The present cross? sectional study aimed to determine the effect of first? line anti? hypertensive drugs
(Enalapril) and Anti- diabetic drugs (Metformin) on oral tissues, in hypertensive patients with/without diabetes mellitus
(DM) type 2. Materials and Methods: In order to measure effects of Anti-hypertensive drugs on oral tissues, Salivary gland
function was measured as xerostomia and unstimulated whole saliva flow rate (UWSFR) in 227 subjects (167 hypertensive
and 60 healthy). Salivary TAC was evaluated by spectrophotometric assay. To measure effects of Anti-diabetic drugs on
oral tissues Sclerostin expression & immunolocalization of dentin matrix protein 1 in osteocytes was evaluated. Results:
Enalapril is not xerogenic, In the presence of DM type 2, all drugs, except metoprolol, had pronounced xerogenic effect.
Binary logistic regression analysis found enalapril to be significantly associated with decreased risk of xerogenic effect
development, while DM type 2 with increased risk. In the presence of enalapril in hypertensive patients with/without DM
type 2 salivary TAC was similar to that in healthy subjects. Metformin administration resulted in normalization of osteoclast
numbers, cathepsin K immunostaining, and of tooth movement as well as partly recovery of alkaline phosphatase expression
in diabetic patients. Metformin also reduced sclerostin expression and improved the immunolocalization of dentin matrix
protein 1 in osteocytes of type 2 diabetes patients. These results suggest that metformin administration reversed the adverse
effects of diabetes on orthodontic tooth movement. Conclusion: Enalapril is not xerogenic but is antioxidant, which
moderately reduces the risk of xerogenic effect development even in the presence of DM type 2. However, metoprolol and
drug combinations exhibit xerogenic effect. In DM type 2, xerogenic effect of all drugs was pronounced except of
metoprolol. Metformin normalizes osteoclast numbers, cathepsin K immunostaining, and reduces tooth movement.
Metformin also reduces sclerostin expression and improves the immunolocalization of dentin matrix protein 1 in osteocytes
of type 2 diabetes patients.
