2022 Volume 64 Issue 4 Pages 158-166
Recently, periodontal inflammatory surface area (PISA) has attracted attention as a new method of evaluation of the severity of periodontal disease for promoting medical-dental collaboration. PISA represents a quantitative estimate of the inflamed area of periodontal tissue and serves as an objective parameter of the severity of periodontal disease as a chronic inflammatory lesion of one organ. As there have been no related reports to date, we conducted this study to evaluate the relationship between PISA and the presence of diabetic complications such as arteriosclerosis. A total of 447 patients with diabetes who were hospitalized for diabetes education between April 2010 and March 2017 at Rakuwakai Otowa Hospital, Japan, were enrolled in the study. We excluded some of these patients from the initial evaluation, as follows: refusal of dental checkups (n=30), lack of radiographic data and/or data on the periodontal pocket depths (n=30), underlying type 1 rather than type 2 diabetes (n=41), and presence of an edentulous jaw (n=34). Finally, 312 patients with type 2 diabetes were included in this study. The results of our analysis showed no significant association between the severity of periodontal disease as evaluated by PISA and any specific complication of diabetes, however, a tendency was noted for association between the severity of periodontal disease and carotid arterial thickening.
In regard to the association with the diabetes severity, in the patient group with HbA1c levels of less than 10%, but not in the patient group with HbA1c levels of ≥10%, the odds ratio for carotid thickening (IMT ≥ 1.1) was significantly higher in the subjects with severe periodontal disease than in the subjects with mild periodontal disease. The odds ratio (95% CI) of carotid artery thickening adjusted for the gender, BMI, smoking habit, and drinking habit was 2.74 (1.02-7.40) (P < 0.05). On the other hand, there was no significant difference in the group with HbA1c levels of 10% or more.
Using PISA to assess the severity of periodontal disease, an association was found between the severity of periodontal disease and arteriosclerosis in diabetic patients with HbA1c levels of less than 10%.
