Article information
Abstract
Diabetes is a condition in which there is a chronically raised blood glucose levels caused by an absolute or relative lack of insulin due to insufficient production by the pancreas, or a deficit in the insulin action for the body needs. Periodontal disease is one of its complications, which is a chronic inflammatory disease that begins with an oral infection that leads to a destruction of periodontal tissues. The purpose of this review is to provide the reader with knowledge concerning the relationship between diabetes mellitus and periodontal diseases, focused on the effects of Diabetes in periodontal health, through the exacerbation of certain factors presents on this condition. It was made a research of scientifically articles via internet search engines like “Med-line” and “B-on”, as well scientifically magazines and books. Immunological, microbiological and wound healing factors were analyzed and compared between diabetics and non-diabetic patients. It was also analyzed clinical attachment loss, and other parameters, which were shown to be significantly higher in diabetes compared to that in non-diabetics, and the clinical attachment loss is higher in those with poor metabolic control. Periodontal therapy is an important factor on the control of diabetic patients and periodontal health. Diabetic patients with good metabolic control should be treated like healthy individuals. For some diabetic patients, the ideal HbA1c levels are not achieved even though they are considered controlled for the disease. There's not a consensus for the use of antibiotics in this patients, but we can see an improving of metabolic control in low doses or in doses without antibacterial effects.
Key-words:
Diabetes Mellitus
Periodontal Disease
Citokines
Inflamation
Periodontal Therapy
Resumo
A diabetes é uma condição sistémica em que se verifica uma elevação crónica dos níveis de glicose causada por uma absoluta ou relativa falta de insulina devido a uma insuficiente produção pelo pâncreas ou uma deficiência da sua acção no organismo. Uma das complicações da condição diabética é a doença periodontal. Esta revisão tem como objectivo mostrar a relação entre ambas as doenças, focando-se nas alterações de determinados factores presentes na Diabetes Mellitus que actuam sinergicamente com a condição de doença periodontal e são os principais responsáveis pelo aumento da destruição periodontal. Foi efectuada uma pesquisa de artigos científicos através dos motores de busca “Med-line” e “B-on”, bem como revistas e livros científicos. Dos artigos pesquisados foram analisados factores associados à resposta imunológica, microbiologia e cicatrização dos tecidos. Na análise dos parâmetros periodontais verificou-se que a perda de inserção é maior e mais prevalente em pacientes diabéticos e à medida que o controlo glicémico diminui os seus valores aumentam. A terapia periodontal é um importante factor no controlo da diabetes e saúde periodontal, verificando-se que pacientes diabéticos bem controlados devem ser tratados com os mesmos protocolos que os pacientes saudáveis. Porém grande parte destes pacientes não conseguem um controlo glicémico, segundo os padrões da ADA e os níveis de HbA1c que apresentam são uma condição controlada para esses pacientes. Alguns casos podem justificar o uso de antibióticos contribuindo para uma maior alteração de moléculas intervenientes na resposta pró-inflamatória e consequentemente um melhor controlo metabólico nestes pacientes.
Palavras-Chave:
Diabetes Mellitus
Doença Periodontal
Citoquinas
Inflamação
Terapia Periodontal
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(Correia D, Alcoforado G, Mascarenhas P. Influência da Diabetes Mellitus no Desenvolvimento da Doença Periodontal. Rev Port Estomatol Med Dent Cir Maxilofac 2010;51:167–176)
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