Lakschevitz Flavia, Aboodi Guy, Tenenbaum Howard, Glogauer Michael
Matrix Dynamics Group, University of Toronto, Canada.
Curr Diabetes Rev. 2011 Nov;7(6):433-9. doi: 10.2174/157339911797579205.
The association between diabetes and periodontal diseases is well-established. Diabetes is a risk factor for periodontal disease, with diabetic patients exhibiting an increased prevalence, extent and severity of gingivitis and perio- dontitis compared to healthy adults. Several mechanisms involved in the pathogenesis of diabetes have also been associated with periodontal disease progression. It is recognized today that there is a bidirectional relationship between diabetes and periodontal disease, with recent research showing that periodontal disease may affect the metabolic control of diabetes in diabetic patients. In this review, we present the current knowledge of the interplay between periodontal diseases and diabetes through the evaluation of randomized control and longitudinal cohort studies published in the past 15 years. Current data support the conclusion that diabetic patients are at increased risk for periodontal diseases, and that patients with poorly controlled diabetes are at risk for severe periodontitis. This results in the destruction of oral connective tissue and generalized bone loss, leading ultimately to tooth loss. Although the effect of periodontal disease on glycemic control in type 1 diabetic patients is controversial, evidence does show a direct correlation between periodontal health and glycemic control in type 2 diabetic patients. Furthermore, several studies have demonstrated the beneficial effect of periodontal treatment on metabolic control of type 2 diabetic patients.
糖尿病与牙周疾病之间的关联已得到充分证实。糖尿病是牙周疾病的一个风险因素，与健康成年人相比，糖尿病患者的牙龈炎和牙周炎患病率、范围及严重程度均有所增加。糖尿病发病机制中涉及的多种机制也与牙周疾病进展相关。如今人们认识到糖尿病与牙周疾病之间存在双向关系，近期研究表明牙周疾病可能会影响糖尿病患者的糖尿病代谢控制。在本综述中，我们通过评估过去15年发表的随机对照研究和纵向队列研究，呈现了目前关于牙周疾病与糖尿病相互作用的知识。当前数据支持以下结论：糖尿病患者患牙周疾病的风险增加，且糖尿病控制不佳的患者有患重度牙周炎的风险。这会导致口腔结缔组织破坏和广泛性骨质流失，最终导致牙齿脱落。尽管牙周疾病对1型糖尿病患者血糖控制的影响存在争议，但证据确实表明2型糖尿病患者的牙周健康与血糖控制之间存在直接关联。此外，多项研究已证明牙周治疗对2型糖尿病患者代谢控制具有有益作用。
