Abstract
In this study we analyzed the mandibular cortical bone of patients with type 1 diabetes mellitus (T1DM) and non-diabetic. Fifty patients with T1DM and 100 non-diabetic ones paired by age and gender were analyzed. Two double-blinded observers evaluated 150 digital panoramic images of both groups. The mandibular cortical bone was analyzed using the Mandibular Cortical Index (MCI), Mental Index (MI), Gonial Index (GI), Antegonial Index (AI) and Upper and Lower Panoramic Mandibular Indexes (UPMI and LPMI), with the aid of RADIOIMP® software. Influence of T1DM in the morphology of the mandibular cortical bone was studied based on obtaining data related to T1DM diagnosis time, blood glucose level, T1DM control and the presence of chronic complications. Collected data were submitted to descriptive (mean and standard deviation) and inferential analyzes (Pearson's chi-squared test and Fisher's exact test) (p≤0.05). According to the MCI, individuals with T1DM had higher frequencies of mandibular cortical alterations, in both sexes and all age groups (p<0.01). For quantitative indexes, MI, GI, AI, UPMI and LPMI, female patients showed statistically significant differences for GI and AI, while male patients had statistically significant differences for all indexes (p<0.05), presenting the individuals with TDM1 inferior measures. Individuals with poor T1DM control showed significantly higher frequency of mandibular cortical alteration (92.3%), with lower means for MI, GI, AI and LPMI (p≤0.05). In conclusion, patients with T1DM showed decrease in the mandibular cortical bone when compared to non-diabetic ones, indicating that poor disease control is associated with these alterations.
Highlights
Bone mineral density (BMD) is the amount of bone tissue in a certain volume of bone
When BMD is used as a bone alteration indicator, most studies suggested that type 1 diabetes mellitus (T1DM) has a connection with osteoporosis, as these patients have reduced BMD [7,8]
In Mandibular Cortical Index (MCI) analysis, it was observed that in both sexes and all age groups, patients with T1DM had higher frequencies of mandibular cortical alterations, with statistically significant difference compared to the non-diabetic individuals (p
Summary
The most recognized exam that evaluates BMD is dual-energy x-ray absorptiometry (DEXA) [1]. Most studies evaluate the thickness and integrity of the inferior border of the mandible [5]. When BMD is used as a bone alteration indicator, most studies suggested that type 1 diabetes mellitus (T1DM) has a connection with osteoporosis, as these patients have reduced BMD [7,8]. BMD in type 2 diabetes mellitus (T2DM) patients tends to be equal or higher than that of nondiabetic individuals [7]. Peak bone mass reduction in some patients with T1DM has led to the hypothesis that insulin has anabolic effects on the bone. Current guidelines for people with diabetes need to be updated to recognize the association between bone alterations and T1DM. New screening tools need to be studied [9]
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