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2018, vol. 34, br. 78, str. 1858-1870
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Parodontopatija kod pacijenata sa dijabetes mellitusom tipa 2
Periodontal disease in patients with type 2 Diabetes mellitus
aUniverzitet u Nišu, Medicinski fakultet, Stomatološka klinika bUniverzitet u Kragujevcu, Fakultet medicinskih nauka cUniverzitet u Nišu, Medicinski fakultet dn/a
e-adresa: dr.rada@yahoo.com
Projekat: Ovaj rad je urađen pod pokroviteljstvom Internog projekta broj 1114629-4/11 Medicinskog fakulteta Univerziteta u Nišu.
Sažetak
Dijabetes (DM; diabetes mellitus) je jedan od najzastupljenijih endokrinih metaboličkih poremećaja. Dijabetes izaziva oštećenje usne duplje i predstavlja faktor rizika za razvoj parodontopatije. Cilj istraživanja je opisati parodontalni status kod pacijenata sa dijabetesom tipa 2 i proceniti demografske, socijalne, medicinske i stomatološke faktore rizika povezane sa parodontopatijom i dijabetesom. Materijal i Metode: Analizirani su demografski podaci, medicinska i stomatološka istorija bolesti, urađen pregled parodonta (određen nivo pripojnog epitela, krvarenje pri sondiranju i prisustvo zubnog kamenca) i citomorfometrijska analiza. Rezultati: 160 ispitanika je učestvovalo u istraživanju, starosti 64,2 (±0,2) godina, prosečne dužine trajanja DM 23,6 (±0,39) godina i srednje vrednosti HbA1c 8,70% (±0,45). Visoke vrednosti nivoa epitelnog pripoja i kamenac bili su zastupljeniji kod starijih pacijenata. Krvarenje pri sondiranju je bio istih vrednosti nezavisno od starosti pacijenata. Citomorfometrijska analiza je pokazala prisustvo većih jedara kod starijih pacijenata. Prema regresionoj analizi faktori povezani sa uznapredovalom parodontopatijom su: starost (P<0,001), pušenje cigareta (p<0,001), bivši pušači (p<0,001), pranje zuba (p=0,017), posete stomatologu (p=0,068), dužina trajanja DM (p=0,034), kserostomija (p=0,500), povećanje vrednosti HbA1c (p=0,119), neuropatija (p=0,017), nefropatija (p=0,389), retinopatija (p=0,550) i periferna vaskularna kardiomiopatija (p=0,060). Zaključak: Parodontopatija je često oboljenje kod starijih dijabetesnih bolesnika. Pušenje cigareta u starijoj životnoj dobi je povezano sa visokom učestalošću uznapredovale parodontopatije. Pušači dijabetičari imaju visok rizik za lošu prognozu parodontopatije i moraju dolaziti na redovne parodontološke kontrolne preglede i terapiju.
Abstract
Diabetes mellitus (DM) is one of the most prevalent endocrine metabolic disorders. It has damaging effects on the oral cavity and is reported to be a risk factor for periodontal disease. The aim of the study was to describe the periodontal status of patients with type 2 DM and to evaluate the multiple demographic, behavioral, medical and dental factors that may be associated with periodontal disease and DM. Material and Methods: Demographic data and medical and dental histories were reviewed, periodontal assessments (loss of attachment, bleeding on probing, presence of supragingival calculus) and cytomorphometric analysis were made. Results: 160 subjects participated in the study, age of 64.2 (±0.2) years, duration of DM 23.6 (±0.39) years and HbA1c 8.70% (±0.45). Severe loss of attachment and calculus were more present in older patients. Bleeding on probing was consistent among subjects in each age group. Cytomorphometric analysis revealed larger nuclear area values in older subjects. Factors possibly associated with advanced periodontal disease included in the regression analysis were: age (P<0.001), current smoking cigarettes (p<0.001), having ever smoked cigarettes (p<0.001), tooth brushing (p=0.017), visits to the dentist (p=0.068), duration of disease (p=0.034), xerostomia (p=0.500), HbA1c(p=0.119), neuropathy (p=0.017), nephropathy (p=0.389), retinopathy (p=0.5 50) and peripheral vascular disease (p=0.060). Conclusion: Periodontal disease was common in adult diabetic population. Cigarette smoking and older age were associated with a higher prevalence of advanced periodontal disease. Smoker-diabetic patients are at high risk for poor periodontal prognosis, and they should be included in regular periodontal control check up and treatment.
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