PRF Growth Factors Levels in Diabetic Patients With Chronic Periodontitis
Condition: Diabetes Mellitus; Chronic Periodontitis
MeSH terms: Periodontitis; Chronic Periodontitis; Diabetes Mellitus
Study type: Observational [Patient Registry]

Summary: 
      Diabetic patients may show different release of growth factors when microvascular
      complications such as; retinopathy or periodontitis are seen. Diabetes have an adverse effect
      on periodontal health and periodontal infection have an adverse effect on glycemic control
      and incidence of diabetes complications. Therefore, the investigators hypothesize that growth
      factors levels releasing from platelet rich fibrin (PRF) in diabetes mellitus (DM) may be
      decrease because of periodontitis is considered to be the sixth microvascular complication of
      diabetes or diabetes may have inductive effect on PRF growth factors levels in periodontal
      disease. Determination of PRF growth factors levels may be beneficial to treatment of
      diabetic patient with periodontal disease by using PRF.
    

Detailed description: 
      The aim of the investigators study was to evaluate levels of platelet derived growth
      factor-AB (PDGF-AB), vascular endothelial growth factor ( VEGF),transforming growth
      factor-beta1 and beta 2 (TGF-β1 and β2), basic-Fibroblast growth factor (b-FGF), insulin like
      growth factor-1 ( IGF-1) in type 2 diabetic (T2DM) patients with chronic periodontitis.

      This study consisted of 80 subjects; 20 patients were T2DM with periodontally healthy
      (DM-CTRL), 20 patients were T2DM with chronic periodontitis (DM-CP ), 20 patients were
      systemically healthy with chronic periodontitis (CP; ), 20 subjects were systemically and
      periodontally healthy (CTRL).

      Subjects were clinically evaluated with regards to the plaque index (PI), gingival index
      (GI), probing pockets depth (PD), clinical attachment level (CAL), bleeding on probing (BOP)
      recorded at six sites per tooth (disto-facial, mid-facial, mesio-facial, mesio-lingual,
      disto-lingual and mid-lingual) using a periodontal Goldman/Fox Williams probe calibrated in
      millimeters.

      PRF was prepared without biochemical manipulation of blood. Intravenous blood from each
      patient was collected in 10 ml sterile tubes without anticoagulant by venipuncture of
      antecubital vein. Immediately test tubes were centrifuged using a centrifugation machine (
      Electro.mag M 815 P Laboratory Centrifuge ; Istanbul, Turkey) at 2700 rpm ( approximately
      700g ) for 12 min . The centrifuged blood presented with a structured fibrin clot in the
      middle of the tube just between the red corpuscles at the bottom and acellular plasma at the
      top. PRF was easily separated from the red corpuscule base using steril scissors and inserted
      into steril tubes. The tubes were put on a shaker and agitated gently. After 5 minutes, the
      tubes were vortexed to form a PRF membrane and the volume of releasate was measured and the
      releasate returned into the tube. The tubes were further agitated gently. Samples were taken
      at 5th minute and immediately centrifuged at 5000rpm for 15 minutes (Electro.mag M 815 P
      Laboratory Centrifuge ; Istanbul, Turkey) to pellet any residual blood cells , and were
      stored at -80 centigrade degree for subsequent assays.

      Samples were assayed by using enzyme-linked immunosorbent assay (ELISA) with an ELX 800 G
      ELISA device (BIO-TEC Instruments, Winooski, USA). The following ELISA kits were used in this
      study: b-FGF, TGF-β2 and IGF 1 (Assay Biotechnology Company, CA, USA); PDGF-AB, VEGF and
      TGF-β1 (Boster Biological Technology, CA, USA).

      Statistical analysis was performed using a commercially available software (SPSS 15.0; SPSS
      Inc., Chicago, IL). The Shapiro-Wilk test was used to investigate whether the data were
      normally distributed. When normal distribution with equal variances was assumed in PDGF-AB,
      VEGF, TGF-β1, variables were compared using one-way analysis of variance (ANOVA) with
      Bonferroni post hoc test. If the assumption of normality failed, comparisons of the age,
      TGF-β2, b-FGF, IGF-1, HbA1c, fasting blood glucose, postprandial blood glucose, full-mouth
      PD, CAL, GI, PI and BOP were tested using the Kruskal-Wallis non-parametric test followed by
      post-hoc group comparisons with the Bonferroni-adjusted Mann-Whitney U test.
    

Intervention name(s): Platelet Rich Fibrin
Intervention type(s): Other
Intervention description(s): Procedure: Platelet Rich Fibrin obtained
Observational model: Case-Control
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        The patients participating the study were recruited from indivuduals referred to Department
        of Periodontology, Faculty of Dentistry, University of Bülent Ecevit University for either
        dental treatment or dental check-ups.
      
Keywords: Diabetes mellitus; Platelet rich fibrin; growth factor