Correlation between diabetes and periodontal disease Research Survey

[Abstract] Diabetes is genetic, and environmental factors of autoimmune systemic chronic metabolic diseases. Periodontal disease is supported in gingival tissue (gums, periodontal ligament and alveolar bone) is a devastating disease. A lot The study shows that: Diabetes and periodontal disease was two-way relationship between diabetes increases the risk of periodontitis and severity of periodontitis are also susceptible to diabetes and promoting factors. periodontitis not only a high incidence of diabetes, and the speed with lesion, damage was severe, the characteristics of poor treatment. At present, the relationship between periodontitis and diabetes Although the basic set, but the interaction between the internal mechanism is not fully clear, this article on periodontal disease associated with diabetes and their interaction mechanisms are reviewed.

[Keywords:] diabetes; periodontal disease

Abstract: Diabetes is a systemic chronic metabolic disease related with genetic and environmental factors and autoimmune. Periodontal disease is a destructive disease in gum support organizations (gum, periodontal membrane, alveolar bone). A lot of Research shows the diabetes and periodontal disease is two -way relationship concerning periodontal disease and diabetes.Diabetes increases the risk of periodontitis, and severity of diabetes is susceptible and promoting factors. Diabetes patients not only have a high incidence rate, but also are characteristic of fast disease Development speed, severe damage, and poor treatment effect. At present, the relationship between periodontal disease and diabetes has basically established, but the internal mechanism of the interaction between them has not been entirely clear. In this paper, the correlation and the interactive mechanism between periodontal disease and diabetes will be reviewed.

Keywords:: diabetes; periodontiti

1 Introduction

Diabetes is genetic, and environmental factors of autoimmune systemic chronic metabolic diseases. Diabetes and complications has become a serious threat to human health, public health problem worldwide, including diabetes, type 2 diabetes accounts for more than 90% incidence of diabetes mainly by insulin resistance (insulin resistance, IR) changes of endogenous insulin on target cells caused by periodontal disease. is harmful to human oral health one of the three diseases, the incidence rate as high as 60% 70%. A number of studies: diabetes and was two-way relationship between periodontal disease and diabetes can increase the risk of periodontal disease, hyperglycemia is a risk factor for chronic periodontitis. and good control of blood sugar can promote periodontal rehabilitation. At present, the relationship between periodontitis and diabetes Although the basic set, but the interaction between the internal mechanism is not fully clear, this article mainly related to periodontitis and diabetes and its interaction mechanisms are reviewed.

2 Correlation between periodontitis and diabetes

With lifestyle changes and the acceleration of the aging process, our country is the prevalence of diabetes rose rapidly, but not with age-related periodontitis as a common and frequently occurring oral, there trends in the incidence increased gradually. In recent years With the study of periodontitis and diabetes gradual deepening of the relationship between the two has been basically clear. periodontitis has been considered the sixth complication of diabetes.

2.1 Diabetes increases the risk of periodontitis and severity of

Found in periodontitis clinical incidence of diabetic patients showed a trend of high incidence, and this high incidence of periodontitis with age, sex and no relationship between oral Healthstatus. Glycemic control in diabetic patients with periodontal disease severity level were positively correlated. the longer the duration of diabetes is more frequent and more severe periodontal disease occurs, as follows: gums repeated serious and difficult to control swelling, bleeding, multiple periodontal abscesses, alveolar bone destruction, tooth mobility shift and fall off. Emrich other than by horse to 1 342 Indians, and found that patients with type 2 diabetes incidence of non-diabetic patients with periodontitis about 3 times, and that periodontitis is a potential complication of diabetes. periodontal conditions Comparative studies have shown that type 1 diabetes clinical periodontal attachment loss was significantly higher than non-

diabetics. diabetic patients because of the relative or absolute insulin levels in the body becoming less hormone secretion and calcium metabolism of calcium and phosphorus can lead to osteoporosis bone decalcification , alveolar bone as pArt of the body, by the effect of diabetes, and other parts of the bone tissue have the same reaction, due to bone loss in patients with type 2 diabetes than non-diabetic patients significantly increased, and thus type 2 diabetes has been considered to be tooth alveolar bone loss contributing factor. animal experimental studies: Zhang Wei-chen, found: alveolar bone resorption activity in diabetic rats, cortical bone thinning, the surface and reduce the number of osteoblasts was flat or star, a rare new bone formation. Mahamed, etc. The results show that bone loss in diabetic mice compared with non-diabetic mice increased significantly, and that the T cell-mediated immune response in diabetic periodontitis contributing factor to bone loss. These results show that 1 diabetes and type 2 diabetes may increase the incidence of periodontitis.

2.2 periodontitis and the promotion of diabetes susceptibility factors

Since the 60 years since the 20th century, scholars have conducted a series of periodontal treatment on glycemic control in diabetic patients affect the experimental research, covering the subgingival scaling, subgingival scaling, root planing and other mechanical treatment and antimicrobial agents therapy and combination of both. The complete periodontal treatment, the symptoms of diabetes and improve the availability of appropriate controls, showed lower glycated hemoglobin levels. Kiran order to study the periodontal health condition such as type 2 diabetes metabolic control of to 44 patients with type 2 diabetes subjects were randomly divided into two groups, the treatment group received full-mouth periodontal scaling and root planing treatment, the control group did not receive any periodontal treatment, again 3 months after treatment detection of the corresponding index and found that periodontal treatment group, with the glycated hemoglobin levels decreased significantly compared with that before treatment, while the control group slightly increased compared with before treatment. This study suggests that non-surgical periodontal therapy in patients with Type 2 diabetes metabolic control. closely related to diabetes and periodontitis, diabetes associated with the risk of severe periodontitis than non-diabetic patients with 2 to 3 times higher, a survey shows that diabetes incidence of periodontitis 59.6%. The survey also diabetic patients showed older age, longer duration, higher prevalence of periodontitis. but will also affect the blood glucose control of chronic periodontitis, severe periodontitis may further cause the deterioration of glycemic control. Qin group

of experimental studies suggest that, through the periodontal based therapy can improve glucose metabolism in diabetic patients with periodontitis and reduce the level of HbA1c levels, to improve the periodontal condition. for periodontal treatment at the same time, active control of diabetes, to correct metabolic disorders, more effective prevention and control of diabetes teeth weeks of disease, improve the therapeutic effect of periodontal disease.

3, the interaction mechanism of periodontitis and diabetes

On the mechanism of interaction between periodontitis and diabetes, many years of Researchhas focused on leukocyte chemotaxis and phagocytosis defects, vascular basement membrane, collagen metabolic disorders and genetic factors are closely related. And get a reasonable explanation, will not go into details in this . In recent years, a large number of studies have shown that the accumulation of advanced glycation end products, hyperlipidemia and insulin resistance, are also involved in the interaction between periodontitis and diabetes.

3.1 The accumulation of advanced glycation end products

Recent studies have found that glucose metabolism in patients with diabetes end products (advanced glycation end praducts, AGEs) in the case of non-enzymatic, glucose, fructose and glucose 6 - phosphate and other biological macromolecules, especially long-lived proteins, such as collagen, matrix proteins such as glycosylation occurs to form the product. It can not be enzymes break down proteins and lipids, blood glucose levels can accelerate the slow increase in the formation and accumulation of AGEs. AGEs can stimulate phagocytic cells to release inflammatory cytokines , inflammatory mediators can activate osteoclasts and collagenase, causing bone and periodontal tissue destruction. AGEs may affect the accumulation of monocyte and neutrophil emigration and phagocytic activity, can not effectively kill the bacteria, so that mature subgingival bacteria and transformed into G-, resulting in periodontal infection. AGEs have been sugar and non-enzymatic protein, so that the body changes a variety of proteins and affect the healing of periodontal infection.

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3.2 Hyperlipidemia

Patients with diabetes (types 1 and 2) high glucose, is usually associated with high blood lipids. Lipids usually presents with high plasma low-density lipoprotein cholesterol (low density lipoproteincholesterol, LDL), triglycerides (triglycerides, TRG) and ��-6 free fatty acid levels were significantly increased. fatty acid metabolism and high cholesterol can affect the function of a variety of cells, causing diabetes complications. from diabetes blood mononuclear cells isolated from inflammatory response to bacteria has a magnifying effect, the performance in lipopolysaccharide stimulated monocytes from excessive inflammatory mediators such as IL-1��, TNF-@ and so on. The single cells with high reactivity independent of high blood sugar, but may be related to high blood cholesterol. Noack and other studies have shown that impaired glucose tolerance as a risk factor of diabetes is not a risk factor for periodontitis, but more like high blood lipid risk factors for periodontitis. suggest that diabetes may increase high blood lipids, another important mechanism for theDevelopment of periodontitis.

3.3 Insulin resistance

On insulin sensitivity and resistance to a variety of mechanisms, adipocytokines, genetic factors, environmental stress and inflammation and so may be in connection with transmitter. Recently found that insulin resistance and inflammation in the classical pathway between the closely linked. pro-inflammatory cytokines and adipose tissue, endocrine interaction between the immune system, causing IR and �� cell structure and dysfunction, eventually leading to type 2 diabetes. periodontal inflammation in the periodontal tissue into the environment, thought to be involved in the process . in the impact of periodontal disease on diabetes, TNF-@ may be crucial factors. has been confirmed that obese adipose tissue secretion of inflammatory cytokines TNF-@ induced insulin resistance is an important factor, cancer and severe systemic infection associated with insulin resistance is also considered. the success of periodontal treatment in diabetic patients with periodontitis can improve blood sugar control, which may be in patients with periodontitis by reducing circulating levels of TNF-@, increased sensitivity to insulin. At present , there is no study confirmed that periodontal disease and a direct link between the IR. However, periodontal disease may cause or make inflammatory neurotransmitter levels, periodontal infection to the body's release of a TNF-@, IL-6 and the source of other inflammatory neurotransmitters. which, TNF-@ and the most closely related to IR. that TNF-@ can prevent the insulin receptor autophosphorylation and to inhibition by inhibiting the tyrosine kinase signal transduction 2, resulting in receptor levels caused by IR.

4 Problems and Prospects

Periodontal disease and diabetes are the high incidence of chronic diseases, both influence each other. In recent years, studies have found that periodontal treatment can affect blood glucose control in diabetic patients, but the mechanism of periodontal disease on diabetes is not yet clear. a better understanding of the molecular interaction between periodontitis and diabetes, mechanism to help identify high risk patients, to promote new drug Developmentand the development of targeted preventive measures.

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