DIAGNOSTIC SIGNIFICANCE OF IDENTIFYING PERIODONTAL PATHOGENS OF PROSTHETIC PERIODONTITIS IN DIABETIC PATIENTS

Objective: To assess the diagnostic significance of the polymerase chain reaction (PCR) in selecting antibacterial therapy for periodontal disease in individuals with removable partial dentures (RPDs) in the setting of type 2 diabetes mellitus (T2DM) Methods: A total of 74 individuals (34 men and 40 women) of middle and old age, ranging from 53 to 76 years, who were using RPDs, were examined and treated. The participants were divided into two groups: the main group (MG), which consisted of 39 patients with T2DM, and the control group (CG), which included 35 individuals without any medical conditions. During the clinical and laboratory study, moderate to severe periodontitis was diagnosed in both the MG and CG, 33/39 and 19/35, respectively. All participants received antibacterial therapy. The choice of antibiotics was based on the sensitivity of the periodontal pathogens in the prosthetic mucosal bed, which was determined using the PCR assay. The following parameters were assessed before and after treatment, including changes in the composition of periodontal pathogens, the severity of periodontitis, the periodontal index (PI) scores, and the levels of salivary sialic acids. Results: A study found that RPDs worsen periodontal diseases in 92% of the MG patients, which is three times higher than the CG, at 31% (p<0.001). The PCR assay, both before and after antibacterial therapy, allowed researchers to identify a decrease in bacterial load of key periodontal pathogens: Prevotella intermedia, Tannerella forsythia (previously named Bacteroides forsythus and Tannerella forsythensis), Treponema denticola, Actinobacillus actinomycetemcomitans, and Porphyromonas gingivalis in the microflora of the prosthetic mucosal bed. This approach led to a 76% reduction in the severity of periodontitis, a 51% decrease in PI, and a 12% reduction in salivary sialic acid levels. Conclusion: The PCR diagnostics can be valuable in guiding antibacterial therapy in patients with T2DM using RPDs by identifying specific periodontal pathogens and their levels, allowing for targeted and effective treatment. Keywords: Removable partial dentures, periodontitis, type 2 diabetes mellitus, PCR diagnostics, sialic acids.