Experimental gingivitis in type 1 diabetics: A controlled clinical and microbiological study

Abstract

Objective: To monitor clinical and microbiological changes during experimental gingivitis in type 1 diabetics and non-diabetics. Materials and Methods: Nine type 1 diabetics with good/moderate metabolic control and nine age-gender matched non-diabetics were recruited. Probing pocket depths in all subjects did not exceed 4 mm and none were affected by attachment loss. According to the original model, an experimental 3-week plaque accumulation resulting in experimental gingivitis development and a subsequent 2-week period of optimal plaque control were staged. Subgingival plaque samples were collected at days 0, 21 and 35 from one site per quadrant, pooled and analysed using checkerboard DNA-DNA hybridization. Results: Diabetics (mean age 25.6 ± 5.8 standard deviation (SD), range 16-35 years) had a mean HbA1c level of 8.1 ± 0.7% (SD), while non-diabetics (mean age 24.8 ± 5.7 (SD), range 15-36 years) were metabolically controlled (HbA1c ≤6.5%). Between Days 0, 21 and 35, no statistically significant differences in mean plaque and gingival index scores were observed between diabetics and non-diabetics. At days 7 and 21, however, diabetics showed statistically significantly higher percentages of sites with gingival index scores ≥2 compared with non-diabetics. Mean DNA probe counts of the red and orange complex species increased significantly (p < 0.05) between days 0 and 21 and decreased significantly (p < 0.05) between days 21 and 35 in both groups. Conclusion: Both diabetics and non-diabetics react to experimental plaque accumulation with gingival inflammation. Type 1 diabetics, however, develop an earlier and higher inflammatory response to a comparable bacterial challenge. Copyright © Blackwell Munksgaard 2005.