Periapical status and prevalence of apical periodontitis in patients with type 2 Diabetes mellitus

Juliana Érnica Bernardo,Ana Paula Fernandes Ribeiro,Rogério De Castilho Jacinto,Júlia Guerra De Andrade,Caroline Loureiro,Gladiston William Lobo Rodrigues

doi:10.33448/rsd-v10i12.20135

Juliana Érnica Bernardo, Ana Paula Fernandes Ribeiro + Show 4 more

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https://doi.org/10.33448/rsd-v10i12.20135

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Abstract

Diabetes mellitus (DM) is a chronic systemic disease that affects the immunoinflammatory response, leading the patient more susceptible to the development of oral diseases, such as apical periodontitis (AP). Thus, this study aimed to clinically and radiographically analyze the periapical status and prevalence of AP in diabetic patients compared to healthy patients. A total of 100 patients were selected and divided into two groups (n = 50): diabetic group - patients with type 2 DM, and control group - systemically healthy patients. Periapical status was analyzed by the periapical index. The quality of the root canal filling and restoration was also evaluated. Difference between the prevalence of AP among the groups were performed by using the Chi-square test or Fisher's exact test (p < 0.05). The total number of teeth was lower in diabetic group (p = 0.049). Teeth without previous endodontic treatment with AP were higher in diabetic group (p = 0.006). However, the number of endodontically treated teeth with AP was greater in the control group (p = 0.027). AP in teeth with previous endodontic treatment was associated with unsatisfactory root canal filling and restoration quality (p < 0.01). The presence of pain showed significantly higher values in the diabetic group (p = 0.003). In conclusion, this study showed an association between the presence of AP and DM in cases of teeth without endodontic treatment. Besides, the presence of pain was significantly higher in diabetic patients. However, healthy patients showed more cases of AP in endodontically treated teeth.

Highlights

Diabetes Mellitus (DM) is a chronic systemic disease with an increasing global prevalence and incidence
It was not possible to dissociate the disease from arterial hypertension, 32 patients had DM associated with controlled arterial hypertension (64%), while 18 patients had only DM (36%)
The present study investigated the relationship between DM and the prevalence of apical periodontitis (AP) compared to healthy patients

Summary

Introduction

Diabetes Mellitus (DM) is a chronic systemic disease with an increasing global prevalence and incidence. Type 2 diabetes is the most common type of disease, accounting for 90-95% of the cases, which represents an important public health problem (American Diabetes, 2013; DeFronzo et al, 2015). Diabetic patients are more susceptible to the development of oral diseases. The most common oral manifestations include xerostomia, candidiasis, neurosensory disorders, lichen planus, gingivitis, periodontal and periapical diseases (Lamster, Lalla, Borgnakke, & Taylor, 2008). Several studies have shown the relationship between diabetes and endodontic infections based on the increase of the prevalence of apical periodontitis (AP) (Lopez-Lopez et al, 2011; Segura-Egea et al, 2005)

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