Comparison of yeast species in the subgingival oral biofilm of individuals with type 2 diabetes and peri-implantitis and individuals with peri-implantitis without diabetes

Abstract

Background: There are no studies that have investigated the presence of yeasts in the subgingival oral biofilm (OB) of type-2 diabetic and non-diabetic patients with peri-implantitis. The aim was to assess the presence of yeasts in the subgingival OB of patients with type 2 diabetes and peri-implantitis and patients with peri-implantitis without diabetes.

Methods: Patients with type 2 diabetes with peri-implantitis (group A), non-diabetic individuals with peri-implantitis and without diabetes (group B), and individuals with and without peri-implantitis (group C) were included. Lifestyle-related and demographic data were collected using a questionnaire and hemoglobin A1c levels were measured. Peri-implant plaque index (PI), bleeding on probing (BOP), and probing depth (PD) were evaluated and crestal bone loss (CBL) were measured. Subgingival OB samples were collected and oral yeasts species were identified using ChromAgar medium. Level of significance was set at P <0.05.

Results: The mean age of individuals in groups A (n = 43), B (n = 41), and C (n = 42) were 55.6 ± 6.4, 54.6 ± 4.5, and 57.1 ± 3.3 years, respectively. The mean HbA1c levels were higher in group A (P <0.01) than groups B and C. Peri-implant PI (P <0.01), BOP (P <0.01), PD (P <0.01), and CBL (P <0.01) were significantly higher in group A compared with patients in groups B and C. Peri-implant PI (P <0.05), BOP (P <0.05), PD (P <0.05), and CBL (P <0.05) were significantly higher among patients in group B compared with group C. Subgingival yeasts were more often isolated from the OB of patients in groups A (74.4%) and B (46.3%) than group C (7.1%). The most common yeast species identified in all groups was Candida albicans. The CFU/mL for subgingival yeasts were higher in group A than groups B (P <0.01) and C (P <0.01). The CFU/mL for subgingival yeasts were higher in group B than group C (P <0.01).

Conclusion: Candida species (predominantly C. albicans) were more often present in the subgingival OB of patients with and without type 2 diabetes with peri-implantitis than systemically healthy individuals without peri-implant diseases.

Keywords: Candida; alveolar bone loss; dental implants; hyperglycemia; inflammation; peri-implantitis.