The Associations of Dental and Periodontal Lesions with the Microvascular Complications in Patients with Type 2 Diabetes Mellitus: A Case–Control Study

Abstract

Background: Diabetes mellitus is closely related to periodontal disease and dental lesions, disorders which through dental infection and metabolic imbalance become negatively potentiated and cause a vicious circle that is almost impossible to break. The aim of this research was to study if the severity of dental and periodontal lesions is related to the presence of microvascular complications and glycemic control in patients with type 2 diabetes mellitus (T2DM). Methods: In total, 112 subjects with T2DM that underwent a dental evaluation were enrolled in this case–control study. The study group included 56 patients with complicated lesions, whereas the control group included 56 patients whose gender and age matched the study group and that presented superficial lesions. The statistical analysis was carried out using SPSS 26.0, with the result being considered statistically significant if the p values were <0.05. Results: Statistically significant differences were recorded between the two groups regarding the value of blood glucose, HbA1c and fibrinogen, as well as kidney function. Statistically significant differences were also recorded between the two groups when analyzing the presence of microvascular complications, as well as individually analyzed, in the case of diabetic peripheral sensory-motor neuropathy (p < 0.001), but also of diabetic retinopathy (p < 0.05). This study developed a score with a predictive value for the presence of complicated dental and periodontal lesions, including blood glucose, fibrinogen, diabetic retinopathy, and diabetic peripheral neuropathy (AUROC 0.847, p < 0.001). Conclusions: There is a high frequency of dental and periodontal complications in patients with T2DM. Patients with microvascular complications, elevated fasting blood glucose, and chronic inflammation, as evidenced by elevated fibrinogen, are more likely to develop complicated dental and periodontal lesions.