PERIODONTAL-DISEASE RELATED TO DIABETIC STATUS - A PILOT-STUDY OF THERESPONSE TO PERIODONTAL THERAPY IN TYPE-1 DIABETES

Variation in the periodontal health status and the response to oral hy giene education, scaling and root planing were studied in 36 subjects with type-1 diabetes mellitus (DM) and in 10 non-diabetic control subj ects. The age range of the subjects was 24-36 years. The diabetic grou p was divided into 3 subgroups based on the levels of glycosylated hem oglobin (HbA1c) over a 3 year period and the presence of diabetic comp lications as follows: (D1) subjects with good metabolic control and no complications (n=13), (D2) subjects with varying metabolic control wi th/without retinopathy (n=15) and (D3) subjects with severe diabetes, i.e., with poor long-term control and/or multiple complications (n=8). Clinical measurements (plaque, subgingival calculus, probing pocket d epth, bleeding after probing and clinical attachment level) were perfo rmed at the baseline and 4 weeks and 6 and 12 months after periodontal therapy. The between-group comparisons were made using the Student t- test and ANOVA. Based on the plaque scores, the oral hygiene status wa s similar in all groups during the whole study. No statistically-signi ficant differences in the periodontal health status could be found bet ween the diabetic group as a whole and the non-diabetic controls at an y examination. The level of periodontal health of the diabetics with g ood control and no complications (D1) and those with moderate control with/without retinopathy (D2) was on the same level with that seen in the non-diabetic controls. Our findings of the significantly higher ex tent of al greater than or equal to 2 mm at the baseline and the fast recurrence of pd greater than or equal to 4 mm during the longitudinal study in diabetic subjects with poor metabolic control and/or multipl e complications (D3) indicate increased periodontal breakdown as a com plication of DM in these subjects. To be able to assess the periodonta l prognosis and the need for periodontal therapy on an individual basi s,the clinical practitioner should be well aware of the diabetic statu s of his/her patients.