Residual Periodontal Ligament Levels in Extracted Teeth of Chronic Periodontitis Patients with Type 2 Diabetes Mellitus
Keywords:
Residual periodontal ligament (RPL), type 2 diabetes mellitus (T2DM), chronic periodontitis, HbA1c, oxidative stress
Abstract
This in vitro study investigates the impact of type 2 diabetes mellitus (T2DM) on residual periodontal ligament (RPL) levels in extracted teeth of chronic periodontitis patients aged 50–60 years. Fifty teeth (25 from diabetic patients with HbA1c ≥6.5% and 25 from non-diabetic controls with HbA1c <5.7%) were analysed. RPL levels were measured using haematoxylin staining and digital callipers, with comparisons between groups assessed via Mann-Whitney U tests. Diabetic patients exhibited significantly lower overall RPL levels (0.69 ± 0.25 mm vs. 0.94 ± 0.32 mm, *p=0.012*), with pronounced reductions in incisors (−48%) *p=0.018*) and premolars (−32%). *p=0.006*). Stratification by HbA1c revealed a non-significant trend of declining RPL with worsening glycemic control (*p=0.542*). These findings underscore the systemic impact of T2DM on periodontal integrity, likely mediated by hyperglycemia-induced oxidative stress and impaired collagen remodelling. Despite limitations in sample size and cross-sectional design, the study highlights the need for integrated diabetes-periodontal care to mitigate tooth loss. Further research with longitudinal designs and inflammatory biomarkers is warranted to elucidate causal mechanisms.
References
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15. Santos, V. R., Lima, J. A., De Mendonça, A. C., et al. (2009). Effectiveness of full-mouth and partial-mouth scaling and root planing in treating chronic periodontitis in subjects with type 2 diabetes. Journal of Periodontology, 80(8), 1237–1245. https://doi.org/10.1902/jop.2009.090030
16. Takeda, M., Ojima, M., Yoshioka, H., et al. (2006). Relationship of serum advanced glycation end products with deterioration of periodontitis in type 2 diabetes patients. Journal of Periodontology, 77(1), 15–20. https://doi.org/10.1902/jop.2006.77.1.15
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18. Caton, J. G., Armitage, G., Berglundh, T., et al. (2018). A new classification scheme for periodontal and peri-implant diseases and conditions – Introduction and key changes from the 1999 classification. Journal of Periodontology, 89(S1), S1–S8. https://doi.org/10.1002/JPER.18-0157
19. D’Aiuto, F., Parkar, M., Andreou, G., et al. (2004). Periodontitis and systemic inflammation: Control of the local infection is associated with a reduction in serum inflammatory markers. Journal of Dental Research, 83(2), 156–160. https://doi.org/10.1177/154405910408300214
20. Tonetti, M. S., Greenwell, H., & Kornman, K. S. (2018). Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. Journal of Periodontology, 89(S1), S159–S172. https://doi.org/10.1002/JPER.18-0006
2. Taylor, G. W. (2001). Bidirectional interrelationships between diabetes and periodontal diseases: An epidemiologic perspective. Annals of Periodontology, 6(1), 99–112. https://doi.org/10.1902/annals.2001.6.1.99
3. Genco, R. J., & Borgnakke, W. S. (2013). Risk factors for periodontal disease. Periodontology 2000, 62(1), 59–94. https://doi.org/10.1111/j.1600-0757.2012.00457.x
4. Naguib, G., Al-Mashat, H., Desta, T., & Graves, D. T. (2004). Diabetes prolongs the inflammatory response to a bacterial stimulus through cytokine dysregulation. Journal of Investigative Dermatology, 123(1), 87–92. https://doi.org/10.1111/j.0022-202X.2004.22711.x
5. Saremi, A., Nelson, R. G., Tulloch-Reid, M., et al. (2005). Periodontal disease and mortality in type 2 diabetes. Diabetes Care, 28(1), 27–32. https://doi.org10.2337/diacare.28.1.27
6. Chapple, I. L. C., & Genco, R. (2013). Diabetes and periodontal diseases: Consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. Journal of Periodontology, 84(4), S106–S112. https://doi.org/10.1902/jop.2013.1340011
7. Graves, D. T., Liu, R., Alikhani, M., et al. (2006). Diabetes-enhanced inflammation and apoptosis: Impact on periodontal pathology. Journal of Dental Research, 85(1), 15–21. https://doi.org/10.1177/154405910608500103
8. Preshaw, P. M., Alba, A. L., Herrera, D., et al. (2012). Periodontitis and diabetes: A two-way relationship. Diabetologia, 55(1), 21–31. https://doi.org/10.1007/s00125-011-2342-y
9. American Diabetes Association. (2021). Standards of medical care in diabetes—2021. Diabetes Care, 44(Supplement 1), S1–S232. https://doi.org/10.2337/dc21-Sint
10. Engebretson, S. P., Hey-Hadavi, J., Ehrhardt, F. J., et al. (2004). Gingival crevicular fluid levels of interleukin-1β and glycemic control in patients with chronic periodontitis and type 2 diabetes. Journal of Periodontology, 75(9), 1203–1208. https://doi.org/10.1902/jop.2004.75.9.1203
11. Salvi, G. E., Collins, J. G., Yalda, B., et al. (1997). Monocytic TNF-α secretion patterns in IDDM patients with periodontal diseases. Journal of Clinical Periodontology, 24(1), 8–16. https://doi.org/10.1111/j.1600-051X.1997.tb01178.x
12. Nishimura, F., Iwamoto, Y., Mineshiba, J., et al. (2003). Periodontal disease and diabetes mellitus: The role of tumor necrosis factor-α in a 2-way relationship. Journal of Periodontology, 74(1), 97–102. https://doi.org/10.1902/jop.2003.74.1.97
13. Mealey, B. L., & Oates, T. W. (2006). Diabetes mellitus and periodontal diseases. Journal of Periodontology, 77(8), 1289–1303. https://doi.org/10.1902/jop.2006.050459
14. Polak, D., & Shapira, L. (2018). An update on the evidence for pathogenic mechanisms that may link periodontitis and diabetes. Journal of Clinical Periodontology, 45(2), 150–166. https://doi.org/10.1111/jcpe.12803
15. Santos, V. R., Lima, J. A., De Mendonça, A. C., et al. (2009). Effectiveness of full-mouth and partial-mouth scaling and root planing in treating chronic periodontitis in subjects with type 2 diabetes. Journal of Periodontology, 80(8), 1237–1245. https://doi.org/10.1902/jop.2009.090030
16. Takeda, M., Ojima, M., Yoshioka, H., et al. (2006). Relationship of serum advanced glycation end products with deterioration of periodontitis in type 2 diabetes patients. Journal of Periodontology, 77(1), 15–20. https://doi.org/10.1902/jop.2006.77.1.15
17. Lalla, E., & Papapanou, P. N. (2011). Diabetes mellitus and periodontitis: A tale of two common interrelated diseases. Nature Reviews Endocrinology, 7(12), 738–748. https://doi.org/10.1038/nrendo.2011.106
18. Caton, J. G., Armitage, G., Berglundh, T., et al. (2018). A new classification scheme for periodontal and peri-implant diseases and conditions – Introduction and key changes from the 1999 classification. Journal of Periodontology, 89(S1), S1–S8. https://doi.org/10.1002/JPER.18-0157
19. D’Aiuto, F., Parkar, M., Andreou, G., et al. (2004). Periodontitis and systemic inflammation: Control of the local infection is associated with a reduction in serum inflammatory markers. Journal of Dental Research, 83(2), 156–160. https://doi.org/10.1177/154405910408300214
20. Tonetti, M. S., Greenwell, H., & Kornman, K. S. (2018). Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. Journal of Periodontology, 89(S1), S159–S172. https://doi.org/10.1002/JPER.18-0006
Published
2023-07-18
How to Cite
Kaushik Vishnu Rajkumar, & Dr. Dinesh Kumar. (2023). Residual Periodontal Ligament Levels in Extracted Teeth of Chronic Periodontitis Patients with Type 2 Diabetes Mellitus. Revista Electronica De Veterinaria, 24(3), 634-638. https://doi.org/10.69980/redvet.v24i3.1904
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