[Study on periodontal status of patients with pre-diabetes]

Objective: To investigate periodontal status of patients with pre-diabetes and evaluate the prevalence of periodontal pathogens in oral cavity. Methods: All the subjects were under regular care in urban area of Beijing, including 88 subjects with normal blood glucose (normal blood glucose group), 27 pre-diabetic patients (pre-diabetic group), 58 well-controlled diabetic patients (glucose well controlled group) and 72 poor-controlled diabetic patients (glucose poor controlled group). Whole unstimulated saliva samples were collected before periodontal examination. Periodontal parameters, including plaque index (PLI), probing depth (PD), bleeding index (BI), bleeding on probing (BOP) and clinical attachment loss (CAL), were examined at mesial-buccal and distal-lingual sites of each tooth. Number of missing teeth was recorded. DNA was extracted from the salivary deposition, Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), Treponema denticola (Td), Campylobacter rectus (Cr), and Prevotella nigrescens (Pn) were detected by using PCR method based on 16SrRNA. Periodontal status and prevalence and quantity of the pathogens under various blood glucose states were compared. Results: The PD scores of four groups had no statistical differences. The CAL [(2.29±1.35) mm] and the number of missing teeth[2.0 (7.0)] in pre-diabetic group were significantly lower than that in glucose poor controlled group [(3.07±1.45) mm, P=0.04 and 5.0 (10.0), P=0.04, respectively]. The number of missing teeth in pre-diabetic group [2.0 (7.0)] was significantly lower than that in glucose well controlled group [5.0 (9.0), P=0.02]. The percent of bleeding on probing [BOP(+)%] in pre-diabetic group [(63.89±20.03)%] was significantly higher than that in normal blood glucose group [(54.51±22.29)%, P=0.04] and glucose well controlled group [(53.12±21.77)%, P=0.03]. The prevalence of Pg in pre-diabetic group (81.5%) was significantly higher than that in glucose poor controlled group (54.2%, P=0.02). The prevalence of Tf in pre-diabetic group (96.3%) was significantly higher than that in glucose poor controlled group (76.4%, P=0.01). Meanwhile the quantity of Pg [1.58 (4.75)] and Tf [5.46 (7.77)] in pre-diabetic group were significantly higher than that in glucose poor controlled group [0.60 (1.87), P=0.01 and 1.63 (3.06), P<0.01, respectively]. The quantity of Pn [0.85 (1.68)] in pre-diabetic group was significantly higher than that in normal blood glucose group [0 (1.02), P=0.04]. Conclusions: Pre-diabetic patients showed severe periodontal infection and BOP(+)% than other three groups and had high risk-level of periodontitis.