Assessment of pathogenetic mechanisms and the effect of periodontal therapy on the compensation of diabetes mellitus

The article provides a review of the modern literature devoted to the study of the relationship between the pathogenetic mechanisms of diabetes mellitus and chronic generalized periodontitis, as well as the effect of periodontal therapy on glycemic control in patients with both diseases. Special attention is paid to key aspects of the pathogenesis of inflammatory periodontal diseases and their relationship with metabolic disorders in diabetes mellitus. It has been established that chronic periodontal inflammation contributes to increased insulin resistance and impaired blood glucose control, while hyperglycemia, in turn, exacerbates the course of periodontitis, creating a vicious circle. The paper considers the main mechanisms of this interaction, including the role of microangiopathies, oxidative stress, and accumulation of glycation end products in tissues, as well as various methods of periodontal therapy, which are based on scaling and root planing with and without the use of antimicrobial medications. Their effectiveness in improving glycemic control, in particular, reducing the level of glycated hemoglobin in patients with diabetes mellitus, has been evaluated. It has been shown that complex periodontal treatment contributes not only to improving the condition of periodontal tissues, but also has a positive effect on carbohydrate metabolism. The results of the study emphasize the need for an interdisciplinary approach to the management of patients with diabetes mellitus and chronic generalized periodontitis, including joint efforts by endocrinologists and dentists. Further research in this area may contribute to the development of more effective strategies for the treatment and prevention of both diseases.

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