THE EFFECT OF BISPHOSPHONATES AND LOW-DOSE DOXCYCLINE THERAPY IN DIABETICS WITH PERIODONTITIS: A REVIEW

ABSTRACT Diabetes mellitus and periodontal disease are chronic diseases affecting a large number of populations worldwide. The major component of soft and hard tissue destruction associated with periodontal disease is the result of activation of the host immuno-inflammatory response to the oral pathogens. Diabetes mellitus alters bacteria–host interactions by prolonging the inflammatory response and dysregu- lating cytokine production, and is among the primary risk factors for periodontal disease. Alveolar bone loss is one of the main outcomes of periodontitis. One of the important long-term complications associated with diabetes mellitus is changed bone metabolism. Recently, the therapeutic strategies for the treatment of periodontal disease have been directed towards to host modulation therapy. In this review, we will evaluate the effects of bisphosphonates and low dose doxcycline drugs as host modulation agents in the treatment of periodontal disease and in diabetics with periodontal disease. Keywords: Periodontitis, diabetes mellitus, bisphosphonate, doxycycline, alveolar bone loss DÜŞÜK-DOZ DOKSİSİKLİN VE BİFOSFONAT TEDAVİSİNİN PERİODONTİTİSLİ DİYABET HASTALARINDAKİ ETKİSİ: DERLEMEÖZ Diabetes mellitus ve periodontal hastalıklar, dünya popülasyonunun geniş bir kitlesini etkileyen kronik hastalıklardır. Periodontal hastalıklar ile ilişkili sert ve yumuşak doku yıkımı, oral patojenlere karşı konak im- muno-inflamatuvar cevabın aktivasyonu sonucu mey- dana gelmektedir. Diabetes mellitus, sitokin üretiminin düzenlenmesini bozarak ve inflamatuvar cevabı uzatarak bakteri-konak etkileşimini değiştirmektedir ve periodontal hastalıklar için başlıca risk faktörleri ara- sındadır. Periodontitisin temel klinik özelliklerinden biri alveoler kemik kaybıdır. Diabetes mellitus ile ilişkili önemli uzun-süreli komplikasyonlarından biri, kemik metabolizmasındaki değişimdir. Son zamanlarda pe- riodontal hastalığın tedavisi için uygulanan terapötik stratejiler konak modülasyon tedavisine doğru yönel- miştir. Bu derlemede, periodontal hastalıklı diyabet hastalarında ve periodontal hastalığın tedavisinde konak modülasyon ajanları olarak kullanılan bifosfo- natlar ve düşük-doz doksisiklin ilaçlarının etkilerini değerlendireceğiz. Anahtar Kelimeler: Periodontit, diabetes mellitus, bifosfonat, doksisiklin, alveolar kemik kaybı

Anahtar Kelimeler:

Periodontitis, diabetes mellitus, bisphosphonate, doxycycline

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