# Tooth Loss Complexity in Partially Edentulous Type 2 Diabetes and Non-diabetic Patients Based on the Prosthodontic Diagnostic Index (PDI) Classification: An Institution-Based Study

## TL;DR

This study finds that type 2 diabetes is linked to more complex tooth loss compared to non-diabetic patients, based on a classification system for partial dentition.

## Contribution

The study demonstrates a significant association between diabetes and increased tooth loss complexity using the Prosthodontic Diagnostic Index.

## Key findings

- Diabetic patients had significantly higher tooth loss complexity (Class III PDI) than non-diabetic patients (p = 0.013).
- Diabetic urban dwellers showed more complex tooth loss than rural counterparts.
- Longer diabetes duration and edentulism history were linked to higher tooth loss complexity in diabetic patients.

## Abstract

Background: The complexity of tooth loss not only compromises oral function and appearance but also has a detrimental impact on oral health-related quality of life. Untreated caries and chronic periodontal disease often lead to partial dentition. This prevalence is further exacerbated by the rising incidence of type 2 diabetes mellitus (DM). These bidirectional effects between diabetes and oral health accelerate tooth loss, necessitating varying levels of prosthodontic intervention to restore oral function and improve patient outcomes. This study aimed to find a correlation between diabetes and the complexity of tooth loss in partially edentulous patients and compare its severity with non-diabetic patients.

Methods: Two hundred partially edentulous patients, non-diabetic (n=100) and diabetic (n=100), reporting to the Department of Prosthodontics, Regional Dental College, Guwahati, India, were classified into four classes according to the Prosthodontic Diagnostic Index (PDI) Classification for partial edentulism. Blood sugar tests were advised as a routine diagnostic procedure.

Results: Diabetic patients showed significantly higher tooth loss complexity (Class III PDI) than non-diabetic participants, as assessed by the PDI classification (p = 0.013). Except for gender, other sociodemographic factors and period of edentulism were all associated with higher tooth loss complexity in the non-diabetic group. PDI Class III was more prevalent in diabetic patients associated with a longer history of diabetes and long-term edentulism. Diabetic urban dwellers demonstrated significantly more complex tooth loss than their rural counterparts.

Conclusion: The complexity of tooth loss was significantly associated with elevated blood glucose level.