Therapeutic Targets for Management of Periodontitis and Diabetes

Abstract

The increasing incidence of diabetes mellitus (DM) and chronic periodontitis (CP) worldwide imposes a rethinking of individualized therapy for patients with both conditions. Central to bidirectional links between DM and CP is deregulated systemic inflammation and dysfunctional immune responses to altered-self and non-self. Control of blood glucose levels and metabolic imbalances associated with hyperglycemia in DM, and disruption of pathogenic subgingival biofilms in CP are currently the main therapeutic approaches for these conditions. Mounting evidence suggests the need to integrate immune modulatory therapeutics in treatment regimens that address the unresolved inflammation associated with DM and CP. The current review discusses the pathogenesis of DM and CP with emphasis on deregulated inflammation, current therapeutic approaches and the novel pro-resolution lipid mediators derived from n-3 polyunsaturated fatty acids.

Simvastatin modulates gingival cytokine and MMP production in a rat model of ligature-induced periodontitis

“…Nonsurgical treatment of periodontitis is currently used in to the clinics and is primarily based on administration of either systemic or local antibiotics 6. Increased bacterial resistance to the therapy, in addition to its side effects,16 has lead to the search for novel therapeutic approaches. The increased knowledge on the inflammatory pathways involved in periodontitis has prompted the investigation of the effects of anti-inflammatory drugs as strategies to reduce gingival inflammation 16.…”

“…Increased bacterial resistance to the therapy, in addition to its side effects,16 has lead to the search for novel therapeutic approaches. The increased knowledge on the inflammatory pathways involved in periodontitis has prompted the investigation of the effects of anti-inflammatory drugs as strategies to reduce gingival inflammation 16. Recent studies have suggested that cholesterol-lowering drugs such as simvastatin are protective against experimental2,4,17 and human periodontitis 18,19.…”

Salivary, gingival crevicular fluid and serum levels of ghrelin and chemerin in patients with periodontitis and overweight

“…4 Periodontitis is associated with several systemic diseases and conditions (eg diabetes is a well-known risk factor for periodontitis and vice versa). 5,6 Other systemic conditions are stress, smoking, hormonal changes and metabolic syndrome. 7 Recently, it has become increasingly clear that nutrition and body weight are modifying factors.…”

Significant of Antibiotic prophylaxis for diabetic patients with periodontal disease, 1 hour before phase 1 periodontal therapy

“…Data Extraction: Among these identified articles, only five articles met the inclusion criteria after reading the abstract of individual articles first. [1][2][3][4][5]…”

“…1 The periodontal disease most commonly plaque-induced gingivitis and CP-gingivitis is defined as a group of conditions affecting the supporting structure of tooth which may consequence to loosening of teeth if untreated. 2 As enlisting the complication of DM, periodontitis has been recognized as the sixth one 5 indicating the bidirectional links between DM and CP. 1 Both diabetes and periodontitis are chronic diseases with decreased collagen turnover, impaired neutrophil function, and increased periodontal destruction, diabetes adversely affects the periodontium.…”