Jin D S S, Liao Y T, He L, Meng H X, Li P
Department of Periodontology, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China.
Zhonghua Kou Qiang Yi Xue Za Zhi. 2019 Mar 9;54(3):157-163. doi: 10.3760/cma.j.issn.1002-0098.2019.03.003.
To investigate periodontal status of patients with pre-diabetes and evaluate the prevalence of periodontal pathogens in oral cavity. All the subjects were under regular care in urban area of Beijing, including 88 subjects with normal blood glucose (normal blood glucose group), 27 pre-diabetic patients (pre-diabetic group), 58 well-controlled diabetic patients (glucose well controlled group) and 72 poor-controlled diabetic patients (glucose poor controlled group). Whole unstimulated saliva samples were collected before periodontal examination. Periodontal parameters, including plaque index (PLI), probing depth (PD), bleeding index (BI), bleeding on probing (BOP) and clinical attachment loss (CAL), were examined at mesial-buccal and distal-lingual sites of each tooth. Number of missing teeth was recorded. DNA was extracted from the salivary deposition, (Pg), (Tf), (Td), (Cr), and (Pn) were detected by using PCR method based on 16SrRNA. Periodontal status and prevalence and quantity of the pathogens under various blood glucose states were compared. The PD scores of four groups had no statistical differences. The CAL [(2.29±1.35) mm] and the number of missing teeth[2.0 (7.0)] in pre-diabetic group were significantly lower than that in glucose poor controlled group [(3.07±1.45) mm, 0.04 and 5.0 (10.0), 0.04, respectively]. The number of missing teeth in pre-diabetic group [2.0 (7.0)] was significantly lower than that in glucose well controlled group [5.0 (9.0), 0.02]. The percent of bleeding on probing [BOP(+)%] in pre-diabetic group [(63.89±20.03)%] was significantly higher than that in normal blood glucose group [(54.51±22.29)%, 0.04] and glucose well controlled group [(53.12±21.77)%, 0.03]. The prevalence of Pg in pre-diabetic group (81.5%) was significantly higher than that in glucose poor controlled group (54.2%, 0.02). The prevalence of Tf in pre-diabetic group (96.3%) was significantly higher than that in glucose poor controlled group (76.4%, 0.01). Meanwhile the quantity of Pg [1.58 (4.75)] and Tf [5.46 (7.77)] in pre-diabetic group were significantly higher than that in glucose poor controlled group [0.60 (1.87), 0.01 and 1.63 (3.06), 0.01, respectively]. The quantity of Pn [0.85 (1.68)] in pre-diabetic group was significantly higher than that in normal blood glucose group [0 (1.02), 0.04]. Pre-diabetic patients showed severe periodontal infection and BOP(+)% than other three groups and had high risk-level of periodontitis.
探讨糖尿病前期患者的牙周状况,评估口腔中牙周病原体的患病率。所有受试者均在北京城区接受常规护理,包括88例血糖正常的受试者(正常血糖组)、27例糖尿病前期患者(糖尿病前期组)、58例血糖控制良好的糖尿病患者(血糖良好控制组)和72例血糖控制不佳的糖尿病患者(血糖不佳控制组)。在进行牙周检查前收集全唾液样本。在每颗牙齿的近中颊侧和远中舌侧位点检查牙周参数,包括菌斑指数(PLI)、探诊深度(PD)、出血指数(BI)、探诊出血(BOP)和临床附着丧失(CAL)。记录缺失牙数量。从唾液沉积物中提取DNA,采用基于16SrRNA的PCR方法检测牙龈卟啉单胞菌(Pg)、具核梭杆菌(Tf)、齿垢密螺旋体(Td)、卷曲螺旋体(Cr)和中间普氏菌(Pn)。比较不同血糖状态下的牙周状况以及病原体的患病率和数量。四组的PD评分无统计学差异。糖尿病前期组的CAL[(2.29±1.35)mm]和缺失牙数量[2.0(7.0)]显著低于血糖不佳控制组[(3.07±1.45)mm,0.04和5.0(10.0),0.04]。糖尿病前期组的缺失牙数量[2.0(7.0)]显著低于血糖良好控制组[5.0(9.0),0.02]。糖尿病前期组的探诊出血百分比[BOP(+)%][(63.89±20.03)%]显著高于正常血糖组[(54.51±22.29)%,0.04]和血糖良好控制组[(53.12±21.77)%,0.03]。糖尿病前期组Pg的患病率(81.5%)显著高于血糖不佳控制组(54.2%,0.02)。糖尿病前期组Tf的患病率(96.3%)显著高于血糖不佳控制组(76.4%,0.01)。同时,糖尿病前期组Pg[1.58(4.75)]和Tf[5.46(7.77)]的数量显著高于血糖不佳控制组[0.60(1.87),0.01和1.63(3.06),0.01]。糖尿病前期组Pn的数量[0.85(1.68)]显著高于正常血糖组[0(1.02),0.04]。糖尿病前期患者比其他三组表现出更严重的牙周感染和BOP(+)%,并且有更高的牙周炎风险水平。