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oral manifestations of diabetus mallites in complete denture wearers/ cosmetic dentistry training
1. INDIAN DENTAL ACADEMY
Leader in continuing dental education
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2. Statement of problem
The oral mucosa has been reported to have a variety
of changes in subjects with diabetes mellitus
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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.
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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
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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
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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
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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
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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.
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10. Stimulated salivary flow was classified as:
1) normal: 1-2ml/min
2) hypo: 0.7 ml/ min
3) xerostomic: 0.1 ml/ min
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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.
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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
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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
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15. 10) candidasis
11) blood coagulation,
12) tissue regeneration above normal times and
13) xerostomia
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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
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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
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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
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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.
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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
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21. Prosthodontic considerations
SHORT APPOINMENTS- only in mornings
NO STRESS
ALGINATE- thin mix
FULL SPACER
MONOPLANE TEETH
TISSUE SIDE SHOULD BE SMOOTH
FREQUENT RECALLS
RELINING AND REBASING
TISSUE CONDITIONERS
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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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23. Thank you
For more details please visit
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