PDF(Pubmed)
Abstract：
This longevity of life expectancy has indirectly led to an increase in the number of chronic diseases such as periodontitis, apical periodontitis (AP), and diabetes mellitus (DM) in the aging society, thus affecting people\'s quality of life. There is an interaction between periodontitis/AP and DM with a two-way relationship. Although type 1 and 2 diabetes (T1DM, T2DM) have different etiologies, glycemic control may affect the infection, inflammation and tissue healing of periodontitis and AP. Non-surgical periodontal treatment may influence the glycemic control as shown by decrease of HbA1c level in T2DM patient. However, the effect of periodontal treatment on glycemic control in T1DM and root canal treatment/apical surgery on T1DM and T2DM patients awaits investigation. DM may affect the periodontal and periapical tissues possibly via altered oral microbiota, impairment of neutrophils\' activity and host immune responses and cytokine production, induction of oxidative stress etc. While periodontitis associated systemic inflammation and hyperlipidemia is suggested to contribute to the control of T2DM, more intricate studies are necessary to clarify the detailed mechanisms. The interactions between DM (T1DM and T2DM) and periodontitis and AP are therefore reviewed to provide a basis for the treatment of subsequent patients with pulpal/periodontal disease and diabetes. A two-pronged approach of medical and dental treatment is needed for the management of these patients, with emphasis on blood glucose control and improving oral hygiene and periodontal maintenance care, to ensure the best treatment outcome.
摘要：
这种长寿的预期寿命间接导致慢性疾病如牙周炎的数量增加，根尖周炎(AP),和糖尿病（DM）在老龄化社会，从而影响人们的生活质量。牙周炎/AP与DM之间存在双向相互作用关系。虽然1型和2型糖尿病（T1DM，T2DM)有不同的病因，血糖控制可能会影响感染，牙周炎和AP的炎症和组织愈合。非手术牙周治疗可能影响T2DM患者的血糖控制，如HbA1c水平降低所示。然而,牙周治疗对T1DM患者血糖控制的影响以及根管治疗/根尖手术对T1DM和T2DM患者的影响有待研究。DM可能通过改变口腔微生物群影响牙周组织和根尖周组织，中性粒细胞活性和宿主免疫反应和细胞因子产生的损害，诱导氧化应激等。虽然牙周炎相关的全身性炎症和高脂血症被认为有助于T2DM的控制，需要更复杂的研究来阐明详细的机制。因此，综述了DM（T1DM和T2DM）与牙周炎和AP之间的相互作用，为后续牙髓/牙周病和糖尿病患者的治疗提供依据。这些患者的管理需要医疗和牙科治疗的双管齐下，重点是血糖控制和改善口腔卫生和牙周维护护理，以确保最佳的治疗效果。
