Abstract

Diabetes mellitus is associated with a number of complications resulting from hyperglycemia. Periodontitis is among the major complications associated with diabetes and reciprocally affects the severity and control of diabetes. Increase inflammation induced by type 2 diabetes directly contributes to the increased prevalence and severity of periodontitis in these patients. Regardless of the amount of dental plaque accumulation, gingivitis is more prevalent in diabetic patients than in healthy controls suggesting an impact of diabetes on periodontal inflammatory response to the bacterial biofilm. Levels of proinflammatory cytokines in the periodontal tissue or gingival crevicular fluid are elevated in patients with poorly controlled diabetes in the absence of periodontal disease when compared to well-controlled and non-diabetic patients. This review focuses on the possible pathological mechanisms underlying the association between periodontal disease and type 2 diabetes, explores new avenues in understanding the inflammatory pathways, and discusses novel therapeutic approaches with a paradigm shift in the prevention and treatment of diabetes and periodontitis.

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