A site‐by‐site follow‐up study on the effect of controlled versus poorly controlled insulin‐dependent diabetes mellitus

Abstract

In the present site-by-site follow-up study, the change in amount of approximal alveolar bone was assessed after 1 year from the baseline examination in 38 and after 2 years in 22 dentate subjects all with insulin-dependent diabetes mellitus. The diabetics, aged 35 to 56 years at baseline, had a history of a mean duration of 18 years of insulin-dependent diabetes mellitus and were under medical treatment at the outpatient clinic of the III Department of Medicine, University Central Hospital of Helsinki as well as at 2 diabetic clinics of the Helsinki Health Centre. Based upon their long-term medical records, 26 subjects were after 1 year, and 16 subjects after 2 years from the baseline, identified as having poorly controlled insulin-dependent diabetes (PIDD). At the 1-year examination, 12 subjects were classified as having controlled insulin-dependent diabetes (CIDD) as compared to 6 subjects at the 2-year examination. After 1 and 2 years, from baseline, site-by-site measurements were recorded for plaque index scores, bleeding after probing, loss of attachment, and radiographic loss of alveolar bone. After 1 and 2 years from baseline, the PIDD subjects exhibited higher mean %s of sites with improved bleeding scores (P < 0.01, chi 2-test) than the CIDD subjects. At the 2-year examination, the mean % of sites with loss of approximal alveolar bone was greater in the PIDD than in the CIDD group (P < 0.05, chi 2-test). The greatest differences between PIDD and CIDD subjects were found when recordings for only canines were analyzed at the 1- and 2-year examinations (P < 0.05, chi 2-test). The results of our current 2-year longitudinal site-by-site examinations confirm earlier results that poorly controlled insulin-dependent diabetes mellitus is strongly related to the amount of alveolar bone loss.

Bidirectional association between diabetes mellitus and inflammatory periodontal disease. A review

“…Other meta-analyses indicated a statistically significantly higher mean clinical attachment loss (CAL) of 1 mm (P=0.02, 95% CI: 0.15-1.84) and a greater mean probing depth of 0.46 mm (P=0.05, 95% CI: 0.01-0.91) in patients with type 2 diabetes mellitus compared with controls. It can be summarized that poor glycemic control in patients with diabetes is associated with an increased risk of progressive loss of periodontal attachment and alveolar bone 20,21 . Although most research on the relationship between diabetes and periodontal disease has focused on mechanisms by which diabetes may affect periodontal status, a growing body of evidence has also examined the converse relationship; namely, how periodontal diseases may affect the metabolic state.…”

“…The relationship between diabetes mellitus and periodontitis has appeared in the literature for over 70 years; however, with conflicting data. Numerous studies in various populations have demonstrated that individuals with diabetes tend to have a higher prevalence of and more severe periodontitis than nondiabetics 9 . Periodontal disease is the most prevalent oral complication in patients with type 2 DM (ref.…”

Communication and Community

“…Metabolic control of diabetes is considered to play the major role in determining the level of periodontal disease. Poorly controlled diabetic patients have more gingival inflammation, periodontal pockets and/or attachment loss than well-controlled diabetic patients (Ervasti et al 1984, Tervonen & Knuuttila 1986, Safkan-Seppälä & Ainamo 1992, Seppälä et al 1993, Tervonen & Oliver 1993, Seppälä & Ainamo 1994. But there are also studies in which no relation between periodontal disease and metabolic control is found (Bacic et al 1988, Hayden & Buckley 1989, Bridges et al 1996.…”

The Role of Genetic Predisposition in Diagnosis and Therapy of Periodontal Diseases in Type 1 Diabetes Mellitus

“…This finding was confirmed in a follow-up site-by-site study by the same authors. 50 The changes in the periodontal conditions are mostly expressed in the first year of the disease, and the damage to the periodontium which develops at this time is not greatly influeced in the further course of the disease (Fig 4). It is an interesting result that younger DM subjects display more periodontal destruction than do non-DM subjects at a later age.…”

“…[38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57] Individuals with DM tend to have a higher prevalence of periodontal diseases and more severe and rapidly progressing forms than those who do not have DM. 41,48 DM is a known risk factor for periodontitis in adults.…”