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Investigation of diabetes mellitus and periodontal disease associations

This thesis had as an overall aim to investigate some of the possible associations between periodontitis and diabetes mellitus. Three areas of investigations were identified: i) clinical/epidemiological ii) genetic/immunological iii) microbiological. 630 outpatients diagnosed with type 1 or type 2 diabetes were included in the first study. The periodontal health of the patients was assessed by means of the Basic Periodontal Examination. For the most advanced cases a full mouth periodontal examination was sought at a later time. The same subjects donated venous blood for genetic analysis. Single nucleotide polymorphisms associated with Interleukin-6, Interleukin-18, Chromosome 9 and FTO (Obesity gene) were analysed. The leukocyte telomere length of the same subjects was also assessed. Associations were found between some of the Interleukin-6 and Interleukin-18 polymorphisms and the presence of severe periodontitis. Also an association of the FTO gene polymorphism was found between severe periodontal disease and type 2 diabetes mellitus. Furthermore, the leukocyte telomere length of the periodontal patients was found to be significantly shorter that that of the periodontally healthy or gingivitis patients. This may be a manifestation of the systemic inflammatory burden that chronic periodontal disease constitutes. A second group of 40 type 2 diabetic patients that were receiving either subgingival debridement or minimal supragingival debridement as part of an ongoing clinical study were chosen for microbiological assessment by means of pyrosequencing at baseline and 2 months following treatment. The results showed a significant clinical improvement in a subgroup (“good responders”) accompanied with a shift of the subgingival microbial population to one more aerobic and one closer to the microbial population associated in the literature with clinical healthy periodontium. Overall several associations on clinical and genetic level were identified. Further observational and experimental studies are needed to elucidate the nature of these associations.
Date January 2014
CreatorsGkranias, N.
PublisherUniversity College London (University of London)
Source SetsEthos UK
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation

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