Rehab M Alhossaini¹, Mansour K Assery², Sami Shafik³ and Khalid Al-Hezaimi⁴*

¹Postgraduate Student in Periodontics, School of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
²Associate Professor of Prosthodontics, School of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
³Professor of Periodontics, School of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
⁴Professor of Endodontics and Periodontics Department, School of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia

*Corresponding Author: Khalid Al-Hezaimi, Professor of Endodontics and Periodontics Department, School of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia.

Received: August 13, 2020; Published: September 16, 2020

Abstract

Introduction: Reports confirm high prevalence of diabetes mellitus and dental caries associated with early tooth loss often replaced by dental implants in the Saudi Arabian society. This study aims to (1) assess clinical periodontal parameters of probing depth (PD), bleeding on probing (BOP) and amount of keratinized tissues (KT) around dental implants and (2) identify and type the fungal colonization present in the peri-implant crevicular fluid (PICF) in diabetic and non-diabetic Saudi nationals.

Materials and Methods: Thirteen individuals were divided into two groups: diabetics (Group I, n = 6) and non-diabetics (Group II, n = 7). PICF Serum samples were collected using paper points. Fifty-two agar plates were prepared: Group I with 24 and Group II with 28. Plates of agar without collected serum served as positive control and plates without C. albicans served as negative control. Microbiological analysis for Candida species included: 1) clinical strains of Candida albicans, Candida albicans ATCC 10231, Candida parapsilosis ATCC 22019, Candida glabrata ATCC 2001 and Candida tropicalis ATCC 750. All plates were incubated at 37°C for 1, 24, 48, 72 and 96-hours’ periods. At each time period, the presence of fungal colonies was assessed and recorded. Clinical periodontal parameters of PD, BOP, and amount of KT around dental implants were recorded.

Results: Mean PD in Group I (4.83 ± 0.75 mm) was significantly higher than Group II (P ≤ 0.001). BOP in Group I (83.30%) was significantly higher than Group II (P < 0.029). No significant difference was found in the amount of KT between the two study groups (P > 0.960). Fungal growth colonies in both groups were similar (P > 0.05).

Conclusion: Significantly higher BOP, PD in Saudi diabetic subjects compared to Saudi non-diabetic subjects. Candida species are present in PICF of Saudi Arabian subjects with slightly more frequent observation seen in diabetic subjects.

Keywords: Candida albicans; Dental Implants; Diabetic Saudi Arabian; Peri-Implant Crevicular Fluid; Fungi Around Dental Implants

References

1. Nobile C and Johnson A. “Candida albicans biofilms and human disease”. Annual Review of Microbiology 69 (2015): 71-92.
2. Montelongo-Jauregui D., et al. “An In vitro model for Candida albicans–Streptococcus gordonii biofilms on titanium surfaces”. Journal of Fungi 2 (2018):66.
3. Gökmenoğlu C., et al. “Evaluation of Candida albicans biofilm formation on various parts of implant material surfaces”. Nigerian Journal of Clinical Practice 1 (2018): 33-37.
4. Blankenship J and Mitchell A. “How to build a biofilm: a fungal perspective”. Current Opinion in Microbiology 6 (2006): 588-594.
5. Mombelli A., et al. “The microbiota associated with successful or failing osseointegrated titanium implants”. Oral Microbiologyand Immunology 4 (1987): 145-151.
6. Leonhardt Å., et al. “Microbial findings at failing implants”. Clinical Oral Implants Research 5 (1999): 339-345.
7. Hultin M., et al. “ Microbiological findings and host response in patients with peri‐implantitis”. Clinical Oral Implants Research 4 (2002): 349-358.
8. Quirynen M., et al. “Dynamics of initial subgingival colonization of ‘pristine’peri‐implant pockets”. Clinical Oral Implants Research1 (2006): 25-37.
9. Rodrigues C., et al. “Candida sp. infections in patients with diabetes mellitus”. Journal of Clinical Medicine 1 (2019): 76.
10. Antony G., et al. “Effect of phenotypic switching on expression of virulence factors by Candida albicans causing candidiasis in diabetic patients”. Revista Iberoamericanade Micología3 (2009): 202-205.
11. Leonhardt Å.,et al. “Microbiologic diagnostics at titanium implants”. Clinical Implant Dentistry and Related Research 4 (2003): 226-232.
12. Janus M., et al. “Candida albicans alters the bacterial microbiome of early In vitro oral biofilms”. Journal of Oral Microbiology 1 (2017): 1270613.
13. Cavalcanti Y., et al. “Modulation of Candida albicans virulence by bacterial biofilms on titanium surfaces”. Biofouling 2 (2016): 123-134.
14. Alsahhaf A., et al. “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”. Journal of Periodontology 12 (2019): 1383-1389.
15. Aguiree F., et al. IDF diabetes atlas (2013).
16. Al Dawish A., et al. “Diabetes mellitus in Saudi Arabia: a review of the recent literature”. Current Diabetes Reviews 4 (2016):359-368.
17. Wayne P. “Method for broth dilution antifungal susceptibility testing of yeasts: NCCLS document. National Committee for Clinical Laboratory Standards”. 18 (2002).
18. Klinge B., et al. “Peri‐implant diseases”. The European Journalof Oral Sciences 126 (2018): 88-94.
19. Derks J and Tomasi C. “Peri‐implant health and disease. A systematic review of current epidemiology”. Journal of Clinical Periodontology 42 (2015): 158-171.
20. Monje A., et al. “Diagnostic accuracy of clinical parameters to monitor peri‐implant conditions: A matched case‐control study”. Journal Periodontology4 (2018): 407-417.
21. Salvi G and Lang N.” Diagnostic parameters for monitoring peri-implant conditions”. International Journal of Oral and Maxillofacial Implants 19 (2004):116-127.
22. Jepsen S., et al. “Primary prevention of peri‐implantitis: Managing peri‐implant mucositis”. Journal of Clinical Periodontology 42 (2015): 152-157.
23. Berglundh T., et al. “Peri‐implant diseases and conditions: Consensus report of workgroup 4 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions”. Journal of Periodontology89 (2018): 313-318.
24. Al‐Sowygh , et al. “Peri‐implant conditions and levels of advanced glycation end products among patients with different glycemic control”. Clinical Implant Dentistry and Related Research 20.3 (2018):345-351.
25. Alrabiah M., et al. “Association of advanced glycation end products with peri‐implant inflammation in prediabetes and type 2 diabetes mellitus patients”. Clinical Implant Dentistry and Related Research 4 (2018): 535-540.
26. Singhal S., et al. “Human soluble receptor for advanced glycation end products and tumor necrosis factor-α as gingival crevicular fluid and serum markers of inflammation in chronic periodontitis and type 2 diabetes”. Journal of Oral Science 58 (2016): 547-553.
27. Duarte P., et al. “Overexpression of interleukin‐1β and interleukin‐6 may play an important role in periodontal breakdown in type 2 diabetic patients”. Journal of Periodontal Reserch4 (2007): 377-381.
28. Takeda M.,et al. “Relationship of serum advanced glycation end products with deterioration of periodontitis in type 2 diabetes patients”. Journal of Periodontology1 (2006): 15-20.
29. Abduljabbar T., et al. “Comparison of periodontal and peri-implant inflammatory parameters among patients with prediabetes, type 2 diabetes mellitus and non-diabetic controls”. Acta OdontologicaScandinavica 5 (2017):319-324.
30. Aguilar‐Salvatierra A., et al. “Peri‐implant evaluation of immediately loaded implants placed in esthetic zone in patients with diabetes mellitus type 2: a two‐year study”. Clinical Oral Implants Research2 (2016): 156-161.
31. Al Amri M., et al. “Effect of oral hygiene maintenance on HbA1c levels and peri‐implant parameters around immediately‐loaded dental implants placed in type‐2 diabetic patients: 2 years follow‐up”. Clinical Oral Implants Research11 (2016): 1439-1443.
32. Gómez‐Moreno G., et al. ”Peri‐implant evaluation in type 2 diabetes mellitus patients: a 3‐year study”. Clinical Oral Implants Research9 (2015): 1031-1035.
33. Alsahhaf A., et al. “Clinical and radiographic indices around narrow diameter implants placed in different glycemic‐level patients”. Clinical Implant Dentistry and Related Research4 (2019): 621-626.
34. Lagunov V., et al. “Evaluation of biologic implant success parameters in type 2 diabetic glycemic control patients versus healthy patients: A meta‐analysis”. Journal of Investigative and Clinical Dentistry 4 (2019): 12478.
35. Al Amri M and Abduljabbar T. “Comparison of clinical and radiographic status of platform‐switched implants placed in patients with and without type 2 diabetes mellitus: a 24‐month follow‐up longitudinal study”. Clinical Oral Implants Research2 (2017): 226-230.
36. Alasqah M.,et al. “Peri‐implant soft tissue status and crestal bone levels around adjacent implants placed in patients with and without type‐2 diabetes mellitus: 6 years follow‐up results”. Clinical Implant Dentistry and Related Research 4 (2018): 562-568.
37. Hammad M., et al. “The effect of glycemic control on Candida colonization of the tongue and the subgingival plaque in patients with type II diabetes and periodontitis”. Oral Surgery, Oral Medicine, Oral Pathology, and Oral Radiology 3 (2013): 321-326.
38. Alrayyes S., et al. “Oral Candidal carriage and associated risk indicators among adults in Sakaka, Saudi Arabia”. BMC Oral Health1 (2019): 86.