INTRODUCTION: Based on the alarming 2008 World Health Organization (WHO) reports concerning the continuously increasing incidence of diabetes mellitus (DM) in the juvenile population we focused our study on the binomial relationship between DM and periodontal disease (PD) within this group of individuals. OBJECTIVE: Related to the clinical stage of periodontal injury we evaluated aspartate aminotransferase (AST) and interleukin 1b (Il-1b) within the gingival crevicular fluid (GCF), as relevant indicators of the PD-related cell destruction and inflammatory processes within juvenile insulin-dependent diabetic (IDDM) subjects. Clinical evaluations consisted of plaque index (PI), papillary bleeding index (PBI) and attachment level (AL) assessment and correlation with the degree of metabolic control. MATERIALS AND METHODS: Measurements of AST (spectrophotometry) and IL-1b (ELISA) were performed within GCF samples from two groups of nondiabetic and diabetic young patients, aged between 6 and 18 years. Glycated hemoglobin (HbA1c) levels were measured by affinity chromatography system. RESULTS AND DISCUSSION: Regardless of the dental pattern (incisive, molar and premolar) AST levels in poorly controlled DM patients displayed higher values compared to well controlled DM patient group, with a considerable increase noted at puberty. Significant differences of the IL-1β levels within the GCF were evidenced between control and IDDM patients, which strengthen the previously reported association between the level of this cytokine and DM in adult population. CONCLUSION: Our study provides an evidence base for associating DM to an increased extent and severity of periodontal destruction even early in life. Therefore, periodontal management of children with DM should be considered in order to diminish the unfavorable effect of such prominent inflammatory process upon metabolic control of DM.
Foia L, Ungureanu D, Toma V, Zlei M, Indrei A, Haba D, et al. Analysis of oral expression of the diabetes-periodontal disease binomial relationship in a juvenile population. Rev Romana Med Lab. 2008;13(4):39-48