Lai, Stefano (2017) Cross sectional study on the variation of plaque pH in diabetic patients: a clinical randomized trial on the capability of Probiotic (Lactobacillus Brevis CD2) to reduce plaque acidogenicity in a sample of diabetic children. Doctoral Thesis.
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Objective: The aim of this study was to evaluate the difference in caries experience and different
caries-related variables between diabetic and non-diabetic children aged 5-13 years old. A
further analysis was carried out on diabetic children after they were divided in two groups based
on their metabolic control.
Material and Methods: We designed a case-control study on two categories of children: the
first group consisted of 68 children diagnosed with type 1 diabetes and the second group
consisted of 136 non-diabetic control children. The diabetic children were then divided into two
subgroups: a) 20 children with adequate metabolic control (Hb1ac≤7.5) and b) 48 children with
poor metabolic control (Hb1ac>7.5). Data on dietary and oral hygienic habits was obtained on
all the subjects participating in the study. Collection of saliva was carried out after stimulating
salivation by chewing on a piece of paraffin for 5 minutes. Microbial flora was analyzed using
the checkerboard DNA-DNA hybridisation method. Plaque acidogenity was recorded using pH
indicator strips up to 30 min after a sucrose rinse. Caries registration was performed using the
Results: No statically significant difference in clinical data was found in the two study groups
with similar caries status. No statistically significant difference was found for tooth brushing
frequency, use of fluoridated toothpaste, mouthwash and other fluoride supplements and the
pattern of dental check-ups between the groups examined. Statistically significant differences
for plaque-pH when analyzed as minimum pH, AUC6.2 and AUC5.7 between all diabetic and the
non-diabetic children (p<0.01 or p<0.05) were found. The bacterial counts differed significantly
between diabetic and non-diabetic subjects regarding S. Mutans, S. Sobrinus, L. Salivarius and
L. Fermentum (p<0.05).
Conclusions: Type 1 Diabetes Mellitus patients showed a more cariogenic bacterial environment and a direct effect on plaque pH reducing it from normal levels was detected.
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