The correlation between root resorption and some immune parameters in well- controlled type Ι diabetic patients during orthodontic treatment

Abstract

Background:Type 1 diabetes mellitus is the result of a breakdown in immune regulation that leads to expansion of auto reactive CD4and CD8T- cells, autoantibody-producing B lymphocytes and activation of the innate immune system, so disturbances of immune system may be the cause and/or associated with diabetes mellitus. Some of these diabetic patients seek an orthodontic care. The orthodontist must remain vigilant as they may be the only health care professional seen by otherwise fit, young patients on a regular basis, and it is also important to implement risk control procedures during and after orthodontic treatment. Aims: The aim of t his study was to analyze serum levels of immunoglobulins ( IgG, IgA , and IgM) ,and complement components (C3, and C4) after 6 months (T6) of orthodontic treatment in well-controlled type Ι diabetic patients wearing orthodontic appliance comparing with non-wearing group and to correlate these immune parameters with grade of root resorption which sometimes happen during orthodontic treatment . Materials and methods: Sixty well- controlled type Ι diabetic patients (HbA1c <8.5), were participating in this study. Thirty cases of them(16 male and 14 females) were wearing fixed orthodontic appliance, and the other thirty cases didn’t wear orthodontic appliances and considered as the controls (12 male and 18 females).The m ean age of study groups was(15± 1SD) years. Periapical radiogr aphs of the upper central incisors were obtained of all patient s before(T0) and 6 months after(T6) orthodontic treatment. At (T6), root resorption was classified as grade 0 (no resorption) ,grade 1 (slight resorption), and grade 2 (moderate to severe resor ption). Serum level of IgG , IgA, IgM ,C3, and C4 were analy zed after 6 months orthodontic treatment were determined using single radial immunodiffusion method (SRID) to the two study groups. Chi square test and T- test were used to assess the associ ation between qualitative and quantitative results respectively ,whil e paired t- test was used to analyze the results after 6 months (T 6) orthodontic treatment, differences were considered significant at P<0.05. Results: There was statistical significant difference in the serum level of IgG , IgA, IgM ,C3 , and C4 after 6 months orthodontic treatment between the two study groups , there were an increase in the serum level of (IgG ,and Ig A) ,and a significant decrease in the serum level of (IgM, C3,and C4 ) in the wearing group comparing with non- wearing gr oup; moreover, a high mean of serum level of IgG and IgA in root resorption grade 1 (R1) than in grade 0 (R0) ,while low mean of serum level of IgM,C3, and C4 were reported in (R1) grade than ( R0) grade. Conclusions :There were signifi cant differences in the mean of serum levels of IgG , IgA, IgM ,C3, and C4 between wearing orthodontic appliance and non- w earing groups of well controlled type Ι diabetic patients and also between root resorption grade 1 comparing with root resorption gr ade 0 in the wearing group . 89