Periodontal Status and Subgingival Microbiota of Insulin‐Dependent Juvenile Diabetics: A 3‐Year Longitudinal Study

This study examined for 3 years the changes in periodontal status and the possible correlations with selected subgingival microbiota and diabetic conditions in a group of 16 insulin‐dependent diabetes mellitus (IDDM, JD) patients as compared with their 16 healthy cohabiting siblings (HS). JD patients were monitored every 3 months for levels of glycosylated hemoglobin (HbA1c). Clinical and microbiological parameters were measured 6 weeks before drawing blood to determine levels of HbA1c. Periodontal parameters were measured at baseline (T0), year 2 (T2), year 3 (T3) and included: probing depth (PD), attachment level (AL), sulcus bleeding index (SBI), and plaque index (PI). Two sites in each patient were selected for microbial samples: a mesio‐facial aspect of the maxillary right first molar (defined as constant site, CS) and a site with the greatest probing depth (defined as deepest site, DS). Microbial samples were analyzed by culture techniques. No significant differences in clinical parameters were found between diabetics and healthy siblings at any examination. The SBI in the non‐diabetic group at T2 and at T3 was significantly lower than at baseline. PD and AL of constant sites in the diabetic group at T3 were significantly higher than baseline. There was a significant increase in Prevotella intermedia at T3 as compared with baseline for deepest sites in the diabetic group. Cluster analysis revealed, in a former study, two clusters (IV and V) at baseline which were significantly different from the overall mean regarding composition of Porphyromonas gingivalis and Capnocytophaga spp. They were not significantly different for periodontal parameters from T0 to T3. These data would suggest no significant differences in clinical parameters between the diabetics and non‐diabetic siblings throughout this 3‐year longitudinal study. J Periodontol 1998;69:120–128.