Characteristics of the rheological properties of oral fluid in patients with diabetes mellitus using full removable plate dentures

Abstract

Summary. Over the past decades, in many countries of the world, there has been a steady increase in the incidence and prevalence of diabetes mellitus, which has allowed foreign authors to qualify these processes as a new epidemic of non-infectious nature of the 21st century. In this case, type 2 diabetes accounts for 90 % of all diabetes cases in the world. One of the first and most frequent manifestations of diabetes mellitus is the disturbance of the secretory function of the salivary glands, which leads to xerostomia. The processes of giposalivation considerably complicate the orthopedic treatment of patients with diabetes in case of complete loss of teeth.

The aim of the study – to determine the peculiarities of changes in the rheological parameters of oral fluid in patients with diabetes mellitus, using complete removable plate dentures (CRPD).

Materials and Methods. To accomplish this aim, 184 patients were examined at the Clinic of the Department of Dentistry Ivano-Frankivsk National Medical University and on the base of the Ivano-Frankivsk Regional Hospital: 96 male and 73 female, in the age range of 45 to 74 years. Among them – 104 people with a verified diagnosis of type 2 diabetes, that used complete demountable dentures (group I); The group II consisted of 80 patients without diabetis, that were also using complete removable constructions. Among the physical and chemical properties of the oral fluid, the salivation rate, viscosity, mucin concentration, total protein content, and the concentration of hydrogen ions in the oral fluid were studied.

Results and Discussion. The concentration index of hydrogen ions in the oral liquid of individuals in group I was 1.1 times lower than that of the group II. The viscosity of oral fluid in patients with type 2 diabetes mellitus (5.12±0.45) mPas) in 2 times exceeded the same value in patients without somatic pathology. The rate of salivation in the group I was 1.4 times lower than in the group II. Concentration of mucin in the oral liquid of patients in Group I (4.35±0.37) g / l) was 2.2 times higher than in patients of group ІІ. The total protein in the oral liquid of patients in group I was 2.1 times higher than that of patients in group ІІ. It can be shown that in patients with diabetes, significant changes were observed in all investigated parameters of oral rheological properties compared to patients without endocrine pathology. One of the objectives of our study was to learn the dynamics of physico-chemical properties of oral liquid in patients with type 2 diabetes and in patients without concomitant somatic pathology, depending on the duration of the use of complete removable plate denture (CRPD). Thus, in the short term of the use of CRPD (1 month), the level of oral liquid in patients of Group I was below the physiological norm with a value of (6.10±0.61), p <0.01. In patients with type 2 diabetes mellitus, who used a long-term (1–3 years old) CRPD, a shift in the acid-base balance of the oral fluid to the side of acidosis was observed. There was a direct correlation between the increase in viscosity of oral fluid in patients of both groups from the prolongation of the use of CRPD, however, in patients with diabetes, the values ​​were significantly higher. In group II, the decrease in salivation was less intense in all terms of observation. When using CRPD for more than 1–3 years, the content of protein in the oral liquid of patients with type 2 diabetes was 2 times higher than that of subjects without background pathology.

Conclusions. Based on the studies conducted, we can conclude that reduced functional activity of the salivary glands in patients with diabetes mellitus. Increasing the viscosity, increasing the content of mucin and total protein in the oral fluid, reducing the salivation rate and reducing the acid-base balance of the oral fluid in patients with type 2 diabetes mellitus using CRPD, probably caused subjective complaints of patients with dry mouth, which caused discomfort when wearing complete removable plate prostheses. The dependence of the negative dynamics of rheological indicators of oral liquid on the period of use of the CRPD is traced. The obtained data allow to develop treatment and prophylactic schemes for elimination of giposalivation and xerostomy in patients with diabetes who use full removable plate dentures, which will significantly improve the quality of life in this category of patients.