Clinical evaluation of periodontal status of diabetic and non-diabetics genetically high-risk patients

• Grant number: 05/04674-0
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: February 01, 2006
• End date: January 31, 2007
• Field of knowledge: Health Sciences - Dentistry - Periodontology
• Principal Investigator: Adriana Campos Passanezi Santana
• Grantee: Otavio Pagin
• Host Institution: Faculdade de Odontologia de Bauru (FOB). Universidade de São Paulo (USP). Bauru , SP, Brazil

Abstract

Recent findings have been suggesting that periodontal disease is more prevalent, incident and severe in diabetic patients due to this pathology be now considered as a diabetes complication. Many hypothesis have been used to explain the increased risk of periodontal disease in diabetics, including vascular and neutrophilic alterations and abnormal collagen metabolism. Recently, it has been proposed that the accumulation of end glicolisation produtcs (AGEs) results in increased monocyte and macrophage chemotaxis, binding to endothelial cell and monocytes by a specific cell receptor called RAGE. The interaction AGE-RAGE, by turn, results in critical cellular alterations, favoring the development of vascular dysfunction and damaged repair responses, stimulating the proliferation of monocytes and inducing the release of free oxygen radicals and inflammatory cytokines, such as IL-1ß and TNF-. It has also been suggested in the past years that cronic infections, such as periodontal disease, could cause a resistance in insulin uptake by the body as a whole, conducting to a prolonged hyperglycemic state that could difficult diabetes control. As so, the aim of this study is to evaluate periodontal status of diabetic patients compared to non diabetics with genetic predisposition to diabetes as well as to evaluate the influence of periodontal treatment in glycemic control. Besides, the correlation between plaque index and the periodontal parameters will be investigated. A total of 30 diabetic patients will be invited to participate in this study, constituting the experimental group (group I). The control group (group II) will be constituted by 30 consanguineous non diabetic relatives of the patients in Group I. After the application of a health questionnaire to investigate the medical history of all patients, the periodontal conditions will be evaluated according to plaque index, probing depth, contour modifications in gingival margin, bleeding on probing, swallowing, abcesses presence, level of clinical attachment and radiographic bone loss. The patients will be clinically evaluated at baseline, 4 and 8 months after treatment and radiographically at baseline and 8 months post-operatively. Laboratory oral glucose tolerance test will be performed initially and at 8-month control. Additionally, to evaluate the effects of periodontal treatment in glycemic control, glycated hemoglobin test will be provided at 4 and 8 months. At each treatment visit, monitoring of glycemic control will be investigated by a glucosymeter. Data will be statistically evaluated according to Students t-test to evaluate periodontal conditions between the groups, paired t-test to evaluate the glycemic control and periodontal conditions before and after treatment in-group and Pearsons correlation test to investigate the correlation between glycemic levels and the clinical parameters as well as plaque index to periodontal parameters. (AU)