Prevalence of periodontal pathogens and metabolic control of type 1 diabetes patients.

OBJECTIVE: The aim of the study was to evaluate the prevalence of periodontal pathogens Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia and Treponema denticola in subgingival plaque collected at different probing depths of type 1 diabetes patients with periodontal disease in correlation to metabolic control. METHODS: Twenty-one patients 40 to 50 years old were included in the study. In each patient blood samples were taken for the evaluation of HbA1c level and subgingival plaque samples were taken with paper points from the two deepest pockets. The presence of five periodontal pathogens was detected by multiplex polymerase chain reaction. RESULTS: The results of 38 plaque samples showed that T. forsythia was found in 48% followed by T. denticola in 31%, P. gingivalis in 26%, P. intermedia in 9% and A. actinomycetemcomitans in 7%. T. forsythia and T. denticola were the most frequent combination of periodontal pathogens found in the same sample. The serum level of HbA1c in nine patients where T. forsythia was detected (7.5 +/- 1.4%) was significantly higher (F-test, p = 0.001) than in 12 patients where T. forsythia was not detected (6.8 +/- 0.5%). Similarly, the serum level of HbA1c was significantly higher (F-test, p = 0.001) in eight patients where T. denticola was detected (7.5 +/- 1.8%) compared to the 13 patients where T. denticola was not detected (7.0 +/- 0.5%). No such correlation was found for P. gingivalis, P. intermedia or A. actinomycetemcomitans. CONCLUSIONS: We conclude that T. forsythia and T. denticola are most frequently found in subgingival plaque samples of type 1 diabetic patients and these findings correlate with poorer metabolic control of diabetes.