OPTIMIZATION OF ORTHODONTIC CARE FOR INDIVIDUALS WITH CONCOMITANT ENDOCRINE SYSTEM DISORDERS IN MODERN CONDITIONS

Abstract

The increasing prevalence of diabetes mellitus worldwide has led to a growing number of patients requiring orthodontic correction in the context of metabolic disorders. Diabetes mellitus alters bone remodeling, slows tooth movement, exacerbates periodontal inflammation, and elevates pro-inflammatory cytokine levels, thereby complicating orthodontic treatment. The absence of clear management protocols for these patients highlights the need for evidence-based approaches to orthodontic care. Purpose of the study. This article aims to provide practical recommendations for safe and effective orthodontic treatment in patients with diabetes mellitus, based on an analysis of how endocrine disorders affect periodontal status and bone remodeling. Research methods. The study was conducted in the form of a systematic review of scientific literature using the PubMed, Scopus, Web of Science databases and Ukrainian sources (2014–2026), with an analysis of 18 of the most relevant publications on the impact of diabetes on periodontal tissues, bone remodeling and features of orthodontic treatment, based on which practical recommendations were developed taking into account the level of compensation of the disease. Results. Current scientific data on the impact of endocrine disorders on oral health have been systematized. The role of advanced glycation end products (AGEs) in the development of periodontal diseases, changes in the biochemical composition and rheological properties of saliva, and the characteristics of alveolar bone remodeling during orthodontic loading have been analyzed. A bidirectional relationship between hyperglycemia and inflammatory periodontal diseases has been established. The mechanisms by which diabetes affects periodontal tissues are explained: through the accumulation of harmful glycation products, alterations in the oral microbiota, impaired salivary secretion, and reduced bone formation. The biomechanical features of orthodontic tooth movement have been identified, including increased periodontal ligament stiffness, an exaggerated inflammatory response, and a higher risk of root resorption. Comprehensive practical recommendations for optimizing orthodontic care have been developed, including mandatory metabolic control, modifications to biomechanical treatment parameters, and enhanced preventive measures. Conclusions. Implementing a differentiated approach that accounts for the extent of diabetes-related compensation can reduce the risk of complications and bring treatment outcomes closer to those of healthy patients, thereby ensuring the safety and effectiveness of orthodontic care for individuals with comorbid endocrine disorders