Microbiological and Immunological Studies of Adult Periodontitis in Patients with Noninsulin‐Dependent Diabetes Mellitus

Abstract

The subgingival microflora and serum antibody response was examined in Periodontitis patients with noninsulin‐dependent diabetes mellitus (NIDDM), impaired glucose tolerance (IGT), and normal glucose tolerance (NGT). The predominant cultivable microflora was determined for subgingival plaque sampled from two deep periodontal pockets in each of eight adult Periodontitis patients with NIDDM. Indirect immunofluorescence for Bactewides intermedius, Bacteroides gingivalis, and Haemophilus actinomycetemcomitans was used to examine these same samples as well as 186 additional subgingival plaque samples from 47 patients with moderate to severe generalized Periodontitis including 25 subjects with NIDDM, six subjects with IGT, and 16 subjects with NGT. Serum antibody levels to 13 microorganisms including seven oral bacterial species and one nonoral control species were measured by enzyme‐linked immunosorbent assays (ELISA) in 377 subjects including 84 normal subjects without periodontal disease, 112 normal subjects with Periodontitis, 19 periodontally normal subjects with IGT, 65 Periodontitis patients with IGT, 15 periodontally normal subjects with NIDDM, and 82 Periodontitis patients with NIDDM. Three hundred eighty‐two bacterial isolates were recovered from the eight patients. B. intermedius was the most frequently isolated microorganism constituting 16% of the total isolates followed by Wolinella recta and B. gingivalis, which each accounted for 13% of the total. Streptococcus sanguis was the most prevalent microorganism, which was found in 75% of the sites. Subgingival plaque samples examined by immunofluorescence demonstrate a high prevalence of black‐pigmented Bacteroides and suggest that the proportion of B. gingivalis but not B. intermedius is higher in NIDDM with Periodontitis than in other groups. Serological studies of B. gingivalis from patients with NIDDM indicate that these isolates comprise a serogroup distinct from those found in adult Periodontitis patients without diabetes. Serum IgG antibody levels were significantly elevated in nondiabetic, IGT, and NIDDM patients with Periodontitis toward both B. gingivalis strains tested. Nondiabetic Periodontitis patients had significantly elevated levels of serum IgG toward B. intermedius strain 9336 while Periodontitis patients with IGT had significantly elevated antibody levels to B. intermedius strain 25261. Microbiologic and immunologic data from the present study suggests that B. intermedius. W. recta, and B. gingivalis are important in the etiology of Periodontitis in adult patients with NIDDM.

Isolation of Fusobacterium necrophorum from cancrum oris (noma).

“…51,52 It is a frequent isolate from endodontic infections 53,54 and pregnancy gingivitis, 55 and has been associated with the periodontal breakdown in Type I diabetics. 56 This organism has also been observed in nonoral infections such as pleuropulmonary infections and abscesses of the head and neck. 57,58 Intraspecies heterogeneity has been demonstrated for P. intermedia, where two distinct DNA homology groups have been observed.…”

Periodontal Disease as a Complication in Type 2 Diabetes Mellitus– A Hospital Based Study in Uttarakhand, India

“…Similar results were reported by a study in Pima Indians which showed type 2 diabetes was associated with severity of periodontitis independent of age. 17 Gender is considered as one of the confounding factors in periodontitis. 2 A study reported higher prevalence of periodontitis in males due to tobacco use and higher incidence in females due to effect of progesterone and oestrogen interplay on periodontium.…”

Bacteroides gingivalis and Bacteroides intermedius recognize different sites on human fibrinogen

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Bacteroides (Porphyromonas) gingivalis and Bacteroides (Porphyromonas) intermedius are metabolically diverse species of gram-negative anaerobic bacilli implicated in the etiology of human periodontal diseases (14,25,33,35). These diseases are characterized by gingival inflammation and loss of connective tissue and bone from around the roots of the teeth (13).

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