Analysis of anti-inflammatory toothpastes efficiency among patients with diabetes mellitus and chronic generalized periodontitis

Relevance. Inflammatory periodontal diseases (IPD) on the background of microangiopathy among patients with diabetes mellitus (DM) are considered one of the main complications. Reduced resistance of periodontal tissues and trophic disorders due to changes in capillary walls leads to development of inflammatory processes with the destruction of gingival joint. The presence of diabetes mellitus in patients with chronic generalized periodontitis requires not only conservative periodontal therapy by a dentist, but also constant maintenance therapy, which consists in the ability of patient to maintain satisfactory oral hygiene and the use of therapeutic and prophylactic toothpastes.

Purpose. To evaluate the effectiveness of using toothpastes with anti-inflammatory components among pa-tients with chronic generalized periodontitis and type 1 diabetes after professional oral hygiene complex.

Materials and methods. The examination of 60 patients with diabetes mellitus type 1 and chronic generalized periodontitis at the age of 20 to 50 years was conducted. All patients underwent a questionnaire on the presence of complaints about state of the oral cavity and a comprehensive dental examination with definition of basic dental indices. Then, a complex of professional oral hygiene with individual hygiene training was carried out. Patients were divided into groups depending on the prescribed paste with anti-inflammatory components. Repeated examination was carried out after 1 month.

Results. In 1 month after conservative therapy was carried out, improvement of all indexes in all groups, improvement of the acid-base state of the oral fluid was found. Patients themselves noted a better way change in state of oral cavity tissues. The best dynamics after treatment complex was observed in the 1st group.

Conclusion. Hygienic and periodontal condition of the oral cavity among patients with diabetes mellitus type 1 was initially at a rather low level. It has been revealed that complex of professional oral hygiene and prescription of therapeutic and prophylactic toothpaste improve periodontal status of patients with diabetes.

1. F. D'Aiuto, D. Gable, Z. Syed, Y. Allen, L. Wanyonyi, S. White, J. E. Gallacher. Evidence summary: The relationship between oral diseases and diabe­tes. British Dental Journal. 2017;222(12):944-948. https://doi.org/10.1038/sj.bdj.2017.544.

2. E. M. Allen, J. B. Matthews, D. J. O'Halloran, H. R. Griffiths, I. L. Chap­ pie. Oxidative and inflammatory status in Type 2 diabetes patients with peri­ odontitis. Journal of Clinical Periodontology. 2011;38:894-901. https://doi.org/10.1111/J.1600-051x.2011.01764.x.

3. D. L. Catalfamo, T. M. Britten, D. L. Storch, N. L. Calderon, H. L. Sorenson, S. M. Wallet. Hyperglycemia induced and intrinsic alterations in type 2 diabetes-derived osteoclast function. Oral Diseases. 2013;19:303- 312. https://doi.org/10.1111/odi.12002.

4. К. S. Elbekyan, G. V. Kasimova, Е. V. Markarova, S. A. Bagdasarov. Treatment of chronic generalized peri­ odontitis against the background of diabetes by synthetic analogs of mela­ tonin. Scientific medical bulletin. 2016;1(3):74-80. (In Russ.). https://doi.org/10.17117/nm.2016.01.074.

5. L. Yu. Orekhova, A. A. Aleksandrova, R. S. Musaeva, G. Н. Tolibova, Е. V. Posokhova. State of oral cavity in pregnant women at various types of diabetes: clinical and cytological characteristics. Original studies. Journal of Obstetrics and Women's Illnesses. 2016;65(6):45-51. (In Russ.). https://doi.org/10.17816/JOWD65645-51.

6. A. A. Alexandrova, L. Yu. Orekhova, L. A. Alexandrova, R. S. Musaeva, E. V. Posokhova. Individual approach in the development of a complex of oral hygiene of pregnant women with diabe­ tes. Parodontologiya. 2017;2(83):33-39. (In Russ.). https://elibrary.ru/item.asp?id=29232381.

7. L. Yu. Orekhova, A. A. Aleksandrova, R. S. Mu­saeva, Е. V. Posokhova. Features of the dental status in patients with dia­ betes and pregnant women. Dental disease prevention measures in these groups of patients (literature review). Parodontologiya. 2014;4(73):18-25. (In Russ.). https://elibrary.ru/item.asp?id=22872753.

8. D. R. Ruiz, G. A. Romito, S. A. Dib. Periodontal disease in gestational and type 1 diabetes mellitus pregnant women. Oral Dis. 2011;17(5):515-21. https://doi.org/10.1111/J.1601-0825.2011.01805.x.

9. С A. Castrillon, J. P. Hincapie, F. L. Yepes, N. Roldan, S. M. Moreno, A. Contreras, J. E. Botero. Occurrence of red complex microorganisms and Aggregatibacter actinomycetemcomitans in patients with diabetes. Journal of Investigative and Clinical Dentistry. 2015;6:25-31. https://doi.org/10.1111/jicd.12051.

10. H. P. Artese, P. L. Longo, G. H. Gomes et al. Supragingival biofilm control and systemic inflammation in patients with type 2 diabetes melli­tus. Braz Oral Res. 2015:29. https://doi.org/10.1590/1807-3107BOR-2015.VOI29.0071.

11. G. Nilsson, P. Hedberg, J. Ohrvik. Survival of the fattest: unexpected findings about hyperglycaemia and obesity in a population based study of 75-years-olds. Open. 2011;7(1):29-32. http://dx.doi.org/10.1136/bmjopen-2010-000012.

12. L. Yu. Orekhova, A. A. Aleksandrova, Е. S. Silina etc. Parodontological status and efficiency of the complex of individual oral hy­giene in prevention of inflammatory periodontal diseases in pregnant wom­en with diabetes mellitus. Parodontologiya. 2015;20(4);77:33-39. (In Russ.). https://elibrary.ru/item.asp?id=25615432.

13. L. Yu. Orekho­va, Е. S. Loboda, D. S. Shcherbakova. Antibacterial and anti-inflammatory ef­fects of periodontal therapy with Vector. Parodontologiya. 2011 ;3(60):31-37. (In Russ.). https://elibrary.ru/item.asp?id=16752401.

14. L. Yu. Orekhova, I. A. Gorbacheva, R. S. Musaeva, L. A. Shestakova, 0. V. Mikhailova. Cytoprotective approach to the problem of inflamma­tory periodontal diseases treatment at the patients with diabetes mellitus decision. Parodontologiya. 2009;1:23-29. (In Russ.). https://elibrary.ru/item.asp?id=12808004.

15. L. Yu. Orekhova, Е. S. Lo­ boda, Е. V. Grinenko, R. S. Musaeva. The effectiveness of complex conserva­tive periodontal therapy using a gentle treatment technique by ultrasonic apparatus with calcium hydroxide polishing suspension among patients with type 1 diabetes and chronic generalized periodontitis. Parodontologiya. 2019;24(3):223-231. (In Russ.). https://doi.org/10.33925/1683-3759-2019-24-3-223-231.