Microflora Analysis Of Saliva Causing

Chronic periodontitis in type 2 diabetic

patient
Presented by
Mahnoor Naveed
B.Sc.(H)Dental Technology
Supervised by
Dr. Jawairia Zaman
 Structure of presentation
INTRODUCTION

OBJECTIVE

OPERATIONAL DEFINITIONS

LITERATURE REVIEW

METHODOLOGY

REFERENCES

QUESTIONNAIRE
 Introduction
• Type 2 diabetes is the most common form of diabetes characterized by
progressive insulin deficiency and impairment of β-cell
function,superimposed on insulin resistance.(1)
• Chronic periodontitis is an oral infection that result into destruction of
periodontium due to bacterial plaque that contains a variety of pathogenic
bacteria, most prevalent are gram-negative anaerobes.(2)
• There is a bidirectional relationship between diabetes and periodontal
disease.(3)
• The increased glucose in the saliva and GCF of diabetic patient change the
environment of microflora that may contribute to the onset and severity of
periodontal disease.
 Hypothesis
• H0 = Saliva of type 2 diabetic patient does not show mixture of gram-
negative anaerobes that characterizes the chronic periodontitis.

• H1 = Saliva of type 2 diabetic patient show mixture of gram-negative

anaerobes that characterizes the chronic periodontitis.
 Objective
• The objective of the study is to identify most common periodontal
pathogen that serve as an important risk factor for causing diabetes
associated chronic periodontitis through salivary analysis.
 Operational definitions
• Type 2 diabetes
Type 2 diabetes is characterized by dysregulation of carbohydrate,lipid and
protein metabolism,and result from impaired insulin secretion,insulin
resistance or combination of both(4)
• Periodontal disease
PD is a chronic inflammatory condition characterized by destruction of
periodontal tissue and resulting in loss of connective tissue, loss of alveolar
bone and formation of pathological pocket around the diseased teeth.(5)
• Saliva
Saliva is the watery liquid that is secreted into the mouth by salivary glands
and bathes the oral mucosa and teeth.(6)

Author, Year
Edison-Andres Cruz-
Olivo,Vanessa Jimenez-
Galeano in 2021.(6)
Jeffrey L.Ebersole, M.John
Novak in 2008.(7)
Literature Review
Study Design Result
It was a observational study P.gingivalis,T.denticola,
conducted on type 1 and type T.forsthyia,prevotella
2 diabetic patient. intermedia.F.nucleatum,
C.rectus,Aggregatibacter
actinomycetemcomitans were
the microoragnsim frequently
found in type 1 type 2
diabetic pt with PD
It was across-sectional Periodontitis site in pt with
study.plaque samples were T2DM showed higher
obtained from 63 Hispanic frequency of P.gingivalis,
American subjects with and Aggregatibacter
without type 2 diabetes. actinomycetemcomitans.
Camphylobacter spp.
 Methodology
Study Design
It will be a cross-sectional study.
Study Setting
Department of Endocrinology at Gulab Devi Chest Hospital Lahore.
Target Population
35-75 years patient diagnosed with type 2 diabetes along with chronic
periodontitis.
Sample Size
N=245 using Cochran’s Formula taking 95% CL, 5% Margin of error and
taking prevalence value from proportion of patients that will visit that will visit
endocrinology department in 6 months i.e 20%.
Sampling technique
Non-probability purposive sampling.
 Sample Selection
Inclusion Criteria
• Diagnosed with T2DM
• Male and female
• Age:35-75 years
• Pt with sign and symptoms of periodontitis.

Exclusion Criteria
• Pt taking any kind of medication that could alter the salivary flow.
• Periodontal or antibiotic therapies in the previous months.
• Use of mouthrinses containing antimicrobials agents.
• Kidney problem or dialysis treatment
• Systemic disease;except diabetes for the case study.
 Data analysis
• Data would be collected on a specially designed
Performa/Questionnaire by researcher itself.
 Variables
Microflora Analysis Of Saliva Causing Chronic
Periodontitis In Type 2 Diabetic Patient
Variables Nature/type

Age Quantitative
Gender Qualitative
Microorganism in the saliva Qualitative
of type 2 diabetic patient

Chronic periodontitis Qualitative

 References
1.Kaur R, Kaur M, Singh J. Endothelial dysfunction and platelet hyperactivity in type 2 diabetes mellitus:
molecular insights and therapeutic strategies. Cardiovascular Diabetology. 2018;17(1):1-17
2.Szkaradkiewicz AK, Karpiński TM. Microbiology of chronic periodontitis. J Biol Earth Sci. 2013;3(1):14-20
3. Gümüş P, Buduneli N. Diabetes mellitus and periodontitis: signs of a bidirectional relationship. European
Medical Journal. 2013;1:30-6
4. K, Banach M, Bekiari E, Rizzo M, Edmonds M. Complications of diabetes 2017. Hindawi; 2018.
5.Löe H. Periodontal disease: the sixth complication of diabetes mellitus. Diabetes care. 1993;16(1):329-34
6.Macpherson P. The role of saliva in oral health and disease. Dental Nursing. 2013;9(10):568-73
7.Cruz-Olivo EA, Jiménez V. Perfil microbiológico en Diabetes y Periodontitis: Revisión sistemática. Salutem
Scientia Spiritus. 2021;7(2):31-40.
8.Ebersole JL, Holt SC, Hansard R, Novak MJ. Microbiologic and immunologic characteristics of periodontal
disease in Hispanic Americans with type 2 diabetes. Journal of periodontology. 2008;79(4):637-46
 Research Questionnaire
Demographic Data
Name: Contact no:
Age: Address:
Gender: Marital Status:
Clinical Data
1.How long you were diagnosed with diabetes?

≤5Years 5-10Years ≥10Years

2.What is the value of HbA1c(%)?

3.Do you take anti-diabetic medicines as advised by your doctor
Yes No
 Clinical Examination

1.Oral Hygiene Good Fair Poor

2.Any dental Present Absent
stain(plaque,
calculus)
3.Tooth mobility Grade 1 Grade 2 Grade 3

4.Periodontal ≤1mm 1-3mm ≥3mm

Pocket
5.Bleeding on Slight Moderate Severe
probing
6.Gingival Slight Moderate Severe
recession
 Salivary Analysis

Microorganism Present Absent

1.Porphyromonas
gingivalis
2.Aggragatibacter
actinomycetemcomitans
3.Fusobacterium
nucleatum
THANK YOU