Study of Salivary Stress Factor Activity in Patients with Diabetes Mellitus During the Period of Adaptation to Complete Removable Laminar Dentures

Abstract

Diabetes mellitus is referred to as non-communicable epidemic of the 21st century and the fight against diabetes is one of medical and social challenges. One of its complications is damage to periodontal tissues that is accompanied by tooth loss. Any removable denture is a foreign body being a stress factor for the oral cavity.
 The objective of the research was to study dynamic changes in the activity of stress factor indicators, namely salivary cortisol, glucose and alpha-amylase levels in diabetic patients after prosthodontic treatment with complete removable laminar dentures.
 Materials and Methods. For this study, patients at the age of 45 to 74 years were divided into two groups: Group I included 52 edentulous patients with type 2 diabetes mellitus who were treated with acrylic resin complete removable laminar dentures; Group II comprised 52 edentulous patients without endocrine pathology who were treated with acrylic resin complete removable laminar dentures as well. Saliva served as the study material. The enzyme-linked immunosorbent assay was used to determine salivary cortisol levels. Glucose concentration in saliva was determined by a unified enzymatic method. Alpha-amylase activity was determined by the enzymatic colorimetric method.
 Results. According to the research results, before prosthodontic treatment, salivary cortisol levels of patients with diabetes mellitus were 2.4 times higher as compared to patients without somatic pathology. In phase I of adaptation to complete removable laminar dentures, in patients with diabetes mellitus, salivary cortisol concentration increased drastically by 1.4 times as compared to the indicator before prosthodontic treatment (5.61±0.83 ng/ml vs. 4.02±0.65 ng/ml, p<0.01), while in the group of patients without endocrine pathology, cortisol levels increased by 1.2 times; salivary glucose level of patients with diabetes mellitus increased by 1.3 times, while in patients without endocrine pathology, it increased by 1.1 times; in patients of Group I, salivary alpha-amylase levels increased by 1.2 times, while in patients of Group II, salivary alpha-amylase concentration increased by 1.05 times.
 Conclusions. In patients with diabetes mellitus, changes in saliva composition indicate a significant reduction in the adaptation mechanisms, that complicates and significantly prolongs the period of adaptation to complete removable laminar dentures.