Bilateral Interrelationship of Diabetes and Periodontium

Abstract

: Periodontitis is a chronic inflammatory disease characterised by destruction of the supporting structures of the teeth which is a common cause of tooth mortality in all individuals throughout the world. Diabetes is a group of metabolic dysregulation, primarily of carbohydrate metabolism, characterized by hyperglycemia that results from defects in insulin secretion, impaired insulin action, or both. Systematic reviews and meta-analysis have shown that the prevalence of periodontitis is increased in diabetic patients. Based on the evidence, degree of hyperglycemia and severity of periodontitis are inter- related. Diabetic patients with severe periodontitis have six times more poor glycemic control than patients with healthy periodontium. However, improved glycemic control has been postulated to reduce the severity of periodontal disease. : In this mini-review, we have presented the previously reviewed studies from the literature and focused on a two-way relationship of diabetes and periodontitis, various pathways involved in it such as RANK/RANKL/OPG axis, AGE-RAGE pathway, Oxidative stress mechanism, and obesity that influence the possibility of periodontitis-Diabetes Mellitus (DM).

Correlations between Salivary Immuno-Biochemical Markers and HbA1c in Type 2 Diabetes Subjects before and after Dental Extraction

“…In our study, both RANKL and OPG showed increased values when compared to non-diabetics both pre- and post-extraction. Another study analyzing these variations in gingival crevicular fluid highlighted that RANKL levels and RANKL/OPG ratio is higher in poorly controlled diabetics with chronic periodontitis, compared to healthy individuals but also subjects with diabetes with optimal metabolic control and periodontitis, and this ratio was not significantly affected by periodontal therapy [ 19 ]. Thus, our study strengthens the belief that the RANKL/OPG ratio is negatively influenced in diabetes, especially in subjects with poor glycemic control.…”

Randomized Controlled Trial on Effects of a Brief Clinical-Based Intervention Involving Planning Strategy on Self-Care Behaviors in Periodontal Patients in Dental Practice

“…Systemic diseases closely related to PD include type 2 diabetes, thrombosis, arteriosclerosis, bacterial endocarditis, aspiration pneumonia, cancer, arthritis, and osteoporosis [6,7]. Disease control in patients with systemic diseases is more challenging when they also have PD, which adversely affects quality of life.…”

Accuracy of radiographic pixel linear analysis in detecting bone loss in periodontal disease: Study in diabetic rats

“…Diabetic patients with severe periodontitis have six times more insufficient glycemic control (hyperglycemia) than patients with healthy periodontium, leading to exaggerated immune-inflammatory responses induced by periodontal pathogens. However, improved glycemic control reduces the severity of periodontal disease ( Badiger et al, 2019 , Wu et al, 2015 ).…”