic(T2 D)patients.METHODS:Several electronic databases were available for our comprehensive search including China National Knowledge Infrastructure(CNKI),Chinese VIP Information(VIP),Wanfang,Web of Science,ScienceDirect and PubMed and were queried for relevant citations(updated to Mar.2019).RevMan was utilized to perform Meta analysis and publication bias detection.After evaluation of the methodological quality of included studies,a fixed or random effect model was utilized to analyze data from included studies.RESULTS:A total of eight articles were finally included in this Meta analysis.In all 3987 subjects,there were 1207 T2 D patients accompanying with microvascular complications and 1734 patients with periodontitis as well.The Meta forest plot presented little heterogeneity of the eight studies(P<0.00001,I^(2)=89%).The total effect demonstrated periodontitis was associated with overall microvascular complications(OR:1.96,95%CI:1.67-2.30,Z=8.25,P<0.00001).Subgroup investigations among the studies in Asian(OR:2.33,95%CI:1.91-2.85)and North American(OR:1.42,95%CI:1.08-1.86)populations confirmed the existed association between retinopathy,nephropathy,and periodontitis.While the strength of such associations between periodontitis and diabetic microvascular complications were more obvious in the Asians than North Americans.All the results indicated that periodontitis was associated with diabetic retinopathy(OR:3.77,95%CI:2.71-5.24),diabetic nephropathy(OR:1.55,95%CI:1.24-1.94)in T2 D patients.CONCLUSION:The periodontitis is associated with diabetic retinopathy,diabetic nephropathy among T2 D patients and further large sample size clinical trials are in need to confirm the findings.

Correlation of periodontal inflamed surface area with glycemic status in controlled and uncontrolled type 2 diabetes mellitus

BACKGROUND The bidirectional link between periodontitis and diabetes mellitus(DM)has been established.Periodontitis causes systemic inflammatory burden through inflammatory mediators.The currently utilized tools[clinical attachment loss(CAL)and probing pocket depth(PPD)]are linear measurements,that do not exactly quantify the inflammatory burden of periodontitis.Periodontal inflamed surface area(PISA)quantifies the surface area of bleeding pocket epithelium and estimates the inflammatory burden.Studies relating to the periodontal status of diabetic patients with and without microvascular complications are scarce.This study assessed the proportion of periodontitis and correlation of PISA with glycemic status in controlled,uncontrolled type 2 DM(T2DM)with and without microvascular complications.AIM To assess the proportion of periodontitis and correlation of PISA with glycemic status in controlled,and uncontrolled T2DM with and without microvascular complications.METHODS This study comprised 180 T2DM patients.Based on glycated hemoglobin(HbA1c)levels,they were grouped into:(1)Controlled T2DMgroup:(HbA1c≤7%);(2)Uncontrolled T2DM group:(HbA1c>7%)without microvascular complications;and(3)Uncontrolled T2DM group:(HbA1c>7%)with microvascular complications.Each group comprised 60 patients.All patients were assessed for periodontal parameters(Bleeding on Probing,PPD,CAL,Oral hygiene index simplified and PISA),and systemic parameters(HbA1c,fasting plasma glucose and post prandial plasma glucose).RESULTS The proportion of periodontitis among controlled T2DM group,uncontrolled T2DM group without microvascular complications,uncontrolled T2DM group with micro-vascular complications was 75%,93.4%and 96.6%respectively.Extent and severity of periodontitis were high in the uncontrolled T2DM group.A significant positive correlation was found between PISA and HbA1c among all patients(r=0.393,P<0.001).The dose–response relationship between PISA and HbA1c was observed.An increase of PISA with 168 mm^(2) was associated with a 1.0%increase of HbA1c.CONCLUSION High proportion and severity of periodontitis,and increased inflamed surface area in uncontrolled T2DM may have contributed to the poor glycemic control and microvascular complications.

Diabetes and Periodontal Diseases: An Established Two-Way Relationship

Background: Periodontal diseases (PD), including periodontitis, are chronic inflammatory pathologies caused by bacteria in the subgingival biofilm which affect the periodontal tissues. PD is now considered a localized, chronic, oral infection that activates the host immuno-inflammatory responses both locally and systemically, and also constitutes a source of bacteraemia. It is a known fact that periodontal diseases exercise an important influence on the pathogenesis of numerous systemic diseases, including diabetes mellitus (DM). In the mid-nineties, sufficient scientific evidence emerged to confirm an association between DM and periodontitis, which then began to be regarded as the sixth complication of DM. Current scientific evidence points to a two-way relationship between DM and periodontal disease, whereby DM is associated with an increase in the incidence and progression of periodontitis, while periodontal infection is associated with worsening glycemic control in diabetic patients. This two-way relationship points to a need to promote oral health in DM patients, and to implement a joint management protocol between endocrinologist and dentist that aims to create adequate conditions for early diagnosis and the effective treatment of both diseases.

THERAPEUTIC EFFECT OF NON-SURGICAL TREATMENT OF CHRONIC PERIODONTITIS IN DIABETIC CHINESE

Objective To observe the therapeutic effect of non-surgical treatment on diabetic Chinese withchronic periodontitis. Methods Moderate to advanced chronic periodontitis ( CP) was studied in 36 diabetes mellitus (DM) patients classified as 20 with high and fluctuating blood glucose level (DM-H) and 16 with relatively low and stable blood glucose level (DM-L). 28 non-DM CP patients acted as controls (Non-DM). Plaque index (PlI) , gingival index (GI) , bleeding on probing (BOP) , probing depth (PD) and clinical attachment loss (AL) of all patients were recorded at 6 sites on each tooth at the baseline and 1, 3 and 6 months after oral hygiene instruction (OHI), scaling and root planing. Results It was found that the short-term effect of non-surgical periodon-tal procedure had resulted in significant resolution of gingival inflammation and pronounced reduction in pocket depth and gain of attachment loss in both DM and Non-DM CP patients. Conclusion The pilot study suggested that non-surgical periodontal treatment allowed for favorable treatment responses in a group of Chinese diabetic subjects with chronic periodontitis and that their various profiles of blood glucose did not influence the short-term healing response to OHI, scaling and root planning.

Association between Diabetes Mellitus and Oral Health Status in Japanese Adults

Aim The objective of this study was to analyze the oral health among Japanese adults, with and without diabetes mellitus. Methodology The subjects were 518 community residents aged 20 to 91 years in Japan, who participated in the ＂Akita health and nutrition survey＂ and the ＂Akita dental disease survey＂, conducted in 2006. The surveys comprised a self-administered questionnaire, along with medical and dental examinations. Results Using the community periodontal index （CPI）, the mean numbers of sextants presenting codes 0, 1 and 2 were significantly lower in diabetics than non-diabetics among the 59 years or younger age group. Although the mean numbers of sextants with codes 0, 1 and 2 among the 60 to 69 years age group were lower, and sextants with a code X among the 59 years or younger age group were higher in diabetics than non-diabetics, no statistically significant differences were detected. The tendency of lower mean numbers of natural teeth and functional tooth units in diabetics than non-diabetics was observed, however no differences were statistically significant. Conclusion The outcome of periodontal disease seemed to be influenced by the diabetic state to some degree, but a clear association between diabetes and oral health status was not found.

Oral manifestations in patients with diabetes mellitus

The purpose of this article was to increase the knowledge about oral manifestations and complications associated with diabetes mellitus.An overview was performed on Google,especially in recent reliable papers in relation to diabetes mellitus and its oral manifestations(keywords were“diabetes mellitus”,“oral manifestations”,and“oral complications”).Data were collected and the results were declared.Diabetes mellitus is one of the most common chronic disorders characterized by hyperglycemia.This disease can have many complications in various regions of the body,including the oral cavity.The important oral manifestations and complications related to diabetes include xerostomia,dental caries,gingivitis,periodontal disease,increased tendency to oral infections,burning mouth,taste disturbance,and poor wound healing.Oral complications in diabetic patients are considered major complications and can affect patients’quality of life.There is evidence that chronic oral complications in these patients have negative effects on blood glucose control,so prevention and management of the oral complications are important.

The Impact of Severity of Periodontal Bone Loss and the Levels of Glycated Hemoglobin (HbA1c) on the Periodontal Clinical Parameters of the 2017 World Workshop among Type 2 Diabetic Patients in Saudi Arabia

Background: Type-2 diabetic patients (uncontrolled levels of glucose blood) usually have periodontal diseases and alveolar bone loss. Objectives: The present study was designed to clarify the impact of severity of periodontal bone loss and the levels of glycated hemoglobin (HbA1c) on the periodontal clinical parameters of the 2017 World Workshop among type 2 diabetic patients in Saudi Arabia (Saudi and non-Saudi). Material and Methods: This study was done on 298 type 2 diabetic patients, selected from the internship clinics, College of Dentistry, King Khalid University, Abha, Saudi Arabia. The selection of patients was dependent on the levels of glycated hemoglobin (HbA1c), and they were categorized into controlled (<7% HbA1c) and uncontrolled type 2 diabetics (>7% HbA1c). All patients were divided according to the severity of periodontal bone loss into three groups, group I: mild periodontal bone loss, group II: moderate periodontal bone loss, and group III: severe periodontal bone loss. Clinical evaluation of periodontal diseases was carried out by clinical parameters according to the 2017 World Workshop. All data were collected and analyzed. A p-value of <0.05 was considered significant, and of <0.001 was considered highly significant. Results: The severity of periodontal bone loss were determined in controlled type 2 diabetics (<7% HbA1c) and compared to uncontrolled type 2 diabetics (>7% HbA1c). An increased percentage of patients with severe periodontal bone loss was observed in uncontrolled type 2 diabetics (>7% HbA1c) (42.9%), as compared to controlled type 2 diabetics (<7% HbA1c) (30.5%) without statistically significant (p = 0.251). An increased mean of age, clinical attachment loss (CAL), and percentage of radiographic bone loss (% RBL) were detected in controlled type 2 diabetics (<7% HbA1c), as compared to uncontrolled type 2 diabetics (>7% HbA1c). In contrast, we found an increased mean of plaque control record (PCR), gingival bleeding index (GBI), and periodontal pocket depth (PPD) in uncontrolled type 2 diabetics (>7% HbA1c) more than in controlled type 2 diabetics (<7% HbA1c) without statistically significant (p > 0.05). Moreover, the mean of age, PCR, CAL, % RBL, and PPD were more in the patients with severe periodontal bone loss, as compared to the patients with mild and moderate periodontal bone. Highly statistically significant differences were recorded (p < 0.001). Conclusion: This study demonstrates the role of uncontrolled diabetes as a risk factor for the increase in the severity of periodontal bone loss. Thus, we suggest including the glycated hemoglobin (HbA1c) levels with periodontal parameters in the evaluation of periodontal bone loss among type 2 diabetics.

What Is Dentists’ Role in Modulating Environmental and Epigenetic Determinant in Oral Health of Diabetic Patients?

Background and Purpose: With the unexpectedly rapid increase in the prevalence of types of diabetes worldwide, this chronic disease is no longer being viewed as a systemic health issue, but also treated as the start of the deadly disease. As the sixth complication of diabetes, periodontitis is a chronic inflammatory condition that leads directly and indirectly to a severer condition of diabetes via its underlying mechanisms. Interestingly, both diseases are not been fully identified in their bidirectional relationships by researchers. Thus, healthcare agencies must pay appropriate attention. This literature review paper aims to investigate and discuss dentists’ role in modulating environmental and epigenetic determinants in the oral health of diabetic patients based on the bidirectional relationship between these diseases, their prevalence and how treatment of one disease affects the other. Methods: The authors conducted electronic searches in PubMed, Google Scholar, One Search UofT, ScienceDirect, and the National Library of Medicine. The paper also included gray literature from government resources related to the topic. The paper will review the epidemiology, pathogenesis, and epigenetics of both diabetes and periodontal disease and their functions with each other. Results: The literature has consistently shown that diabetes and periodontal disease have responded to the formation and severity of each other. Patients with pre- and diabetes have potentially higher risks of causing periodontal disease and other complications if adequate diagnosis and treatment are not involved timely. The combination of risk factors, including individual, social, environmental, and genetic, play a crucial role in the development of diabetes and the severity of periodontitis. Conclusions: Based on the results, the collaboration between dentists and other healthcare practitioners is inevitable in the overall development of treatment for both diseases. With the proper and updated knowledge, dentists can benefit patients’ overall physical conditions through strategic intervention in diabetes patients.

Survey on Knowledge Toward Diabetic Periodontal Condition and Oral Health Among Medical Staff and Patients

The study was conducted to understand the cognitive status of medical staff and patients on the status of periodontal disease and oral health care in patients with diabetes,and to provide reference for the implementation and improvement of diabetes management and health education.Using the Diabetes Periodontal Status and Oral Health Knowledge Questionnaire,108 doctors,190 nurses,and 212 inpatients were investigated.This study demonstrated that,the total scores of doctors,nurses,and patients with diabetes periodontal status and oral health knowledge were(31.18±5.14),(28.58±4.09)and(18.67±3.45)points,respectively.The results of regression analysis showed that education level,department,and related training experience(p<0.05,p<0.01)were the influencing factors of the diabetic periodontal status and oral health knowledge level of the medical staff,meanwhile the monthly income,department,and relevant training experience(p<0.05,p<0.01)were the factors influencing the diabetic periodontal status and oral health care knowledge level of the patients.In summary,the cognitive level of diabetic periodontal status and oral health care knowledge of the medical staff and patients’needs to be improved.Medical staff should pay attention to the study of diabetic periodontal status and oral health care knowledge,further perform a good job in the relevant health education of patients,which is helpful to maintain good oral hygiene.

Analysis of the Relationship between Oral Diseases and Glycemic Control of Diabetes in the West African Context: Survey at the Centre Anti-Diabetique d’Abidjan (CADA),cote d’Ivoire

The relationship between diabetes and periodontitis is established and described as a bidirectional influence, whereas that with dental caries is still controversial. The objective of this study was to analyze the relationship between blood glucose control and oral diseases in a population of diabetics followed at the “Centre Anti Diabétique d’Abidjan” (CADA). The dental condition of the diabetics included in this cross-sectional study was assessed by the DMF index, periodontal condition by the CPITN and oral hygiene by the OHIS index. Diabetes data were extracted from CADA patient medical records. Blood glucose control has been defined by an average of the blood glucose values of the last 3 months less than or equal to 1.26 g/l. Regression models were constructed to estimate the risk of diabetes imbalance adjusted for all characteristics collected. The sample of 356 diabetics consisted of 53.7% women with an average age of 55.6 years (range: 12 - 85 years). The average DMF index was 7.9 (Std: 6.6) with an estimated prevalence of caries of 77.0%, that of periodontitis of 53.1%. The proportion of subjects with good glycemic control was estimated at 41.3%. The characteristics associated with glycemic control were: dry mouth (p = 0.005), type of diabetes treatment (p < 0.00014) and duration of diabetes (p = 0.039) and periodontal status assessed with the CPITN (p = 0.014). The results of this study confirmed the link between periodontitis and glycemic control of diabetes described in the literature but didn’t find significant association between dental caries and diabetes.

2型糖尿病合并慢性牙周炎患者血清LRG1、LDH与牙周指标和牙周病变程度的关系

目的探究2型糖尿病(T2DM)合并慢性牙周炎(CP)患者血清富含亮氨酸α-2糖蛋白1(LRG1)、乳酸脱氢酶(LDH)与牙周指标和牙周病变程度的关系。方法选取2022年7月至2023年7月宁夏医科大学总医院口腔医院收治的112例T2DM合并CP患者(T2DM合并CP组),根据牙周病变程度将其分为轻度、中度和重度组;选取同期本院112例单纯CP患者(CP组),再选取112例单纯T2DM患者(T2DM组);检测LRG1、LDH和牙周指标;Pearson法分析血清LRG1、LDH及二者与牙周指标的相关性;重度T2DM合并CP的影响因素采用多因素logistic回归分析;绘制ROC曲线分析血清LRG1、LDH对重度T2DM合并CP的诊断价值。结果CP组、T2DM组以及T2DM合并CP组LRG1、LDH水平依次升高(P<0.05)。轻度、中度和重度组血清LRG1、LDH、附着丧失(AL)、牙周探诊深度(PD)、牙龈出血指标(BI)水平依次升高(P<0.05)。根据Pearson相关性分析得知,血清LRG1与LDH呈正相关(P<0.05),二者均与AL、PD、BI呈正相关(P<0.05)。根据logistic回归分析得知LRG1、LDH、AL、PD、BI均为影响重度T2DM合并CP的因素(P<0.05)。根据ROC曲线得知血清LRG1和LDH二者联合诊断重度T2DM合并CP的AUC为0.910,两者联合优于各自单独诊断(Z_(联合vs LRG1)=2.659、Z_(联合vs LDH)=2.627,P<0.05)。结论LRG1、LDH在T2DM合并CP患者血清中显著升高,两者与牙周指标和牙周病变程度有关。