“…Chronic hyperglycemia associated with diabetes not only decreases bone metabolism but also increases secretion of proinflammatory cytokines such as interleukin 1 (14,15), tumor necrosis factor-a (15)(16)(17) and prostaglandin E 2 (18). Furthermore, it is also reported that hyperglycemia can induce periodontal tissue destruction associated with the formation of advanced glycation end products (15,19,20), vascular dysfunction (21), altered immune function (22) and decreased collagen synthesis (23)(24)(25).…”