DİABETİK HASTALARDA PERİODONTAL TEDAVİ ile HbA1c ARASINDAKİ İLİŞKİ

Year 2009, Volume: 2009 Issue: 3, 213 - 218, 01.03.2009

Dr. Ela Tules Fırat Yrd. Doç. Dr. Ahmet Dağ

Abstract

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Keywords

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DİABETİK HASTALARDA PERİODONTAL TEDAVİ ile HbA1c ARASINDAKİ İLİŞKİ

Abstract

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-α) konsantrasyonlarına eşlik ettiği ileri sürülmektedir. Periodontitisin, diabetes mellitusun (DM) komplikasyonlarından biri olduğu çalışmalarda gösterilmiştir. Periodontal lezyonlardaki porphyromonas gingivalis gibi potent bakteriyel ürünlerin, diabetik hastalarda diabetik olmayanlara göre daha fazla TNF-α üretimini uyardıkları ileri sürülmektedir. TNF-α’nın diabetik hastalarda insülin direncini attırdığı bilinmektedir. Dolayısıyla, periodontitis ve hiperglisemi birlikteliğinde serum TNF-α seviyesi daha da yükseleceğinden diabetik kontrolün güçleşmesi söz konusu olacaktır. Başarılı bir periodontal tedavinin periodontal hastalığı olan kişilerde serum TNF-α seviyesini azattığı rapor edilmiştir. Serum TNF-α seviyesindeki azalma ile glisemik kontrol üzerindeki iyileşme arasında pozitif korelasyon tespit edilmiştir. Bu ilişki, muhtemelen azalan serum TNF-α’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

Keywords

Diabetes mellitus, HbA1c, periodontal tedavi

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