The relationship between periodontitis and diabetes mellitus (DM) is widely accepted. Several studies identified a greater incidence of periodontitis and an increase of its severity in diabetic patients, approximately threefold.
In this study, we want to investigate the influence of type 2 DM (T2DM) in the development of periodontitis.
Single center, randomized trial with 90 patients T2DM. Exclusion criteria: chronic renal disease (GFR<90); pregnancy; antibiotics (last 3 months); hemoglobinopathies; bleeding disorders; less than three teeth; periodontal treatment (last 6 months) and smoking habits. Metabolic and biometric parameters were registered and used a computerized periodontal probe to record periodontal status. Variables were analyzed by χ2 tests and multivariable regression with a significance level of 5%.
A total of 90 individuals were observed: 70 males (77.8%); mean age of 64.3 years (±9.95), BMI of 29.1 kg/m2 (±4.42), waist circumference of 103.4 cm, HbA1c of 6.69% (±0.95), T2DM was diagnosed for 11.3 years (±8.66), and 84% had dyslipidemia. Patients had in average 21.4 teeth (±7.1), 98.1% of teeth had bleeding on probing, 11.1% had suppuration and 100% had dental plaque. CAL ranged from 0 to 11 mm. PD was present in 98% of T2DM patients: 55% had initial PD, 30% moderate and 15% severe.
There is an association between metabolic control (HbA1c) and the severity of PD (P<0.001) but not with the duration of T2DM (P=0.415). From multivariable analysis it was found that regardless metabolic control, diabetic patients had a higher risk of develop PD if they were obese or with higher waist measure (P<0.001) and dyslipidemia (P=0.025).
We conclude that patients with T2DM had a high prevalence of PD and similar to other diabetes complications, susceptibility to periodontitis is increased with poor glycemic control. Obesity, high waist circumference and dyslipidemia are a risk factor for PD even with a good glycemic control.