Diabetes, periodontitis, and the subgingival microbiota

Both type 1 and type 2 diabetes have been associated with increased severity of periodontal disease for many years. More recently, the impact of periodontal disease on glycaemic control has been investigated. The role of the oral microbiota in this two-way relationship is at this stage unknown. Further studies, of a longitudinal nature and investigating a wider array of bacterial species, are required in order to conclusively determine if there is a difference in the oral microbiota of diabetics and non-diabetics and whether this difference accounts, on the one hand, for the increased severity of periodontal disease and on the other for the poorer glycaemic control seen in diabetics

Efficacy of Gluma Desensitizer® on dentin hypersensitivity in periodontally treated patients Eficácia do Gluma Desensitizer® sobre hipersensibilidade dentinária em pacientes periodontalmente tratados

The aim of this double-blind, controlled, split-mouth designed clinical trial was to assess the effect of a single application of Gluma Desensitizer® on alleviating dentin hypersensitivity. Twelve subjects entered the study and ten completed the protocol. Each subject had two teeth treated: one with Gluma Desensitizer® according to the manufacturer's instructions and one with water. The assessment of pain was performed with the VAS (Visual Analogue Scale), after tactile (probe), thermal (cold blast of water) and thermal/evaporative (cold blast of air) stimuli at baseline, immediately after treatment, after 1 week and after 4 weeks. The mean VAS values for the test and control teeth were compared by the paired t test (alpha = 0.05). Repeated measurements ANOVA was used to compare the different experimental times. The results showed that for test teeth, at baseline, mean VAS values were 1.76 (&plusmn; 2.82), 7.10 (&plusmn; 2.10) and 4.75 (&plusmn; 2.65), and, after 4 weeks, the mean values were 1.70 (&plusmn; 2.31), 5.50 (&plusmn; 3.30) and 4.61 (&plusmn; 3.14), respectively for probe, water and air stimuli. For the control teeth, at baseline, the mean VAS values were 1.86 (&plusmn; 2.92), 6.61 (&plusmn; 2.31) and 4.08 (&plusmn; 2.91) and, after 4 weeks, 2.66 (&plusmn; 3.07), 6.32 (&plusmn; 2.94) e 4.76 (&plusmn; 3.26).There were no statistically significant differences between test and control teeth at any time. No intra-group differences were demonstrated either. It was concluded that Gluma Desensitizer® had no effect on hypersensitive teeth from periodontally treated patients for a period up to 4 weeks.<br>O objetivo deste estudo clínico duplo-cego, controlado, de boca-dividida foi avaliar o efeito de uma aplicação única do Gluma Desensitizer® no alívio da hipersensibilidade dentinária. Doze sujeitos participaram do estudo, sendo que destes dez completaram o estudo. Cada um dos participantes teve dois dentes tratados, um com o Gluma Desensitizer®, de acordo com as orientações do fabricante, e o outro com água. Para a avaliação da dor foi utilizada a EVA (Escala Visual Analógica), após os estímulos táctil (sonda), térmico (jato de água frio) e térmico/evaporativo (jato de ar frio) no início do experimento, imediatamente após o tratamento, uma e quatro semanas após. Os valores médios encontrados na EVA foram comparados pelo teste-t pareado (alfa = 0,05). Para os diferentes tempos experimentais utilizou-se ANOVA para medidas repetidas. Os resultados mostram que, no início do tratamento, os valores médios foram de 1,76 (&plusmn; 2,82), 7,10 (&plusmn; 2,10) e 4,75 (&plusmn; 2,65) para os dentes teste e, após quatro semanas, os valores médios foram de 1,70 (&plusmn; 2,31), 5,50 (&plusmn; 3,30) e 4,61 (&plusmn; 3,14) respectivamente para os estímulos sonda, água e ar. Para os dentes controle, no início do tratamento, os valores médios segundo a EVA foram de 1,86 (&plusmn; 2,92), 6,61 (&plusmn; 2,31) e 4,08 (&plusmn; 2,91) e, após 4 semanas, 2,66 (&plusmn; 3,07), 6,32 (&plusmn; 2,94) e 4,76 (&plusmn; 3,26). Não ocorreram diferenças estatisticamente significativas entre os dentes teste e controle em nenhum dos tempos experimentais. Também não ocorreram diferenças intragrupo. Concluímos que o Gluma Desensitizer® não tem efeito sobre a hipersensibilidade dentinária de pacientes periodontalmente tratados num período de até quatro semanas