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oral manifestations of diabetus mallites in complete denture wearers/ cosmetic dentistry training

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oral manifestations of diabetus mallites in complete denture wearers/ cosmetic dentistry training

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education
  2. 2. Statement of problem The oral mucosa has been reported to have a variety of changes in subjects with diabetes mellitus
  3. 3. DIABETES MELLITUS Diabetes mellitus is a chronic metabolic disease characterised by hyperglycaemia, associated with irregularities in the metabolism of carbohydrates, lipids, and proteins, and susceptibility to the development of specific form of renal , occular, neurological, cardiovascular diseases.
  4. 4. TYPE I: This is common before 40yrs of age. It is insulin dependent Not related to obesity Due to destruction of islets of langerhans If it is from child hood – JUVENILE DIABETUS
  5. 5. Type II: also called non insulin dependent It is the 5th most common condition and ,6th most common cause leading cause of mortality. This type occurs only after 40yrs And the prevalence increases with age Their cause is more genetic and it is not associated with and auto immune diseases The predisposing factors are: obesity and sedenterism
  6. 6. Patients with D.M present a higher susceptibility of infections due to a deficiency of polymorph nuclear leucocytes, as a result of vascular alterations and neuropathies . D.M increases the susceptibility to erosion and ulceration of the mucosa where it comes in contact with the base of the complete denture
  7. 7. Cardinal signs of D.M 1) polydypsia 2) polyphagia 3) polyurea
  8. 8. Purpose of the study The purpose was to compare diabetic and non- diabetic subjects wearing complete dentures with regard to salivary flow, salivary buffering capacity, denture retention and oral mucosal lesions
  9. 9. Materials and methods This sample consisted of 60 individuals in which 60 were denture wearers 30 were suffering from type II D. M and the other 30 were controls with matching age, sex and race.
  10. 10. Stimulated salivary flow was classified as: 1) normal: 1-2ml/min 2) hypo: 0.7 ml/ min 3) xerostomic: 0.1 ml/ min
  11. 11. Buffering capacity was classified as: 1) low: 4.5 pH 2) medium: 4.5-5.5 pH 3) high: >5.5 pH
  12. 12. Each subject was evaluated regarding denture retention and was asked for a self report of comfort, efficiency, and occlusion of the complete denture. Retention for considered to be present when the subject did not complain about moment or displacement of complete denture during mastication , talking , breathing, smiling, or even at rest.
  13. 13. Prosthodontic point Subjects commonly report 1) dry mouth 2) loss of taste 3) speech difficulty 4) lack of adaptation of the dentures 5) burning sensation of the mouth 6) difficulty in mastication
  14. 14. What we observe 1) loss of tissue resiliency 2) high degree of inflammatory response. 3) ketonic breath {striking feature} 4) a high frequency of periodontal disease 5) gingival displacement 6) residual bone resorption 7) periodontal abscess, 8) gingival over growth 9) vascular alterations
  15. 15. 10) candidasis 11) blood coagulation, 12) tissue regeneration above normal times and 13) xerostomia
  16. 16. Sennerby etal in his study concluded that lose of stability in dentures was because of lose of resiliency of underlying tissues and that was because of osteoclastic activity Berghal and berghal showed that psychological factors accentuate for xerostomia And he even concluded that drugs like anti depressants, anti hypertensive's will play role in xerostomia in diabetics
  17. 17. Results Comparison of two groups revealed no difference in salivary flow A significant difference in mean buffering capacity was observed between case and control groups And blood glucose also showed a mean diff between the two groups
  18. 18. DISCUSSION Skyes etal observed that subjects with D.M are more susceptiable to infections as a result of vascular alterations and neuropathies. Astro etal reported an increased risk of infections in the presence of reduced flow, low buffering capacity and inadequate hygiene of complete dentures. With in the scope of investigation statical analysis failed to reveal a diff in salivary flow rate between the groups
  19. 19. The buffering capacity of saliva is responsible for the maintenance of the oral pH in order to guarantee the tooth integrity and to inhibit acid production by bacterial plaque.
  20. 20. Dry mouth is an uncomfortable and potentially harm full oral symptom which is usually caused by a decrease in the salivary secretion rate. This condition is more prevalent in the elderly population primarily because of the increased use of drugs and susceptibility to disease in this age group
  22. 22. REFERENCES 1. Daniell Cristina de lima, DDS, etal ORAL MANIFESTATIONS OF DIABETES MELIITUS IN COMPLETE DENTURE WARERS Journal of Prosthetic Dentistry 2008; 64-69 2. Leanne m,sykes , Bsc,Bds, Mdent etal POTENTIAL RISK OF SERIOUS ORAL INFECTIONS IN THE DIABETIC PATIENT A CLINICAL REPORT : Journal of Prosthetic Dentistry 2001; 569-573 3. Macedo Firoozamand l, etal STUDY OF DENTURE INDUCED FIBROUS HYPERPLASIA CASES DIAGNOSED FROM 1979- 2001: QUINTESSENCE INT 2005; 36: 825-829
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