Evaluation of the effects of diabetes mellitus and smoking on long term periimplant sulcus microflora in patients with dental i̇mplant

Evaluation Of The Effects Of Diabetes Mellitus And Smoking On Long Term Periimplant Sulcus Microflora İn Patients With Dental İmplant Aim: In this study, it was aimed to compare clinical and microbiological findings obtained from implants and teeth of individuals with dental implants in function for at least 3 years with respect to presence of.diabetes mellitus (DM) and smoking. Material and Methods: The study included 35 individuals with and without DM who have been rehabilitated by dental implants between 2010 and 2015 at the Department of Periodontology, Faculty of Dentistry, Inonu University. Informed consent was obtained from all subjects who were willing to participate in this study. According to the study protocol, individuals included in the study were divided into 4 groups; Smoking individuals with DM (S-D), non-smoking individuals with DM (NS-D), smoking healthy individuals (S-ND) and healthy non-smoking individuals. During clinical evaluation, plaque index (PI), gingival index (GI), bleeding on probing (BOP) and probing depth (PD) measurements were performed for all implants and teeth of the study subjects. Panoramic radiographs were taken from the individuals for radiographic evaluation. Subgingival microbiological samples were taken from the implants and teeth for the evaluation of the content of subgingival microflora. The samples obtained were analyzed by PCR (polymerase chain reaction) method at the Department of Microbiology, Faculty of Medicine, Inonu University. For comparing clinical and laboratory findings, Oneway Anova test was used for quantitative data whereas Chi-square test, Fisher's Exact Chi-square test, Continuity (Yates) correction and Fisher Freeman Halton test were used for qualitative data. Results: In this study, during the evaluation of periimplant site the rate of periimplantitis in the S-D group and the rate of healthy implants and the rate of gingivitis in the NS-ND group were statistically significant (p <0.05). The incidence of Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella intermedia and Eikenella corrodens among the microorganisms examined was similar in all groups (p> 0.05). Prevotella nigrescens, Streptococcus mutans, Peptostreptococcus and Treponema denticola species were found to be statistically significantly higher in smoking groups. Tannerella forsythia and Campylobacter rectus were found to be significantly lower in non-smoking diabetic patients while Streptococcus sanguinis was significantly lower in smoking groups (p <0.05). ix The incidence of Prevotella nigrescens in smokers with diabetes mellitus was found statistically significantly higher in the implants than in the teeth (p: 0.039, p <0.05). In the other groups, the distribution of the microorganisms was similar both on teeth and implants (p> 0.05). In the NS-ND group, the incidence of Tannerella forsythia and Treponema denticola was found significantly lower in the PD 0-4 mm area than in the PD 4-6 mm area. In the areas with PD> 6 mm, the ratio of Eikenella corrodens in S-ND group, Porphyromonas gingivalis in S-ND group and Campylobacter rectus and Tannerella forsythia in S-D group were significantly higher (p <0.05). Conclusion: In conclusion, our findings suggest that periodontal and periimplant clinical findings are worse in patients with diabetes and smoking makes the periimplant microflora composition more complex at long-term implants in diabetic and healthy individuals. Key Words: Dental implants, microbiology, diabetes mellitus, cigarette.