CLINICAL ASSESSMENT OF DENTAL STATUS IN PATIENTS WITH TYPE I AND TYPE II DIABETES MELLITUS AGAINST THE BACKGROUND OF AUTOIMMUNE THYROIDITIS

Abstract

Diabetes mellitus (DM) is considered one of the key factors disrupting oral homeostasis, often leading to the rapid progression of gingivitis and periodontitis. A growing body of evidence suggests that inflammatory reactions in the gingiva among patients with type I and II DM may be exacerbated by concomitant autoimmune processes, such as autoimmune thyroiditis (AIT). Clinical observations indicate that individuals with such comorbid endocrine disorders exhibit deeper periodontal pockets and increased tooth mobility, with destructive changes in periodontal tissues progressing even under adequate glycemic control. Aim of the study was to perform a clinical assessment of dental status indicators (PMA, OHI-S, CPITN, and periodontal index) in patients with type I and type II diabetes mellitus complicated by autoimmune thyroiditis, taking into account the existing periodontal tissue changes. Materials and methods. The study involved 150 individuals aged 24 to 60 years, divided into three groups: two main groups (46 patients with type I DM and AIT, 59 with type II DM and AIT) and a control group (45 subjects without endocrine pathology). Dental examination included measurements of PMA, OHI-S, the periodontal index, and CPITN, along with recording patient complaints such as gum bleeding and pain, unpleasant mouth odor, and increased tooth mobility. Statistical analysis of the obtained data was performed using Student’s t-test at p<0.01. Results. It was revealed significant oral hygiene disturbances in patients with type I and II DM and AIT (OHI-S values above 3.5), elevated PMA indicating moderate inflammation (over 32 %), and periodontal index scores predominantly consistent with severe periodontitis (exceeding 4.0). CPITN analysis confirmed the absence of healthy periodontium (CPITN0=0 %) and the predominance of moderate to severe lesions (CPITN3–4). In contrast, the control group showed significantly lower dental indices (p<0.01). Conclusions. The combination of type I or type II diabetes mellitus with autoimmune thyroiditis significantly complicates inflammatory-destructive processes in the periodontal tissues. A comprehensive approach, including individualized measures for glycemic and autoimmune response control, is required for effective management of these patients.