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DİABETİK HASTALARDA PERİODONTAL TEDAVİ ile HbAlc ARASINDAKİ İLİŞKİ

THE ASSOCIATION OF PERIODONTAL THERAPY AND HbA1c IN DIABETIC PATIENTS

Journal Name:

  • Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi

Publication Year:

  • 2009

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
In the last half-century, studies emphasized that periodontal infections are only localized to periodontium but today this concept is completely changed. Recent evidence, the literatures suggest that severe periodontitis acts like a systemic subclinic disease and contribute to inflammatuar host response that associated with increased serum levels of C-reactive protein (CRP), interleukine-6 (IL-6), interleukine-1 (IL-1) and tumour necrozis factor (TNF-a.). Data indicate that periodontitis is one of the complications of diabetes mellitus (DM). Potent bacterial products in the periodontal lesion, such as P. gingivalis endotoxin, enhance TNF-a production significantly more in peripheral blood monocytes from DM patients than in monocytes from non-DM patients. It is known that TNF-a is exacerbates the insulin resistance in DM. Thus in the assocation of periodontitis and hyperglisemia the glisemic control is complicated. Succesful periodontal therapy is reported to decrease circulating TNF-a in patients with periodontal disease. Additionally, the reduction in circulating TNF-a is correlated with an imrovement in glisemic control of diabetes, possibly mediated through an improvement in insulin resistance. In the light of this evidence we want to discuss the results of the studies about the effect of the periodontal therapy on glisemic control with the current literatures.
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Abstract (Original Language): 
Son yarım yüzyılda periodontal infeksiyonların sadece periodonsiyumda lokalize olduğu ileri sürülmüşse de günümüzde bu görüş tamamen değişmiştir. Yapılan araştırmalar sonucunda periodontitisin subklinik kronik bir hastalık gibi sistemik inflamatuar cevaba katıldığı ve yüksek serum C-reaktif protein (CRP), interlökin-6 (IL-6) , interlökin-1 (IL-1) ve tümör nekroze edici faktör (TNF-a) konsantrasyonlarına eşlik ettiği ileri sürülmektedir. Periodontitisin, diabetes mellitusun (DM) komplikasyonlarından biri olduğu çalışmalarda gösterilmiştir. Periodontal lezyonlardaki porphyro-monas gingivalis gibi potent bakteriyel ürünlerin, diabetik hastalarda diabetik olmayanlara göre daha fazla TNF-a üretimini uyardıkları ileri sürülmektedir. TNF-a'nın diabetik hastalarda insülin direncini attırdığı bilinmektedir. Dolayısıyla, periodontitis ve hiperglisemi birlikteliğinde serum TNF-a seviyesi daha da yükseleceğinden diabetik kontrolün güçleşmesi söz konusu olacaktır. Başarılı bir periodontal tedavinin periodontal hastalığı olan kişilerde serum TNF-a seviyesini azattığı rapor edilmiştir. Serum TNF-a seviyesindeki azalma ile glisemik kontrol üzerindeki iyileşme arasında pozitif korelasyon tespit edilmiştir. Bu ilişki, muhtemelen azalan serum TNF-a'nın insulin direncinde de azalmaya neden olmasına bağlanmaktadır. Amacımız 'diabetik hastalarda periodontal tedavinin glisemik kontrol üzerine etkisi'nin araştırıldığı çalışmaların sonuçlarını mevcut literatür ışığında tartışmaktır .
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PDF icon arastirmax-diabetik-hastalarda-periodontal-tedavi-ile-hbalc-arasindaki-iliski.pdf
  • 3
213-218
  • Turkish

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