Diabetes mellitus related bone metabolism and periodontal disease

Abstract

Diabetes mellitus and periodontal disease are chronic diseases affecting a large number of populations worldwide. Changed bone metabolism is one of the important long-term complications associated with diabetes mellitus. Alveolar bone loss is one of the main outcomes of periodontitis, and diabetes is among the primary risk factors for periodontal disease. In this review, we summarise the adverse effects of diabetes on the periodontium in periodontitis subjects, focusing on alveolar bone loss. Bone remodelling begins with osteoclasts resorbing bone, followed by new bone formation by osteoblasts in the resorption lacunae. Therefore, we discuss the potential mechanism of diabetes-enhanced bone loss in relation to osteoblasts and osteoclasts. The negative impact of diabetes on bone quantity and quality can lead to an increased risk of fractures and severe gum disease. Dana Graves from the University of Pennsylvania in Philadelphia and colleagues reviewed the mechanisms behind bone loss in people with diabetes and the link to severe gum disease (periodontitis). Diabetes reduces bone-forming cells and bone turnover, while enhancing the number of cells that break down and absorb bone tissue back into the body. These changes in bone metabolism increase the risk of fracture and severe periodontitis. Diabetes is one of the main risk factors for periodontitis, people with diabetes being three to four times more likely to have the disease. This higher risk is most likely due to an exaggerated immune and inflammatory response to the bacteria responsible for gum disease.