Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Prediyabetik ve Tip 2 Diyabetik Hastalarda Ağız ve Diş Sağlığının Değerlendirilmesi: Kesitsel Çalışma
Evaluation of Oral and Dental Health in Prediabetic and Type 2 Diabetic Patients: A Cross-Sectional Study
Şelale ŞAHİNa , Gizem AYANb , Bahri EVRENc , Burak DAYId
aMalatya İl Sağlık Müdürlüğü, Malatya, Türkiye
bÇanakkale Onsekiz Mart Üniversitesi Diş Hekimliği Fakültesi, Restoratif Diş Tedavisi AD, Çanakkale, Türkiye
cİnönü Üniversitesi Tıp Fakültesi, Endokrinoloji ve Metabolizma Hastalıkları BD, Malatya, Türkiye
dİnönü Üniversitesi Diş Hekimliği Fakültesi, Restoratif Diş Tedavisi AD, Malatya, Türkiye
Turkiye Klinikleri J Dental Sci. 2025;31(2):291-7
doi: 10.5336/dentalsci.2024-106589
Article Language: TR
Full Text
ÖZET
 Amaç: Tip 2 diyabet (T2DM) ve prediyabet, hem sistemik hem de ağız sağlığını olumsuz etkileyen metabolik durumlardır ve birbirleriyle ilişkili etkilerinin kapsamlı bir şekilde değerlendirilmesini gerekmektedir. Bu çalışmanın amacı, prediyabet ve T2DM'nin yetişkinlerde ağız ve diş sağlığı üzerindeki etkilerini incelemektir. Gereç ve Yöntemler: Toplam 139 kişi değerlendirilmiştir; 46'sı prediyabetik, 47'si T2DM'li ve 46'sı kontrol grubunda yer almıştır. Ağız ve diş sağlığı değerlendirmeleri çürük, kayıp, dolgulu diş sayısı [Decay, missing, filled teeth (DMFT)] indeksi, plak indeksi (Pİ), gingival indeks (Gİ) ve uyarılmamış tükürük akış hızı (UTAH) ölçümlerini içermiştir. Tüm bireyler için açlık plazma glukozu (APG), HbA1c ve beden kitle indeksi ölçümleri de yapılmıştır. Bulgular: T2DM grubunda, kayıp diş sayısı (M) ve DMFT indeksi, prediyabet ve kontrol gruplarına kıyasla anlamlı derecede daha yüksek; buna karşın UTAH anlamlı derecede daha düşük bulunmuştur. Ayrıca, prediyabet grubunda M kontrol grubuna kıyasla anlamlı derecede daha yüksek, UTAH ise anlamlı derecede daha düşük belirlenmiştir. Glikozlanmış hemoglobin (HbA1c) ve APG ile DMFT skoru, Pİ ve Gİ arasında anlamlı pozitif bir korelasyon gözlemlenmiştir. Buna karşın, tüm bireylerde UTAH ile hem HbA1c hem de APG arasında anlamlı negatif bir korelasyon tespit edilmiştir. Sonuç: Bu bulgular, hem T2DM'nin hem de prediyabetin yetişkin hastalarda ağız ve diş sağlığı üzerinde olumsuz etkilere sahip olabileceğini göstermekte ve bu popülasyonlarda kapsamlı ağız sağlığı değerlendirmelerine olan ihtiyacı vurgulamaktadır.

Anahtar Kelimeler: Diyabet; periodontal indeks; prediyabetik durum
ABSTRACT
 Objective: Type 2 Diabetes Mellitus (T2DM) and prediabetes are metabolic conditions that adversely affect both systemic and oral health, necessitating a comprehensive assessment of their interconnected impacts. The aim of this study is to investigate the effects of prediabetes and T2DM on oral and dental health in adults. Material and Methods: A total of 139 subjects were evaluated; 46 with prediabetes, 47 with T2DM, and 46 as controls. Oral and dental health assessments included the decay, missing, filled teeth index, plaque index (PI), gingival index (GI), and unstimulated salivary flow rate (USFR). Fasting plasma glucose (FPG), HbA1c, and body mass index measurements were also obtained for all subjects. Results: In the T2DM group, the number of missing teeth (M) and the DMFT index were significantly higher compared to the prediabetes and control groups, while UTAH was significantly lower. Additionally, in the prediabetes group, M was significantly higher compared to the control group, and UTAH was significantly lower. A significant positive correlation was observed between HbA1c and APG with the DMFT score, PI, and GI. However, in all individuals, a significant negative correlation was found between UTAH and both HbA1c and APG. Conclusion: These findings indicate that both T2DM and prediabetes are likely to negatively impact oral and dental health in adult patients, underscoring the need for comprehensive oral health assessments in these populations.

Keywords: Diabetes mellitus; periodontal index; prediabetic state
REFERENCES:
  1. Vieira R, Souto SB, Sánchez-López E, Machado AL, Severino P, Jose S, et al. Sugar-Lowering Drugs for Type 2 Diabetes Mellitus and Metabolic Syndrome-Strategies for In Vivo Administration: Part-II. J Clin Med. 2019;8(9):1332. [Crossref]  [PubMed]  [PMC] 
  2. Chinnasamy A, Moodie M. Prevalence of undiagnosed diabetes and prediabetes in the dental setting: a systematic review and meta-analysis. Int J Dent. 2020;2020:2964020. [Crossref]  [PubMed]  [PMC] 
  3. Bansal N. Prediabetes diagnosis and treatment: a review. World J Diabetes. 2015;6(2):296-303. [Crossref]  [PubMed]  [PMC] 
  4. Fiorentino TV, Marini MA, Andreozzi F, Arturi F, Succurro E, Perticone M, et al. One-hour postload hyperglycemia is a stronger predictor of type 2 diabetes than impaired fasting glucose. J Clin Endocrinol Metab. 2015;100(10):3744-51. [Crossref]  [PubMed] 
  5. Lima RPE, Belém FV, Abreu LG, Cunha FA, Cota LOM, da Costa JE, et al. Effect of periodontal therapy on serum levels of il-6 in type 2 diabetics: a systematic review. Int J Periodontics Restorative Dent. 2019;39(1):e1-e10. [Crossref]  [PubMed] 
  6. Kogawa EM, Grisi DC, Falcão DP, Amorim IA, Rezende TM, da Silva IC, et al. Impact of glycemic control on oral health status in type 2 diabetes individuals and its association with salivary and plasma levels of chromogranin A. Arch Oral Biol. 2016;62:10-9. [Crossref]  [PubMed] 
  7. Lamster IB, Cheng B, Burkett S, Lalla E. Periodontal findings in individuals with newly identified pre-diabetes or diabetes mellitus. J Clin Periodontol. 2014;41(11):1055-60. [Crossref]  [PubMed] 
  8. Huang Y, Guo W, Zeng J, Chen G, Sun W, Zhang X, et al. Prediabetes enhances periodontal inflammation consistent with activation of toll-like receptor-mediated nuclear factor-κb pathway in rats. J Periodontol. 2016;87(5):e64-74. [Crossref]  [PubMed] 
  9. Costa KL, Taboza ZA, Angelino GB, Silveira VR, Montenegro R Jr, Haas AN, et al. Influence of periodontal disease on changes of glycated hemoglobin levels in patients with type 2 diabetes mellitus: a retrospective cohort study. J Periodontol. 2017;88(1):17-25. [Crossref]  [PubMed] 
  10. El-Sharkawy HM, Anees MM, Van Dyke TE. Propolis Improves Periodontal Status and Glycemic Control in Patients With Type 2 Diabetes Mellitus and Chronic Periodontitis: A Randomized Clinical Trial. J Periodontol. 2016;87(12):1418-26. [Crossref]  [PubMed] 
  11. Anton DM, Martu MA, Maris M, Maftei GA, Sufaru IG, Tatarciuc D, et al. Study on the effects of melatonin on glycemic control and periodontal parameters in patients with type ii diabetes mellitus and periodontal disease. Medicina (Kaunas). 2021;57(2):140. [Crossref]  [PubMed]  [PMC] 
  12. Kamiab N, Mohammadi Kamalabadi Y, Sheikh Fathollahi M. Dmft of the first permanent molars, dmft and related factors among all first-grade primary school students in Rafsanjan urban area. J Dent (Shiraz). 2021;22(2):109-17. [PubMed]  [PMC] 
  13. Kudiyirickal MG, Pappachan JM. Diabetes mellitus and oral health. Endocrine. 2015;49(1):27-34. [Crossref]  [PubMed] 
  14. Saghiri MA, Karamifar K, Fakharzadeh A, Conte M, Morgano SM. Effect of diabetes on tubular density and push-out bond strength of mineral trioxide aggregate to dentin. J Endod. 2020;46(11):1584-91. [Crossref]  [PubMed] 
  15. Saghiri MA, Freag P, Nath D, Morgano SM. The effect of diabetes on the tensile bond strength of a restorative dental composite to dentin. Odontology. 2022;110(4):648-54. [Crossref]  [PubMed] 
  16. Ahmad R, Haque M. Oral health messiers: diabetes mellitus relevance. Diabetes Metab Syndr Obes. 2021;14:3001-15. [Crossref]  [PubMed]  [PMC] 
  17. Leite RS, Marlow NM, Fernandes JK, Hermayer K. Oral health and type 2 diabetes. Am J Med Sci. 2013;345(4):271-3. [Crossref]  [PubMed]  [PMC] 
  18. Wu CZ, Yuan YH, Liu HH, Li SS, Zhang BW, Chen W, et al. Epidemiologic relationship between periodontitis and type 2 diabetes mellitus. BMC Oral Health. 2020;20(1):204. [Crossref]  [PubMed]  [PMC] 
  19. Genco RJ, Graziani F, Hasturk H. Effects of periodontal disease on glycemic control, complications, and incidence of diabetes mellitus. Periodontol 2000. 2020;83(1):59-65. [Crossref]  [PubMed] 
  20. Alasqah M, Mokeem S, Alrahlah A, Al-Hamoudi N, Abduljabbar T, Akram Z, et al. Periodontal parameters in prediabetes, type 2 diabetes mellitus, and non-diabetic patients. Braz Oral Res. 2018;32:e81. Erratum in: Braz Oral Res. 2019;32:e81err. [Crossref]  [PubMed] 
  21. Zhang Y, Liu C, Chen B, Chen F, Duan JY, Zhang MJ, et al. [Associations of impaired glucose metabolism with chronic peridontitis in pre-diabetes patients]. Beijing Da Xue Xue Bao Yi Xue Ban. 2020;52(1):71-6. Chinese. [PubMed]  [PMC] 
  22. Joshipura KJ, Muñoz-Torres FJ, Dye BA, Leroux BG, Ramírez-Vick M, Pérez CM. Longitudinal association between periodontitis and development of diabetes. Diabetes Res Clin Pract. 2018;141:284-93. [Crossref]  [PubMed]  [PMC] 
  23. Montero E, Carasol M, Fernández-Meseguer A, Calvo-Bonacho E, García-Margallo MT, Sanz M, Herrera D. Prediabetes and diabetes prevalence in the workers? oral health study. Clin Oral Investig. 2019;23(12):4233-41. [Crossref]  [PubMed] 
  24. Chan AKY, Tamrakar M, Jiang CM, Lo ECM, Leung KCM, Chu CH. Common medical and dental problems of older adults: a narrative review. Geriatrics (Basel). 2021;6(3):76. [Crossref]  [PubMed]  [PMC] 
  25. Pandey AK. Physiology of saliva: an overview. J Dent Indones. 2014;21(1):32-8. [Link] 
  26. Prasanthi B, Kannan N, Patil R. Effect of diuretics on salivary flow, composition and oral health status: a clinico-biochemical study. Ann Med Health Sci Res. 2014;4(4):549-53. [Crossref]  [PubMed]  [PMC] 
  27. Kaur S, Kaur K, Rai S, Khajuria R. Oral health management considerations in patients with diabetes mellitus. Arch Med Health Sci. 2015;3(1):72-9. [Crossref] 
  28. López-Pintor RM, Casañas E, González-Serrano J, Serrano J, Ramírez L, de Arriba L, et al. Xerostomia, hyposalivation, and salivary flow in diabetes patients. J Diabetes Res. 2016;2016:4372852. [Crossref]  [PubMed]  [PMC] 
  29. Hoseini A, Mirzapour A, Bijani A, Shirzad A. Salivary flow rate and xerostomia in patients with type I and II diabetes mellitus. Electron Physician. 2017;9(9):5244-9. [Crossref]  [PubMed]  [PMC] 
  30. Ferizi L, Dragidella F, Spahiu L, Begzati A, Kotori V. The influence of type 1 diabetes mellitus on dental caries and salivary composition. Int J Dent. 2018;2018:5780916. [Crossref]  [PubMed]  [PMC] 
  31. Javed F, Al-Kheraif AA, Al Amri MD, Alshehri M, Vohra F, Al-Askar M, et al. Periodontal status and whole salivary cytokine profile among smokers and never-smokers with and without prediabetes. J Periodontol. 2015;86(7):890-8. [Crossref]  [PubMed] 
  32. Rafatjou R, Razavi Z, Tayebi S, Khalili M, Farhadian M. Dental health status and hygiene in children and adolescents with type 1 diabetes mellitus. J Res Health Sci. 2016;16(3):122-6. [PubMed]  [PMC] 
  33. Barylo ОS, Kanishyna ТМ, Shkilniak LI. The effects of diabetes mellitus on patients? oral health. Wiad Lek. 2018;71(5):1026-31. [PubMed] 
  34. Coelho AS, Amaro IF, Caramelo F, Paula A, Marto CM, Ferreira MM, et al. Dental caries, diabetes mellitus, metabolic control and diabetes duration: A systematic review and meta-analysis. J Esthet Restor Dent. 2020;32(3):291-309. [PubMed] 
  35. Salehi M, Mesgarani A, Karimipour S, Pasha SZ, Kashi Z, Abedian S, et al. Comparison of salivary cortisol level in type 2 diabetic patients and pre-diabetics with healthy people. Open Access Maced J Med Sci. 2019;7(14):2321-7. [Crossref]  [PubMed]  [PMC] 

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