RESUMEN
Immune modulating factors are necessary for pathogen clearance, but also contribute to host tissues damage, as those seen in periodontal diseases. Many of these responses can be exacerbated by host conditions including type 2 diabetes [T2D], where toll-like receptor 4 [TLR4] and the receptor for advanced glycated end products [RAGE] play a significant role. Here we investigate causality associated with the increase in inflammatory markers observed in periodontally diseased patients with T2D using multi-variant correlation analysis. Inflammation associated with periodontal diseases, characterized by elevated pro-inflammatory cytokines, innate immune receptor expression, and cellular infiltrate was exacerbated in patients with T2D. In addition, a feed forward loop regulated by poor glycemic control was associated with a loss of mucosal barrier integrity and accumulation of innate immune receptor ligands resulting in an exacerbation of ongoing inflammation, where RAGE and TLR4 cooperated to induce responses in oral epithelial cells, which were exacerbated by hyperglycemia.
Asunto(s)
Periodontitis Crónica/inmunología , Diabetes Mellitus Tipo 2/inmunología , Hiperglucemia/inmunología , Inmunidad Innata/inmunología , Inmunidad Mucosa/inmunología , Inflamación/inmunología , Boca/inmunología , Receptor Cross-Talk/inmunología , Adolescente , Adulto , Anciano , Estudios de Casos y Controles , Periodontitis Crónica/complicaciones , Periodontitis Crónica/metabolismo , Periodontitis Crónica/patología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/patología , Células Epiteliales/inmunología , Células Epiteliales/metabolismo , Células Epiteliales/patología , Femenino , Humanos , Hiperglucemia/complicaciones , Hiperglucemia/metabolismo , Hiperglucemia/patología , Inflamación/complicaciones , Inflamación/metabolismo , Inflamación/patología , Ligandos , Masculino , Persona de Mediana Edad , Boca/metabolismo , Boca/patología , Cultivo Primario de Células , Receptor para Productos Finales de Glicación Avanzada , Receptores Inmunológicos/inmunología , Receptores Inmunológicos/metabolismo , Transducción de Señal/inmunología , Receptor Toll-Like 4/inmunología , Receptor Toll-Like 4/metabolismoRESUMEN
This article presents a rationale for utilizing complete immediate denture therapy, highlighting various advantages, disadvantages, and contraindications for this treatment. Jerbi's technique for presurgical cast carving is reviewed and a unique case report is detailed, involving a 22-year-old patient whose hopelessly debilitated dentition was treated by full-mouth extraction and placement of a maxillary and mandibular complete immediate denture. In addition, a brief review of changing dietary patterns and social habits is presented in relation to the recent escalation of rampant dental caries in youth and young adult patient populations.