Assessment of peridontal vessels hemodynamics among patients with diabetes mellitus type 1

Abstract

Relevance. Processes of disturbance of regional hemodynamics, tissue blood flow, insufficiency of transcapillary metabolism and antioxidant system caused by dysfunction of periodontal vascular endothelium among patients with diabetes type 1 directly lead to diabetic microangiopathy accompanied by decrease of level of microcirculation and perfusion of periodontal tissues among patients with absolute insulin insufficiency. The reduction of linear and volumetric blood flow rates in periodontal vessels among patients with type 1 diabetes compared to values obtained by ultrasonic dopplerography in healthy patients can be considered as distinctive features of the manifestation of this systemic disease on microcirculation of periodontal tissues.Purpose. To evaluate the hemodynamics of periodontal vessels among patients with diabetes mellitus type 1 and without diabetes before and after conservative periodontal therapy.Materials and methods. 40 patients at the age 20-30 years were surveyed: 20 patients with diabetes mellitus type 1 and 20 patients without diabetes. All subjects underwent dental examination. To study the state of microcirculation of periodontal tissues patients of both groups underwent high-frequency ultrasound Doppler “Minimax-doppler-k”. Further was conducted professional oral hygiene complex with training in rules of individual oral hygiene. Reexamination was scheduled after 4 weeks. Results. During the conduction have been registered average baseline of the linear (Vam) and volumetric (Qam) blood flow in periodontal vessels in patients with diabetes mellitus type 1 and without diabetes. Average linear (Vam) and volumetric (Qam) blood flow before the conduction of professional oral hygiene complex were considerably lower compared to patients without diabetes. This points reduction of microcirculation and perfusion of periodontal tissues in patients with diabetes mellitus type 1 and without diabetes. Reassessment of blood flow in periodontal tissues in 4 weeks after professional oral hygiene revealed an increase in rate of microcirculation in periodontal tissues among patients with diabetes mellitus type 1 and without diabetes. Conclusion. Our study confirms the theory of hemodynamic impairment and local hemostasis in patients with type 1 diabetes, which is reflected in the appearance of trophic disorders of an inflammatory-dystrophic nature and a decrease in hemodynamic parameters. After conservative periodontal therapy, we revealed positive changes in hemodynamics of periodontal vessels, which was recorded using ultrasound dopplerography. Our results will allow us to select the optimal algorithms for the timely diagnosis, prevention and treatment of dental diseases in patients with type 1 diabetes in future.