GINGIVAL INFLAMMATION AS A SIGN OF DIABETIC SYSTEMIC CHRONIC COMPLICATIONS
to an endocrinologist for prompt treatment of the underlying disease and DM complications . For proper dental care the dentist should be aware of the diabetic status of each patient . Information on the levels of HbA1c over a longer period of time and the presence / absence of any diabetic complications is needed in assessing periodontal prognosis and the need for periodontal therapy on individual basis . Close collaboration between the patient , the primary health care and oral health professionals , and application of new therapeutic modalities could be a way of improving the diabetic patient ’ s general and oral health 7 , 8 .
6 . Conclusion It is observed that pronounced gingival inflammation in diabetics is associated with systemic diabetic chronic microvascular complications and poor glycemic control . As periodontal disease is a complex multifactorial disease related to DM , the prevention and control of periodontal disease must be considered an integral part of DM control . The findings in this study highlight a need to promote oral health in patients with DM as an integral component of total patient care .
Acknowledgment This research was supported by a grant from the Serbian Ministry of Education and Science , No . 175061 .
REFERENCES
1 . Barr EL , Zimmet PZ , Welborn TA , Jolley D , Magliano DJ , Dunstan DW , Cameron AJ , Dwyer T , Taylor HR , Tonkin AM , Wong TY , McNeil J , Shaw JE . Risk of cardiovascular and all-cause mortality in Individuals with diabetes mellitus , impaired fasting glucose , and impaired glucose tolerance : the Australian Diabetes , Obesity , and Lifestyle Study ( AusDiab ). Circulation . 2007 ; 116 ( 2 ): 151- 157 . 2 . Rohlfing CL , Wiedmeyer HM , Little RR , England JD , Tennill A , Goldstein DE . Defining the relationship between plasma glucose and HbA1c : analysis of glucose profiles and HbA1c in the Diabetes Control and Complications Trial . Diabetes Care . 2002 ; 25 ( 2 ): 275-278 . 3 . Koro CE , Bowlin SJ , Bourgeois N , Fedder DO . Glycemic control from 1988 to 2000 among U . S . adults diagnosed with type 2 diabetes : a preliminary report . Diabetes Care . 2004 ; 27 ( 1 ): 17-20 . 4 . King GL . The role of inflammatory cytokines in diabetes and its complications . J Periodontol . 2008 ; 79 ( 8Suppl ): 1527-1534 . doi : 10.1902 / jop . 2008.080246 . 5 . Taylor G . Bidirectional interrelationships between diabetes and periodontal diseases : an epidemiologic perspective . Ann Periodontol . 2001 ; 6 ( 1 ): 99-112 . 6 . Löe H . Periodontal disease . The sixth complication of diabetes mellitus . Diabetes Care . 1993 ; 16 ( 1 ): 329-334 . 7 . Mealey BL , Rethman MP . Periodontal disease and diabetes mellitus . Bidirectional relationship . Dent Today . 2003 ; 22 ( 4 ): 107- 113 . 8 . Southerland JH , Taylor GW , Offenbacher S . Diabetes and periodontal infection : Making the connection . Clin Diabetes 2005 ; 23 ( 4 ): 171-178 . 9 . Karjalainen KM , Knuuttila ML , von Dickhoff KJ . Association of the severity of periodontal disease with organ complications in type 1 diabetic patients . J Periodontol . 1994 ; 65 ( 11 ): 1067-1072 . 10 . Mealey BL , Oates TW ; American Academy of Periodontology . Diabetes mellitus and periodontal diseases . J Periodontol . 2006 ; 77 ( 8 ): 1289-1303 . 11 . Scannapieco FA , Panesar M . Periodontitis and chronic kidney disease . J Periodontol . 2008 ; 79 ( 9 ): 1617-1619 . doi : 10.1902 / jop . 2008.080313 . 12 . Lalla E , Lamster IB , Feit M , Huang L , Spessot A , Qu W , Kislinger T , Lu Y , Stern DM , Schmidt AM . Blockade of RAGE suppresses periodontitis associated bone loss in diabetic mice . J Clin Invest 2000 ; 105 ( 8 ): 1117-1124 . 13 . Hudson BI , Bucciarelli LG , Wendt T , Sakaguchi T , Lalla E , Qu W , Lu Y , Lee L , Stern DM , Naka Y , Ramasamy R , Yan SD , Yan SF , D ’ Agati V , Schmidt AM . Blockade of receptor for advanced glycation endproducts : a new target for therapeutic intervention in diabetic complications and inflammatory disorders . Arch Biochem Biophys . 2003 ; 419 ( 1 ): 80-88 . 14 . Liu R , Bal HS , Desta T , Krothapalli N , Alyassi M , Luan Q , Graves DT . Diabetes enhances periodontal bone loss through enhanced resorption and diminished bone formation . J Dent
Res . 2006 ; 85 ( 6 ): 510-514 . 15 . Lappin DF , Eapen B , Robertson D , Young J , Hodge PJ . Markers of bone destruction and formation and periodontitis in type 1 diabetes mellitus . J Clin Periodontol . 2009 ; 36 ( 8 ): 634-641 . 16 . Iacopino AM . Periodontitis and diabetes interrelationships : the role of inflammation . Ann Periodontol . 2001 ; 6 ( 1 ): 125-137 . 17 . Katz J . Elevated blood glucose levels in patients with severe periodontal disease . J Clin Periodontol . 2001 ; 28 ( 7 ): 710-712 . 18 . Silness J , Löe H . Periodontal disease in pregnancy . II . Correlation between oral hygiene and periodontal condition . Acta Odontol Scandinav . 1964 ; 22 ( 1 ): 121-135 . 19 . Löe H , Silness J . Periodontal disease in pregnancy . I . Prevalence and severity . Acta Odontol Scandinav . 1963 ; 21 ( 6 ): 533- 551 . 20 . Morrison EC , Ramfjord SP , Hill RW . Short-term effects of initial , nonsurgical periodontal treatment ( hygienic phase ). J Clin Periodontol . 1980 ; 7 ( 3 ): 199-211 . 21 . Ramfjord SP . The Periodontal Disease Index ( PDI ). J Periodontol . 1967 ; 38 ( 6 ): Suppl : 602-610 . 22 . Page RC , Beck JD . Risk assessment for periodontal diseases . Int Dent J . 1997 ; 47 ( 2 ): 61-87 . 23 . Güneri P , Unlü F , Yeşilbek B , Bayraktar F , Kokuludağ A , Hekimgil M , Boyacioğlu H . Vascular endothelial growth factor in gingival tissues and crevicular fluids of diabetic and healthy periodontal patients . J Periodontol . 2004 ; 75 ( 1 ): 91-97 . 24 . Lalla E , Cheng B , Lal S , Kaplan S , Softness B , Greenberg E , Goland RS , Lamster IB . Diabetes-related parameters and periodontal conditions in children . J Periodontal Res . 2007 ; 42 ( 4 ): 345-349 . 25 . Rabelo SB , Villaverde AB , Nicolau R , Salgado MC , Melo Mda S , Pacheco MT . Comparison between wound healing in induced diabetic and nondiabetic rats after low-level laser therapy . Photomed Las Surg . 2006 ; 24 ( 4 ): 474-479 . 26 . Salvi GE , Kandylaki M , Troendle A , Persson GR , Lang NP . Experimental gingivitis in type 1 diabetics a controlled clinical and microbiological study . J Clin Periodontol . 2005 ; 32 ( 3 ): 310-316 . 27 . Manfredi M , McCullough MJ , Vescovi P , Al-Kaarawi ZM , Porter SR . Update on diabetes mellitus and related oral diseases . Oral Dis . 2004 ; 10 ( 4 ): 187-200 . 28 . Teeuw WJ , Gerdes VE , Loos BG . Effect of periodontal treatment on glycemic control of diabetic patients . A systematic review and meta-analysis . Diabetes Care . 2010 ; 33 ( 2 ): 421-7 . doi : 10.2337 / dc09-1378 . 29 . The Diabetes Control and Complications Trial Research Group . The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus . N Engl J Med . 1993 ; 329 ( 14 ): 977-986 . 30 . UK Prospective Diabetes Study Group . Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes ( UKPDS 33 ). Lancet . 1998 ; 352 ( 9131 ): 837-853 .
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