Epidemiologic evidence indicates that periodontitis is more frequent in patients with uncontrolled diabetes mellitus than in healthy controls, suggesting that it could be considered the “sixth complication” of diabetes. Actually, diabetes mellitus and periodontitis are two extraordinarily prevalent chronic diseases that share a number of comorbidities all converging toward an increased risk of cardiovascular disease. Periodontal treatment has recently been shown to have the potential to improve the metabolic control of diabetes, although long-term studies are lacking. Uncontrolled diabetes also seems to affect the response to periodontal treatment, as well as the risk to develop peri-implant diseases. Mechanisms of associations between diabetes mellitus and periodontal disease include the release of advanced glycation end products as a result of hyperglycemia and a range of shared predisposing factors of genetic, microbial, and lifestyle nature. This review discusses the evidence for the risk of periodontal and peri-implant disease in diabetic patients and the potential role of the dental professional in the diabetes-periodontal interface.

中文翻译：

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糖尿病患者的牙周炎和植入并发症

流行病学证据表明，与健康对照组相比，未控制的糖尿病患者牙周炎更常见，这表明它可以被认为是糖尿病的“第六种并发症”。实际上，糖尿病和牙周炎是两种非常普遍的慢性疾病，它们有许多共同的并发症，所有这些都会增加心血管疾病的风险。牙周治疗最近被证明具有改善糖尿病代谢控制的潜力，尽管缺乏长期研究。不受控制的糖尿病似乎也会影响对牙周治疗的反应，以及发生种植体周围疾病的风险。糖尿病和牙周病之间的关联机制包括高血糖导致晚期糖基化终末产物的释放，以及一系列遗传、微生物和生活方式的共同诱发因素。本综述讨论了糖尿病患者牙周和种植体周围疾病风险的证据，以及牙科专业人员在糖尿病-牙周界面中的潜在作用。