scholarly journals Interdisciplinary cooperation between dentists and endocrinologists for identification and management of diabetes mellitus

2019 ◽  
Vol 22 (1) ◽  
pp. 35-43
Author(s):  
Elena E. Maslak ◽  
Victoria N. Naumova

Background: DM mellitus (DM) leads to worsening periodontal diseases, and in turn the inflammatory diseases of maxillofacial region adversely affect the glycemic control and exacerbate the severity of DM, thereby engendering a vicious cycle that compromises the DM management in patients. Taking account of the bidirectional relationship between DM and periodontal disease, interdisciplinary examination of patients with both DM and periodontal diseases is warranted to improve the health outcomes in patients. Aims: This study aims to evaluate the perceptions of dentists and endocrinologists on the interdisciplinary cooperation for identification and management of patients with DM. Materials and methods: Studying patients knowledge about DM and their compliance in providing endocrinological recommendations, dental screening survey to identify DM risk and signs The research was done in 2015-2016 years using clinical survey (dental status survey), statistical analysis. 432 patients from different dental organizations and 433 doctors (371 dentists and 62 endocrinologists) took part in the research. The research was approved by Regional research ethics committee. The written informed consent was taken from each participant. Results: There was insufficient interdisciplinary collaboration for identification and management of patients with diabetes, and lack of motivation among dental patients to endocrinological survey. Hence, it is important to incorporate definitive screening for risk of DM for patients with inflammatory periodontal disease and include dentists in consultation for patients with DM. The feasibility of statutory determination of collaboration between specialists in identification and management of patients with DM was found, dental lectures are necessary in DM school. Conclusions: Our findings suggest the necessity of including dentists in the standard of medical management of patients with DM and incorporating DM screening by a questionnaire upon dental examination.

2021 ◽  
Vol 6 (2) ◽  
pp. 43-56
Author(s):  
Gowhar Nazir ◽  
◽  
Josee Amin ◽  

Diabetes mellitus and periodontits are both highly prevalent chronic inflammatory diseases. Both diseases share the same risk factors and are a significant global health care burden adversely affecting the quality of life. Evidence from various studies have demonstrated that diabetes is a major risk factor for periodontal disease and is associated with increased incidence, prevalence and severity of periodontal disease. Hyperglycemia associated with diabetes mellitus results in an increased host immunoinflammatory response which adversely affects the periodontal health. Conversely, periodontits is associated with poor metabolic control in patients with diabetes and increased development of diabetic complications suggesting a bidirectional relationship between the two diseases. Periodontal infection via bacteremia exerts a wide systemic effect by contributing to chronic systemic inflammatory burden worsening diabetic state by increasing insulin resistance. Moreover, studies have demonstrated an improvement in glycemic control following periodontal therapy in prediabetic and diabetic patients with periodontitis.


2021 ◽  
Vol 14 ◽  
Author(s):  
Leandro Bueno Bergantin

Background: A link between inflammatory diseases, e.g., epilepsy, dementia, diabetes, and COVID-19, has been established. For instance, observational studies with several individuals established that people with epilepsy have shown an enhanced incidence of manifesting dysfunctions related to cognition, e.g., dementia, while people with dementia have a higher incidence of manifesting epilepsy, thus an evident bidirectional relationship between epilepsy and dementia might occur. In addition, epilepsy commonly cooccurs in patients with diabetes, so an association between these two disorders is also discussed. Intriguingly, some reports have also observed a poor prognosis for people with both diabetes and COVID-19. It is recognized that a dyshomeostasis of both Ca2+ and cAMP signalling pathways could be a molecular connection for these disorders. Objectives: Therefore, clarifying this clinical relationship among epilepsy, dementia, diabetes, and COVID-19 may outcome in novel hypotheses for identifying the etiology of these disorders.


Author(s):  
G. A. Loban ◽  
T. O. Petrushanko ◽  
V. V. Chereda ◽  
M. O. Faustova ◽  
M. M. Ananieva ◽  
...  

Background. Periodontal tissues inflammatory diseases are widespread among young people. Objective. This study was aimed at elaborating the method to assess risks of periodontal inflammatory diseases and determining its efficacy depending on the state of dental tissues, gum tissues and sex.          Methods. The study included 182 students (93 men, 89 women) aged 19-29: 22 individuals had no lesions of hard dental tissues and no signs of periodontal disease; 51 individuals were found to have DMF index <6; 52 individuals – DMF index ≥6; 57 individuals were diagnosed with chronic catarrhal gingivitis. Primary groups were formed in autumn; re-examination was carried in spring. The research participants were assessed for detection of risks of periodontal inflammatory disease by the method developes by the authors (Patent UA 54041). Results. The study revealed that the risk of development of preiodontitis increases in individuals with high caries and gingivitis intensity. In spring, more individuals suffer from microbial imbalance in in the composition of gingival sulcus fluid and decrease in the mean stability coefficient value that indicates an increased risk of inflammatory periodontal disease development. Women were less likely to experience seasonal dysbiotic changes in the gingival sulcus fluid composition compared with men. Conclusions. The method suggested for assessment of the risk of periodontal inflammatory diseases is of high informativeness. It allows clinicians detecting early pre-nosological signs of oral microbiocenosis imbalance that enhances the effectiveness of early diagnosis of inflammatory periodontal diseases.


2019 ◽  
Vol 2019 ◽  
pp. 1-20 ◽  
Author(s):  
Kívia Queiroz de Andrade ◽  
Cássio Luiz Coutinho Almeida-da-Silva ◽  
Robson Coutinho-Silva

Porphyromonas gingivalis(P. gingivalis) andFusobacterium nucleatum(F. nucleatum) are Gram-negative anaerobic bacteria possessing several virulence factors that make them potential pathogens associated with periodontal disease. Periodontal diseases are chronic inflammatory diseases of the oral cavity, including gingivitis and periodontitis. Periodontitis can lead to tooth loss and is considered one of the most prevalent diseases worldwide.P. gingivalisandF. nucleatumpossess virulence factors that allow them to survive in hostile environments by selectively modulating the host’s immune-inflammatory response, thereby creating major challenges to host cell survival. Studies have demonstrated that bacterial infection and the host immune responses are involved in the induction of periodontitis. The NLRP3 inflammasome and its effector molecules (IL-1βand caspase-1) play roles in the development of periodontitis. We and others have reported that the purinergic P2X7 receptor plays a role in the modulation of periodontal disease and intracellular pathogen control. Caspase-4/5 (in humans) and caspase-11 (in mice) are important effectors for combating bacterial pathogens via mediation of cell death and IL-1βrelease. The exact molecular events of the host’s response to these bacteria are not fully understood. Here, we review innate and adaptive immune responses induced byP. gingivalisandF. nucleatuminfections and discuss the possibility of manipulations of the immune response as therapeutic strategies. Given the global burden of periodontitis, it is important to develop therapeutic targets for the prophylaxis of periodontopathogen infections.


2021 ◽  
Vol 74 (3) ◽  
pp. 702-707
Author(s):  
Galyna F. Biloklytska ◽  
Svitlana Yu. Viala

The aim: Is to characterize the «Medico-sociological map» developed by us to identify systemic and local risk factors for periodontal disease in patients with type I and II diabetes mellitus as a resource to improve the treatment of generalized periodontitis. Materials and methods: We have developed a Medic-sociological map to identify systemic and local risk factors for periodontal disease in patients with type I and type II diabetes mellitus. Methods of accumulation of primary dental and endocrinological information, review and analytical methods. Statistical methods for comparing empirical data and their generalization. Results: Thanks to the «Medico-sociological map» developed by us, systemic and local risk factors for the development of periodontal tissue diseases in patients with type I and II diabetes mellitus have been identified. Factors for improving the well-being of patients in the treatment of periodontal diseases have been comprehensively studied. Patients with type 1 and type 2 diabetes mellitus have been shown to give up healthy habits (cigarette smoking) and lead a healthy lifestyle and reduce the health risks that can be caused by generalized periodontitis in combination with diabetes mellitus. Conclusions: It has been demonstrated that resources to improve the effectiveness of periodontitis treatment in patients with diabetes mellitus include not only cooperation with endocrinologists, but also our «Medico-sociological map» to identify systemic and local risk factors for periodontal disease in patients with type I and II diabetes mellitus.


2018 ◽  
pp. 54-59
Author(s):  
N.N. Saveleva ◽  
I.I. Sokolova ◽  
S.I. German ◽  
T.V. Tomilina

The review of the scientific literature is devoted to the topical issues of studying the etiology of periodontal diseases, which are one of the most common and complex pathologies of the maxillofacial region. Analysis of recent studies proves a stable relationship between the development of periodontal diseases and disorders in the immune system, the neurohumoral system, metabolic disorders, genetic predisposition, and so on. The article presents the data obtained in the course of studying the literature on the role of disorders in the functioning of individual organs (gastrointestinal tract, liver, lungs, heart, and urinary system) in the development of chronic periodontal diseases. The article notes that the anatomical and physiological proximity of the periodontal and digestive tract tissues, the generality of innervation and humoral regulation create prerequisites for the involvement of periodontal disease in the pathological process in diseases of the gastrointestinal tract. One of the main etiological factors in the development of inflammatory diseases of the gastrointestinal tract and periodontium is Helicobacter pylori, which is found in the loci of the oral cavity: in the oral and gingival fluid, on the mucous membrane of the tongue and cheeks, and in the periodontal pockets. It is pointed out that the liver also occupies a special place in the development of periodontal diseases, which is explained by the performance of its significant functions for the human body: regulatory, metabolic, antitoxic and other. There is evidence that the pathology of periodontal disease plays a leading role in the structure of dental diseases in patients with chronic obstructive pulmonary diseases, which is clinically manifested by symptoms of generalized periodontitis of the І-ІІ degrees of development and its complications - partial or complete secondary adentia, and with tooth preservation - defects in dental series and violations of occlusion, function, aesthetics. Scientists suggest a general biological mechanism for the development of generalized periodontitis and cardiovascular diseases, linking the development of periodontal diseases in patients with cardiovascular pathology with microcirculatory disorders. The dependence of the severity of inflammatory changes in the periodontal tissues on the disturbances of salt metabolism in urolithiasis is proved. The data obtained indicate that diseases of the internal organs contribute to the structural damage of periodontal tissues and they are a risk factor for periodontal diseases, which necessitate the presence of not only theoretical knowledge and practical skills in dentistry, but also their awareness of the features and clinical manifestations of somatic pathology. An urgent and justified step in the treatment of periodontal diseases is also the involvement in the process of rendering complex dental care to internist doctors capable of quickly and qualitatively assessment the condition of the internal organs and the basic systems of the patient's body.


2021 ◽  
Vol 2 ◽  
Author(s):  
Fernanda G. Rocha ◽  
Aym Berges ◽  
Angie Sedra ◽  
Shirin Ghods ◽  
Neeraj Kapoor ◽  
...  

Periodontal diseases are chronic inflammatory diseases of the periodontium that result in progressive destruction of the soft and hard tissues supporting the teeth, and it is the most common cause of tooth loss among adults. In the US alone, over 100 million individuals are estimated to have periodontal disease. Subgingival bacteria initiate and sustain inflammation, and, although several bacteria have been associated with periodontitis, Porphyromonas gingivalis has emerged as the key etiological organism significantly contributing to the disease. Currently, intensive clinical maintenance strategies are deployed to mitigate the further progression of disease in afflicted individuals; however, these treatments often fail to stop disease progression, and, as such, the development of an effective vaccine for periodontal disease is highly desirable. We generated a conjugate vaccine, comprising of the purified capsular polysaccharide of P. gingivalis conjugated to eCRM®, a proprietary and enhanced version of the CRM197 carrier protein with predetermined conjugation sites (Pg-CV). Mice immunized with alum adjuvanted Pg-CV developed robust serum levels of whole organism-specific IgG in comparison to animals immunized with unconjugated capsular polysaccharide alone. Using the murine oral bone loss model, we observed that mice immunized with the capsule-conjugate vaccine were significantly protected from the effects of P. gingivalis-elicited oral bone loss. Employing a preclinical model of infection-elicited oral bone loss, our data support that a conjugate vaccine incorporating capsular polysaccharide antigen is effective in reducing the main clinical endpoint of periodontal disease—oral bone destruction. Further development of a P. gingivalis capsule-based conjugate vaccine for preventing periodontal diseases is supported.


2012 ◽  
Vol 08 (01) ◽  
pp. 35 ◽  
Author(s):  
Corneliu Sima ◽  
Michael Glogauer ◽  
◽  

Diabetes and periodontal diseases (PDs) exhibit a bidirectional relationship centered on an enhanced inflammatory response that manifests both locally and systemically. Diabetes is an established risk factor for PD, whereas the treatment of the latter has been shown to improve glycemic control in diabetic patients. Although compelling evidence fromin vitroand animal studies supports a plausible biological explanation for the relationship between the two conditions centered on systemic low-grade inflammation, the limited number of comparable large randomized clinical trials is reflected in the limited specific guidelines offered by the international organizations for diabetes and periodontitis regarding the management of the two diseases in an individual. Further understanding of the biological phenomena underlying PDs and diabetes is critical for individual therapeutic approaches to patients with both conditions by endocrinologists and periodontists.


Author(s):  
A. I. Furdychko ◽  
A. Yu. Buchkovska ◽  
M. A. Pasichnyk

Summary. Inflammatory periodontal diseases continue to be one of the pressing problems of modern dentistry [1]. It is known that there is a close relationship between general-somatic pathology and diseases of the oral cavity [2]. The aim of the study – to learn the effectiveness of the use of anti-dysbiotic hepatoprotector in the complex treatment of patients with periodontal inflammatory diseases on the background of chronic non-calculous cholecystitis. Materials and Methods. The main (group 1) group consisted of 106 people who suffered from inflammatory periodontal disease (IPD) with concomitant chronic non-calculous cholecystitis (CNC). The comparison group included 92 patients with IPD without concomitant pathology (group 2). To compare the research results of the patients with IPD, 30 healthy teethed individuals without periodontal pathology and without somatic diseases (group 3 or the control group) were involved. The state of the hepatobiliary system in patients of the main group was assessed by the doctors of the Gastroenterology Department of Zolochiv District Hospital of Lviv region. Results and Discussion. The symptomatic HCG and the presence of solid and soft dental deposits were diagnosed in all patients. The Green-Vermillion’s index was the highest in patients from the main group (1.67±0.01); it was probably (p <0.05) higher than that in the comparison group (1.54±0.04), as well as in the control group (0.44±0.07). The PMA index in the subgroup 1A immediately after treatment decreased by 9.7 (p <0.001) times. The index of bleeding in the subgroup 1A decreased by 10.7 (p <0.001) times. The PMA index in the subgroup 1A immediately after treatment decreased by 10.4 (p <0.001) times. The index of bleeding in the subgroup 1A under the influence of the proposed therapy decreased by 6.5 (p <0.001) times.The difference regarding the data before treatment remained lower by 2.2 times and 2.0 (p <0.001) times, however, the difference between the subgroups 1A and 1B in 3 months and 6 months was already 2.1 times in both cases. Conclusions. It was found that the clinical course of inflammatory periodontal diseases was much more difficult in these patients. The presence of pathology in the hepatobiliary system in patients increases the risk of periodontal disease. Therefore, in order to improve the efficacy of treatment, it is advisable to use this antidysbiotic drug in the complex treatment, and the results obtained in 3 and 6 months after treatment indicate a long-lasting positive effect.


PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249011
Author(s):  
S. M. Mahmudul Hasan ◽  
Mosiur Rahman ◽  
Keiko Nakamura ◽  
Yuri Tashiro ◽  
Ayano Miyashita ◽  
...  

Introduction The prevalence of periodontal disease is high in diabetes patients worldwide, including Bangladesh. Although associations of periodontal disease outcomes and clinical determinants of diabetes have been investigated, few studies have reported on the relationship between periodontal diseases outcomes with modifiable factors, such as self-care and oral hygiene practices, in patients with diabetes. Moreover, in order to develop targeted strategies, it is also important to estimate their aggregated contribution separately from that of the established sociodemographic and diabetics related clinical determinates. Therefore, this study was performed to elucidate 1) the relationship of diabetes patients’ self-care and oral hygiene practices to periodontal disease and 2) the relative contributions of selected factors to periodontal disease outcome in type 2 diabetes patients. Methods The data were obtained from the baseline survey of a multicentre, prospective cohort study. A total of 379 adult patients with type 2 diabetes from three diabetic centres in Dhaka, Rajshahi and Barishal, received periodontal examinations using the community periodontal index (CPI) probe, glycated haemoglobin examination, other clinical examinations, and structured questionnaires. Multiple logistics regression analyses were performed to assess the associations between selected factors and prevalence of any periodontal disease and its severity. Results More than half of the participants were female (53.8%) and 66.8% of the total participants was 21–50 years old. The prevalence of any (CPI code 2+3+4; 75.7%) and severe form (CPI code 4; 35.1%) of periodontal disease were high in type 2 diabetes patients. In multivariate analysis, the odds of periodontal disease increased with unfavourable glycaemic control indicated by HbA1c ≥ 7%, and decreased by 64%, 85% and 92% with adherence to recommended diet, physical activity, and oral hygiene practices, respectively. Diabetes self-care practice explained the highest proportion of the variance (13.9%) followed by oral hygiene practices (10.9%) by modelling any periodontal disease versus no disease. Variables of diabetes conditions and oral hygiene practices explained 10.9% and 7.3% of the variance by modelling severe (CPI code 4) or moderate (CPI code 3) forms of periodontal disease versus mild form of periodontal disease. Findings also conferred that while poor diabetes control had an individually adverse association with any form of periodontal diseases and its severity, the risk of diseases was moderated by oral hygiene practices. Conclusions This study suggested that, in addition to diabetes-related clinical determinants, self-care practices, and oral hygiene practices must be taken into consideration for prevention and control of periodontal disease in patients with diabetes.


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