title: [Pathogenic aspects of the periodontal disease associated to diabetes mellitus].
abstract: OBJECTIVE
  Systematic review of present knowledge about the association between diabetes mellitus (DM) and periodontal disease (PD) with emphasis on their physiopathogenesis.
  
  
  METHODS
  Bibliographic search through MEDLINE and LILACS databases, in the last five years, using the following descriptors: "diabetes mellitus", "periodontal disease", and "periodontitis".
  
  
  METHODS
  Periodontal tissues are the oral structures most affected by DM. DM predisposes to the development of PD, which leads to loss of glycemic control, which emphasizes the importance of the two-way relationship between these two diseases. Several mechanisms are involved in the physiopathology of PD associated with DM: production of advanced glycosilation products, deficient immune response, inheritance of certain genetic polymorphisms, alterations in blood vessels, conjunctive tissue and salivary composition. In the initial phase, gingivitis and periodontitis predominate. If not detected early, these problems can develop into advanced periodontal disease. Puberty, with its hormonal alterations, longer duration of the disease, poor metabolic control and inadequate oral hygiene are factors that contribute to PD progression and aggressiveness.
  
  
  CONCLUSIONS
  Better knowledge about the mechanisms involved in the physiopathogenesis of PD associated with DM would help to institute early preventive and therapeutic measures. It is important for doctors and dentists to instruct their patients with DM about the need for good glycemic control and adequate oral hygiene, to minimize the risks for the appearance of periodontal disease and consequent loss of glycemic control.
authors.affiliation: Faculdade de Medicina, Universidade Federal da Bahia, Salvador, Bahia. cresio.alves@uol.com.br
authors.forename: Crésio
authors.initials: C
authors.lastname: Alves
authors.forename: Juliana
authors.initials: J
authors.lastname: Andion
authors.forename: Márcia
authors.initials: M
authors.lastname: Brandão
authors.forename: Rafaela
authors.initials: R
authors.lastname: Menezes
mesh_terms: D016207:Cytokines / Q000378:metabolism; D048909:Diabetes Complications / Q000276:immunology / Q000378:metabolism; D018450:Disease Progression; D005891:Gingivitis / Q000150:complications; D006801:Humans; D018836:Inflammation Mediators / Q000378:metabolism; D009910:Oral Hygiene; D010510:Periodontal Diseases / Q000209:etiology* / Q000276:immunology / Q000378:metabolism / Q000517:prevention & control; D010518:Periodontitis / Q000150:complications; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic / Q000378:metabolism; D012463:Saliva
chemical_list: D016207:Cytokines; D018836:Inflammation Mediators; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic
vernacular_title: Mecanismos patogênicos da doença periodontal associada ao diabetes melito.