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LETTER TO THE EDITOR
Year : 2012  |  Volume : 3  |  Issue : 2  |  Page : 86

Prosthodontic care in diabetes mellitus: Old problem, new findings, yet more questions


1 Shree Bankey Bihari Dental College and Research Centre, Ghaziabad, India
2 Conservative Dentistry, Institute of Dental Studies and Technology, Ghaziabad, India
3 Department of Prosthodontics, Institute of Technology and Sciences (ITS)-ITS Dental College, Ghaziabad, India
4 Dental College Azamgarh, Uttar Pradesh, India

Date of Web Publication3-Sep-2012

Correspondence Address:
Prince Kumar
Shree Bankey Bihari Dental College and Research Centre, Ghaziabad
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2155-8213.100397

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How to cite this article:
Kumar P, Goel R, Kumar A, Singh V. Prosthodontic care in diabetes mellitus: Old problem, new findings, yet more questions. Dent Hypotheses 2012;3:86

How to cite this URL:
Kumar P, Goel R, Kumar A, Singh V. Prosthodontic care in diabetes mellitus: Old problem, new findings, yet more questions. Dent Hypotheses [serial online] 2012 [cited 2017 Mar 24];3:86. Available from: http://www.dentalhypotheses.com/text.asp?2012/3/2/86/100397

Sir,

Diabetes mellitus is a chronic endocrinal disease that occurs when the production of insulin from pancreas is inadequate or when the body cannot utilize the insulin it produces. Diabetes mellitus almost affect every organ of the body including their long term damage. As a dental professional, Prosthodontist is one who handles patients of almost every ages and are supposed to apprehend the fact that this well established metabolic disorder can have a considerable impact on final outcome of the Prosthodontic management. The saliva play an imperative role in the retention of removable prosthetics and in the maintenance of oral microbiota equilibrium is well recognized and cannot be overlooked. [1] Diabetes mellitus is well known to fetch the qualitatively and quantitatively alteration in the parenchyma of major salivary glands leading into hypo salivation and associated polyurea. Hypo salivation is normally coupled with the augmentation of fungi such as Candida and other species leading to enhance the chances of oral infections. Moreover, the raised blood glucose levels interfere with vascular functions and normal defense mechanism of polymorphonuclear neutrophils subjecting the patient to more deleterious immune-compromised state. Other common oral manifestations of candidiasis includes median rhomboid glossitis, atrophic glossitis, denture stomatitis and angular chelitis. [2] Long term usage of complete dentures can further stimulate the proliferation of fungi especially with the prosthesis in poor condition. The majority of complete denture diabetic patients usually report an altered taste sensation with other neurosensory disorders like burning mouth syndrome. Furthermore, the presence of diabetic retinopathy and neuropathy severely compromise the patient's oral and denture hygiene activity. The risk of dental caries in diabetic patients is frequently aggravated by xerostomia and reduced buffering activity of saliva which further limits the possibility of that particular tooth to be used as an abutment for fixed prosthesis and for overdenture fabrication. [3] As this condition is commonly associated with impaired wound healing, any surgical procedure like pre-prosthetic surgery or dental implant placement should be performed only when the diabetes is in well controlled state. [4] Other diabetic factors like reduced blood supply increase the amount of residual ridge resorption making the fabrication of complete denture more challenging for the Prosthodontists. With regards to dental implantology, diabetes is a relative contraindication for implant placement however, careful selection of patients with well controlled glycaemic levels and adequate antibiotic administration are considered to improves the implant survival in such patients. [5] The ultimate goal of any Prosthodontic therapy for patients with diabetes requires thorough understanding of the disease and acquaintance with its clinical manifestations. This letter is an attempt to draw an attention towards the potential risks of diabetes associated with Prosthodontic care and relevant treatment modification to achieve optimal prognosis. I hope it will prove to be a gentle nudge to steer the researchers in this direction.

 
  References Top

1.Darvel BW, Clark RK. The physical mechanism of complete denture retention. Br Dent J 2000;189:248-52.  Back to cited text no. 1
    
2.Guggenheimer J, Moore PA, Rossie K, Myers D, Mongelluzzo MB, Block HM, et al. Insulin-dependent diabetes mellitus and oral soft tissue pathologies, II: Prevalence and characteristics of Candida and Candidal lesions. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;89:570-6.  Back to cited text no. 2
    
3.Miko S, Ambrus SJ, Sahafian S, Dinya E, Tamas G, Albrecht MG. Dental caries and adolescents with type 1 diabetes. Br Dent J 2010;208:E12.  Back to cited text no. 3
    
4.Loo WT, Jin LJ, Cheung MN, Wang M. The impact of diabetes on implants and periodontal healing. Afr J Biotechnol 2009;8:5122-7.   Back to cited text no. 4
    
5.Javed F, Romanos GE. Impact of diabetes mellitus and glycemic control on the osseo integration of dental implants: A systematic literature review. J Periodontol 2009;80:1719-30.  Back to cited text no. 5
    




 

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