Published date: Apr 25 2022

Journal Title: KnE Medicine

Issue title: The International Online Seminar Series on Periodontology in conjunction with Scientific Seminar

Pages: 151-159

DOI: 10.18502/kme.v2i1.10847

Natalina .natalinahaerani@yahoo.comDepartment of Periodontology, Faculty of Dentistry, Universitas Indonesia

Putriani GrisnandaSpecialist Program in Periodontology, Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Indonesia

Irene NathaniaSpecialist Program in Periodontology, Department of Periodontology, Faculty of Dentistry, Universitas Indonesia, Indonesia

Yuniarti SoerosoDepartment of Periodontology, Faculty of Dentistry, Universitas Indonesia

Robert LessangDepartment of Periodontology, Faculty of Dentistry, Universitas Indonesia

Benso SulijayaDepartment of Periodontology, Faculty of Dentistry, Universitas Indonesia

Background: According to the American Academy of Periodontology (AAP)’s classification of periodontal disease in 2017, diabetes mellitus is one of the grade modifiers of the progressivity of the disease, which is determined by the HbA1c level of a patient. Systemic condition is often considered as a risk factor that aggravates periodontal tissue breakdown. However, the progressivity of periodontal disease can also be found in healthy (nondiabetic) patients.

Objective: To identify the role of type-2 diabetes mellitus and its effect on the severity of periodontal breakdown in periodontitis stage 4 grade C patients.

Case Report: This case report describes the condition of female patients, aged 30–40 years, who presented to the periodontology clinic in RSKGM FKG UI, with the chief complaint of severe tooth mobility. The patients reported were healthy and diabetic (type-2 diabetes mellitus) patients diagnosed with periodontitis stage 4 grade C. Initial therapies were carried out, such as, such as scaling, occlusal adjustment and dental splint.

Results: Clinical outcomes after one week showed no inflammation, no oedematous, no redness on gingiva and less mobility on several teeth. Both groups showed extended and aggressive progress of the disease, however, the systemic conditions also played a critical role in the overall periodontal tissue breakdown.

Conclusion: Management of systemic disease is crucial in order to prevent periodontal breakdown or complications that could happen in periodontal therapies.

Keywords: periodontitis, systemic disease, diabetes mellitus, case report

[1] World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications: Report of a WHO consultation. Part 1, Diagnosis and classification of diabetes mellitus. World Health Organization; Geneva 1999. Available from: https://apps.who.int/iris/handle/10665/66040

[2] Cowie CC, Rust KF, Byrd-Holt DD, et al. Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: National Health and Nutrition Examination Survey 1999–2002. Diabetes Care. 2008;29(6):1263–1268.

[3] Kathiresan TS, Masthan KMK, Sarangarajan R, et al. A study of diabetes associated oral manifestations. Journal of Pharmacy & Bioallied Science. 2017;9(1):21–26.

[4] Caton JG, Armitage G, Berglundh T, et al. A new classification scheme for periodontal and peri-implant diseases and conditions – Introduction and key changes from the 1999 classification. Journal of Clinical Periodontology. 2018;45(20):1–8. https://doi.org/10.1111/jcpe.12935

[5] Preshaw PM, Alba AL, Herrera D, et al. Periodontitis and diabetes: A two-way relationship. Diabetologia. 2012;55:21–31.

[6] Bartold PM, van Dyke TE. Periodontitis: A hostmediated disruption of microbial homeostasis. Unlearning learned concepts. Periodontol 2000. 2013;62:203–17.

[7] Gumus P, Buduneli N. Diabetes mellitus and periodontitis: Signs of a bidirectional relationship. European Medical Journal. 2013;1:30–36.

[8] Ervasti T, Knuuttila M, Pohjamo L, et al. Relation between control of diabetes and gingival bleeding. J Periodontol. 1985;56:154.

[9] Taylor JJ, Preshaw PM, Lalla E. A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes. Journal of Clinical Periodontology. 2013;40(140):113.

[10] Ishikawa M, Yoshida K, Okamura et al. Oral Porphyromonas gingivalis translocates to the liver and regulates hepatic glycogen synthesis through the Akt/ GSK-3ß signaling pathway. Biochimica et Biophysica Acta. 2013;1832:2035–2043.

[11] Cha´varry NGM, Vettore MV, Sansone C, et al. The relationship between diabetes mellitus and destructive periodontal disease: A meta-analysis. Oral Health & Preventive Dentistry. 2009;7:107–127.

[12] Lalla E, Lamster B, Stern DM, et al. Receptor for advanced glycation end products, inflammation, and accelerated periodontal disease in diabetes: Mechanisms and insights into therapeutic modalities. Annals of Periodontology. 2001;6:113–118.

[13] Polak D, Shapira L. An update on the evidence for pathogenic mechanisms that may link periodontitis and diabetes. Journal of Clinical Periodontology. 2018;45:150–166.

[14] Botero JE, Yepes FL, Roldan N, et al. Tooth and periodontal clinical attachment loss are associated with hyperglycaemia in patients with diabetes. Journal of Periodontology. 2012;83: 1245-1250. https://doi.org/10.1902/jop.2012.110681

[15] Quintero AJ, Chaparro A, Qurynen M, et al. Effect of two periodontal treatment modalities in patients with uncontrolled type 2 diabetes mellitus: A randomized clinical trial. Journal of Clinical Periodontology. 2018;45:1098–1106. https://doi.org/10.1111/jcpe.12991

[16] Duarte PM, Feres M, Yassine LLS, et al. Clinical and microbiological effects of scaling and root planing, metronidazole and amoxicillin in the treatment of diabetic and non- diabetic subjects with periodontitis: A cohort study. Journal of Clinical Periodontology. 2018;45:1326–1335. https://doi.org/10.1111/jcpe.12994