Giuca M R, Pasini M, Giuca G, Caruso S, Necozione S, Gatto R
Department of Surgical, Medical, Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.
Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Eur J Paediatr Dent. 2015 Dec;16(4):319-23.
The purpose of this study was to evaluate the effects of type 1 diabetes and the possible role of metabolic control on the periodontal status of diabetic adolescents.
Three groups of 40 patients each were examined: diabetic subjects with a good metabolic control (well controlled WC) (glycated haemoglobin HbA1c ≤ 7%) (20 males and 20 females; mean age: 14.1 ± 1.5 years); diabetic subjects with poor metabolic control (poorly controlled PC) (glycated haemoglobin HbA1c> 7%) (20 males and 20 females; mean age: 14.5 ± 1.3 years); and patients in good general health, which constituted the control group (20 males and 20 females; mean age: 14.1 ± 1.2 years). For each subject, a periodontal evaluation was performed and the following parameters were assessed: Plaque Index (PI), Gingival Index (GI), Bleeding on probing (BOP), Probing Depth (PD), Clinical Attachment Level (CAL). Chi-square was used to compare categorical variables. Kruskal-Wallis one-way ANOVA by ranks was used to compare the quantitative variables (GBI, PD) among the 3 groups. Post-hoc comparison between pairs of groups was assessed by Wilcoxon's rank sum test, with a downward adjustment of the alpha level to compensate for multiple comparisons.
The levels of PI in WC subjects (1.9 ± 0.8) and in PC subjects (2.1 ± 0.6) were significantly higher compared to healthy subjects in the control group (0.8 ± 0.7) (p <0.0001). Similarly, the GI in both PC (1.9 ± 0.8) and WC subjetcs (1.7 ± 0.9) was significantly higher (p <0.05) compared to controls (0.9 ± 0.8). GBI in the PC (60.2 ± 23.6%) and the WC (57.4 ± 22.5%) groups was significantly higher compared to healthy subjects (35.9 ± 18.7%) (p <0.05). The PD parameter was found significantly higher (p <0.05) in the PC group (26.7 ± 12.6) and WC group (23.5 ± 11.3%) compared with controls (8.3 ± 6.2%). Regarding the CAL, no significant differences were found between the groups (p> 0.05). In addition, the comparisons between groups PC and WC were not statistically significant (p> 0.05).
Adolescents affected with type 1 diabetes show a higher level of bacterial plaque, gingival inflammation with bleeding on probing and probing depth, compared to healthy subjects. There were no significant changes with regard to the accumulation of plaque and periodontal status among diabetic patients both with good control and with poor metabolic control.
本研究旨在评估1型糖尿病的影响以及代谢控制对糖尿病青少年牙周状况的可能作用。
对三组患者进行检查，每组40例：代谢控制良好的糖尿病患者（良好控制组，WC）（糖化血红蛋白HbA1c≤7%）（20名男性和20名女性；平均年龄：14.1±1.5岁）；代谢控制不佳的糖尿病患者（控制不佳组，PC）（糖化血红蛋白HbA1c>7%）（20名男性和20名女性；平均年龄：14.5±1.3岁）；以及健康状况良好的患者，作为对照组（20名男性和20名女性；平均年龄：14.1±1.2岁）。对每位受试者进行牙周评估，并评估以下参数：菌斑指数（PI）、牙龈指数（GI）、探诊出血（BOP）、探诊深度（PD）、临床附着水平（CAL）。采用卡方检验比较分类变量。采用Kruskal-Wallis秩和检验对三组间的定量变量（GBI、PD）进行比较。两组间的事后比较采用Wilcoxon秩和检验，并对α水平进行下调以补偿多重比较。
WC组（平均1.9±0.8）和PC组（平均2.1±0.6）的PI水平显著高于对照组健康受试者（平均0.8±0.7）（p<0.0001）。同样，PC组（平均1.9±0.8）和WC组（平均1.7±0.9）的GI均显著高于对照组（平均0.9±0.8）（p<0.05）。PC组（60.2±23.6%）和WC组（57.4±22.5%）的GBI显著高于健康受试者（35.9±18.7%）（p<0.05）。PC组（平均26.7±12.6）和WC组（平均23.5±11.3%）的PD参数显著高于对照组（平均8.3±6.2%）（p<0.05）。关于CAL，各组之间未发现显著差异（p>0.05）。此外，PC组和WC组之间的比较无统计学意义（p>0.05）。
与健康受试者相比，1型糖尿病青少年的菌斑水平更高，牙龈炎症伴探诊出血和探诊深度更深。代谢控制良好和控制不佳的糖尿病患者在菌斑积累和牙周状况方面均未出现显著变化。
