Relationship Between Periodontitis and Diabetes: Lessons From Rodent Studies

Pontes, Carla Cruvinel; Flyvbjerg, Allan; Buschard, Karsten; Holmstrup, Palle

doi:10.1902/jop.2007.060491

Cited by 60 publications

(32 citation statements)

References 142 publications

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“…[36] The association between diabetes mellitus and periodontal disease is therefore, considered to be bidirectional: diabetes as a risk factor for periodontitis and periodontitis as a possible severity for diabetes. In fact, aggressive periodontitis is recognized as the sixth serious complication of diabetes.…”

Section: Epidemiological Considerationsmentioning

confidence: 99%

Diabetes and periodontitis

Deshpande

Jain

Sharma

et al. 2010

J Indian Soc Periodontol

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The main aim of this review is to update the reader with practical knowledge concerning the relationship between diabetes mellitus and periodontal diseases. Exclusive data is available on the association between these two chronic diseases till date. Articles published on this relationship often provide the knowledge of definitions of diabetes mellitus and periodontal diseases, prevalence, extent, severity of periodontal disease, complications of diabetes along with the possible underlying mechanisms. The authors reviewed human epidemiological studies, cross-sectional observations and longitudinal cohort, case control that evaluated variables exclusively over the past 30 years and the predominant findings from the “certain” articles are summarized in this review. This review clarifies certain queries such as 1) Do periodontal diseases have an effect on the metabolic control of diabetes? 2) Does diabetes act as a risk factor of periodontitis? 3) What are the possible underlying mechanisms relating the connection between these two chronic diseases? 4) What is the effect of periodontal intervention on metabolic control of diabetes? After a thorough survey of literature, it was observed that diabetes acts as a risk factor in development of periodontitis as periodontitis is significantly aggravated in patients suffering from diabetes having long term hyperglycemia. Different mechanisms underlying the association between the accelerated periodontal disease and diabetes are emerging but still more work is required. Major efforts are required to elucidate the impact of periodontal diseases on diabetes. At the same time, patients are needed to be made aware of regular periodontal maintenance schedule and oral hygiene.

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Section: Epidemiological Considerationsmentioning

confidence: 99%

Diabetes and periodontitis

Deshpande

Jain

Sharma

et al. 2010

J Indian Soc Periodontol

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“…Experimental PD in rats is based upon subgingival placement of ligatures that facilitate accumulation of bacteria, which in turn initiate periodontal inflammation (Graves, Fine, Teng, Van Dyke, & Hajishengallis, 2008; Pontes Andersen et al, 2007). Thus, subgingival placement of the ligature increases biofilm formation, and a direct comparison between ligature‐induced PD in rats and naturally occurring PD in humans is not possible (Graves et al, 2008).…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, standardized animal models with controlled diet, housing and microbial sampling may be preferable for these studies (Kaye, 2012), which is why rat models with ligature‐induced PD have been used frequently. Animal models with both T2D and PD have increased inflammatory cytokine responses, elevated oxidative stress, raised AGE levels, altered glucose metabolism, and increased severity of PD (Pontes Andersen, Flyvbjerg, Buschard, & Holmstrup, 2007). In addition to being a local irritant, the ligature serves as a reservoir for bacteria, which mediates periodontal tissue destruction (Bjornsson et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Ligature‐associated bacterial profiles are linked to type 2 diabetes mellitus in a rat model and influenced by antibody treatment against TNF‐α or RAGE

Grauballe

Belstrøm

Østergaard

et al. 2017

Clinical & Exp Dental Res

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There is a bidirectional relationship between periodontal disease (PD) and type 2 diabetes mellitus (T2D). T2D may lead to ecological perturbations in the oral environment, which may facilitate an altered microbiota. However, previous studies have been inconclusive in determining the effect of T2D on oral bacterial profiles. Therefore, we aimed to evaluate the influence of T2D on the ligature‐associated bacterial profile in a diabetic rat model with PD and investigated the impact of blocking inflammatory pathways with antibodies targeting either Tumor Necrosis Factor α (TNF‐α) or the receptor of advanced glycation end‐products (RAGE). A total of 62 Zucker obese rats (45 T2D) and 17 lean (non‐T2D) were divided into 4 treatment groups; lean with PD, obese with PD, obese with PD and anti‐TNF‐α treatment, and obese with PD with anti‐RAGE treatment. Periodontal disease was ligature induced. Ligature‐associated bacterial profiles were analyzed using Human Oral Microbe Identification Microarray (HOMIM). Ligature‐associated bacterial profiles differed between lean and obese rats. Furthermore, treatment with antibodies against TNF‐α or RAGE had an impact on subgingival bacterial profiles. T2D phenotypes are associated with different ligature‐associated bacterial profiles and influenced by treatment with antibodies against TNF‐α or RAGE.

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“…An explanation in this regard may be derived from the fact that periodontal disease elevates the systemic burden of infl ammatory mediators (such as CRP) that aggravate the existing metabolic disorder in patients with chronic hyperglycemia [9,10], however, SRP reduces the severity of periodontal infection and decreases the systemic burden of infl ammatory mediators which in turn reduces the hyperglycemic state in prediabetic patients. An interesting fi nding in the present study was that despite reduction in the severity of periodontal infl ammation in both groups compared to baseline values, FBG levels in both groups remained unchanged.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, studies [4,[6][7][8] have shown that prediabetic patients (patients with impaired glucose tolerance) are also susceptible to periodontal destruction as compared to their systemically healthy controls. It has been proposed that local periodontal infection increases the systemic burden of infl ammatory mediators (such as C-reactive protein [CRP]), which in turn aggravate the existing metabolic disorder in hyperglycemic patients [9,10]. Additionally, increased production and accumulation of advanced glycation endproducts in periodontal tissues raised cellular oxidative stress and production and accumulation of proinfl ammatory cytokines (such as interleukin (IL)-6, IL-1β, IL-18, matrix metalloproteinase [MMP]-8, and MMP-9) in the serum, saliva, and gingival crevicular fl uid of patients with persistent hyperglycemia tend to worsen periodontal infl ammation [11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Impact of scaling and root planing on clinical periodontal status and glycemic levels in prediabetic patients

Alshehri¹,

Javed²

2015

Interventional Medicine and Applied Science

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Objective:The aim was to assess the eff ect of scaling and root planing (SRP) on clinical periodontal parameters and glycemic levels in prediabetic patients. Methods: Fifty prediabetic patients with periodontal disease were included. Demographic data (age, gender, education status, duration of prediabetes, type of treatment adopted for prediabetes management, and oral hygiene maintenance protocols) were recorded using a questionnaire. Patients were randomly divided into two groups (25 patients/group). In Group 1, SRP alone was performed, in Group 2, SRP + oral doxycycline (100 mg) administration. In both groups, fasting blood glucose (FBG) levels and periodontal parameters (plaque index [PI], bleeding on probing [BOP], and probing depth [PD]) were assessed at baseline and after 6 months. Statistical analysis was performed using one-way analysis of variance. Results: Age, gender, and duration and treatment of prediabetes were comparable among patients in Groups 1 and 2. PI, BOP, and PD signifi cantly reduced in both groups than baseline values. Reduction in periodontal parameters among Groups 1 and 2 were comparable. There was no signifi cant reduction in FBG levels among patients in Groups 1 and 2 after 6 months of SRP. Conclusion: SRP was eff ective in reducing periodontal infl ammation in prediabetic patients. FBG levels did not show any signifi cant diff erence after SRP in both groups.

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Relationship Between Periodontitis and Diabetes: Lessons From Rodent Studies

Abstract: Findings from rodent studies have been useful in increasing our understanding of periodontitis, diabetes, and their association and hold great promise for future investigations given the wide variety of possibilities for testing biologic hypotheses.

Cited by 60 publications

References 142 publications

Diabetes and periodontitis

Diabetes and periodontitis

Ligature‐associated bacterial profiles are linked to type 2 diabetes mellitus in a rat model and influenced by antibody treatment against TNF‐α or RAGE

Impact of scaling and root planing on clinical periodontal status and glycemic levels in prediabetic patients

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