A personalized approach to diagnosing the risks of developing inflammatory periodontal diseases and non-carious hard tooth tissue lesions depending on carbohydrate metabolism disorders

One of the important tasks of modern dentistry is the search for indicators that would allow predicting the development of inflammatory periodontal diseases and associated non-carious hard tooth tissue lesions such as wedge-shaped defects, increased tooth wear, and dentin hypersensitivity (hyperesthesia). The solution to this problem could be the creation of a clinical decision support system to predict the risks of their development depending on carbohydrate metabolism disorders. The purpose of the research is to assess the risks of developing inflammatory periodontal diseases and non-carious dental diseases in patients depending on carbohydrate metabolism disorders. Materials and methods. Data from 358 patients with carbohydrate metabolism disorders in the period from 2021 to 2023 were studied. From these, data from 105 patients were selected and divided into 3 groups as follows: I — 26 patients with metabolic syndrome (MS) and carbohydrate metabolism disorders; II — 52 patients with type 2 diabetes mellitus (T2DM); III — 27 patients with MS without carbohydrate metabolism disorders (comparison group). Risk factors considered were elevated venous plasma glucose levels before and 2 hours after meals, and glucose levels in mixed unstimulated oral fluid. Relative risks (RR) for the occurrence of chronic periodontitis and non-carious dental lesions (increased tooth wear, abrasion, hypersensitivity) were calculated with a confidence level of 0.95. Correlations between the state of periodontal tissues in carbohydrate metabolism disorders and elevated venous plasma glucose levels and glucose levels in mixed unstimulated oral fluid samples were also calculated (Spearman’s correlation coefficients). Results. The risk of developing periodontitis in patients with T2DM is 7.269 compared to patients with MS without carbohydrate metabolism disorders (comparison group). The sensitivity of the T2DM risk for the occurrence of chronic periodontitis is 93%. T2DM and MS are not risk factors for the development of wedge-shaped defects (RR = 1.731 and 1.385, respectively). In patients of group I (MS with carbohydrate metabolism disorders), the risk of increased wear of hard tooth tissues is 2 times higher compared to group III — RR = 2.077. In patients with MS and T2DM, compared to the comparison group, the risk of developing dentin hypersensitivity is 2.5 times higher — RR = 2.67 and 2.596, respectively. The presence of T2DM, with a sensitivity of 83%, is a predictor for the development of dentin hypersensitivity; however, the converse is not true — the absence of T2DM is not a factor determining the absence of dentin hypersensitivity (specificity is only 54%). Conclusion. This study demonstrates the validity of developing personalized risk models for the development of inflammatory periodontal diseases and non-carious dental diseases depending on carbohydrate metabolism disorders.