Abstract
The bidirectional relationship between periodontitis and diabetes mellitus has been well documented. Periodontitis causes systemic inflammatory burden through inflammatory mediators. The currently used tools such as Clinical Attachment Loss (CAL) and Probing Pocket Depth (PPD) to assess periodontitis are linear measurements, that do not exactly quantify the inflammatory burden of periodontitis. Periodontal Inflamed Surface Area (PISA) reflects the surface area of bleeding pocket epithelium and estimate the inflammatory burden. This study was undertaken to assess the proportion of periodontitis and correlation of PISA with glycemic status in controlled, uncontrolled type 2 diabetes mellitus (T2D) with and without micro-vascular complications. The study comprised of 180 T2D patients who were divided into three groups based on their Glycosylated Hb levels (HbA1c) (i) well controlled T2D group: (HbA1c ≤ 7%) (ii) Uncontrolled T2D group: (HbA1c > 7%) without complications, and (iii) Uncontrolled T2D group: (HbA1c >7%) with microvascular complications. All subjects were assessed for the periodontal parameters (Bleeding on Probing (BOP), PPD, CAL and PISA) and systemic parameters (HbA1c, FPG, and PPPG). The proportion of periodontitis among Uncontrolled T2D group without complication and Uncontrolled T2D group with micro-vascular complications was (93.4% and 96.6%) very high as compared to Well controlled T2D group (75%) (p <0.001). Extent and severity of periodontitis were high in uncontrolled T2D group. Uncontrolled T2D with micro-vascular complications group attained the highest mean score for PPD, CAL, BOP and PISA. Positive correlation was found between PISA and HbA1c among the groups (r = 0.079, 0.109, 0.248 respectively). A statistically significant positive correlation has been found between PISA and HbA1c among all study subjects (r= 0.393, p < 0.001). Disclosure C. Radhakrishnan: None. R.J. Vadakkekuttical: None. K. Anil: None. F.C. Parambath: None.
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