Renata S. Leite, DDS, MS
Project 6: The Relationship Between Periodontal Diseases And Type 2 Diabetes Mellitus In The Gullah Population And The Effects Of Mechanical Periodontal Therapy and Systemic Antibiotics On The Glycemic Control And On the Active Matrix Metalloproteinase-8 (aMMP-8) Level In The Gingival Crevicular Fluid (GCF) Of These Patients (Start date 7/1/07)
Our overall hypothesis is that treatment of periodontal disease will produce better diabetes glycemic control (glycated hemoglobin A1c, or HbA1c) and reduced levels of the catalytically active form of MMP-8 in the Gullah African American diabetes patients living on the Sea Islands of the South Carolina coast. The GCF aMMP-8 levels will be measured through a site-specific, novel noninvasive technique allowing the pathophysiological status of the periodontium tissue to be monitored. We will conduct an interventional study on this population with minimal genetic admixture.
Specific Aim 1: To ascertain the rate of periodontal disease progression on poorly controlled type 2 diabetic Gullah African American patients as compared to well-controlled Gullah African American patients. The host inflammatory response appears to be the critical determinant for susceptibility and severity of marginal periodontitis especially in systemically compromised individuals, with diabetic status perhaps increasing host susceptibility to periodontal infection due to impaired immune response. Patients have been evaluated as part of a previous COBRE project entitled "Epidemiological Study of Periodontal Disease and Diabetes" by Dr. J. Fernandes. A reevaluation will be made at the time of periodontal therapy. Clinical periodontal parameters and HbA1c levels will be compared.
Specific Aim 2: To assess the effects of periodontal therapy on the level of glycemic control in this Gullah African American population. Authors addressing whether the treatment of periodontitis or other infections of the oral cavity can improve glycemic control in diabetic patients report contradictory results. We will treat periodontal patients with mechanical therapy (scaling and root planing) and oral hygiene instruction, with or without systemic antibiotic administration. The HbA1c, fasting glucose and clinical periodontal parameters will be evaluated prior to the periodontal intervention, and at 3 and 6 months after therapy. We plan to continue to recruit, enroll and assess new subjects from the Gullah African American community living on the Sea Islands of the South Carolina coast for future research projects.
Specific Aim 3: To assess the concentration of the catalytically active form of MMP-8 (aMMP-8) at baseline (prior to periodontal intervention) and at 3 and 6 months later. Polymorphonuclear (PMN) leukocyte-derived aMMP-8 is predominantly present in periodontitis-affected gingival crevicular fluid (GCF). Analysis of GCF for aMMP-8 could provide a novel useful noninvasive technique to assess and monitor the pathophysiological status of the periodontium tissue in a site-specific manner.