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Size: 856.17 KB
Language: en
Added: Aug 09, 2020
Slides: 52 pages
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Diabetes and Periodontitis
2-Way Relationship Between Diabetes and Periodontal disease Diabetic people are more susceptible to periodontal disease Periodontitis complicates glycaemic control and enhances insulin resistance resulting in hyperglycaemia Hyperglycaemia, in turn, causes increased susceptibility to re-infection and more severe periodontal disease Diabetes Periodontal Disease
Effect of Diabetes on Periodontitis
DIABETES MELITUS
Thus, Periodontitis is a complication of Diabetes
IN PERIODONTITIS
IN DIABETES
SYNERGESTIC DESTRUCTION IN PRESENCE OF BOTH
CLINICAL FEATURES IN DIABETIC PATIENTS
PATHOGENESIS
MICROBIOLOGY
AGE-RAGE INTERACTIONS CAUSE DESTRUCTIVE EFFECTS
1. AGE- RAGE INTERACTION ON NEUTROPHIL
2. AGE- RAGE INTERACTION ON MONOCYTES/MACROPHAGES
2. AGE- RAGE INTERACTION ON MONOCYTES/MACROPHAGES
3. AGE- RAGE INTERACTION ON VASCULAR ENDOTHELIAL CELLS
4. AGE- RAGE INTERACTION ON FIBROBLAST
IMPAIRED WOUND HEALING
Summary Changes in subgingival environment Altered microbiota Altered tissue homeostasis and wound healing ↓ collagen production- alterations in wound healing Increased MMP’s activity Accumulation of AGE’s in blood vessels ↓ tissue turnover Increased Oxidative stress induced by neutrophils and macrophages
DIABETES INDUCED PERIODONTAL DESTRUCTION IS DUE TO Alters response of periodontal tissues to local factors with increased bone loss and delayed postsurgical healing
TREATMENT
Response to Periodontal treatment in patients with DM
HOST MODULATORY AGENTS
SUBANTIMICROBIAL DOSE OF DOXYCYCLINE
BISPHOSPHONATES
OTHER TREATMENT MODALITIES
PRECAUTIONS
Effect of Periodontitis on Diabetes
Summary Periodontitis induce increased C reactive protein, IL-6, TNF- ⍺ levels Such elevated systemic inflammatory state exacerbate insulin resistance and aggravate glycemic control Treatment of periodontitis improves glycemic control in diabetic patients