Diabetes tied to periodontitis onset, progression
Adult patients with diabetes are at increased risk of periodontitis onset and progression, according to a systematic review and meta-analysis.
Researchers pooled data from 13 studies investigating the association between diabetes and periodontitis and presented at least two measurements of periodontal conditions (eg, attachment level, periodontal probing depth or alveolar bone height). The total population comprised 49,262 individuals, among whom 3,197 had diabetes.
Meta-analyses showed diabetes to be associated with an elevated risk of incidence or progression of periodontitis (relative risk, 1.86; 95 percent CI, 1.3–2.8). However, there is limited information regarding the association between diabetes and periodontal destruction.
Potential mechanisms linking diabetes to periodontitis onset and progression involve polymorphonuclear leukocytes permanence in tissues that occur following an insult. This leads to extensive tissue damage, which relates in turn to to faster progression of chronic inflammatory diseases in general. [J Immunol 2012;188:844-853]
The elevated prolonged inflammation process associated with chronic hyperglycaemia in diabetic patients induces high proportions of apoptotic cells, resulting in periodontitis. Moreover, diabetes has been implicated in microvascular pathological alterations in the gingiva, which then result in increased periodontal inflammation. [Diabetes Care 2011;34:181-183]
Researchers highlighted the need for additional longitudinal studies with large sample sizes and information on periodontal destruction. These studies should estimate the cluster effect of common risk factors to determine their combined effect with blood glucose level on periodontitis onset and progression.