Abstract
ABSTRACT Objective: This study aimed to evaluate the association between glycemic control status in type 2 diabetes mellitus (T2DM) patients and apical periodontitis. Methods: Twenty-seven patients were involved in this study. The survey was based on anamnesis, intra and extra oral examination and radiographic evaluation. Diabetes mellitus information involved type of diabetes and blood glucose analysis. Patients were divided according to their metabolic control status (glycemic controlled and poorly controlled T2DM patients). Results: A higher fasting blood glucose level (p = 0.004) and a higher percentage of HbA1c (p = 0.0001) were demonstrated in poorly controlled T2DM patients when compared to glycemic controlled T2DM. However, the frequency of apical periodontitis and the elapsed time since diabetes mellitus diagnosis were higher in controlled T2DM patients, reaching 64%. Nevertheless, controlled T2DM patients presented a higher number of apical periodontitis cases (p < 0.05). Findings support that controlled patients T2DM presented higher presence of apical periodontitis than poorly controlled T2DM ones. In these patients, the time elapsed since the diagnosis was higher, which may have provided a longer period of oscillation and/or uncontrolled metabolism. Conclusions: Therefore, it might contribute to the development and maintenance of apical periodontitis in glycemic controlled patients of this study.
Highlights
Diabetes Mellitus (DM) is a heterogeneous group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin action, insulin secretion or both [1]
After evaluating several reports in the literature regarding the relationship between apical periodontitis and DM, our study aimed to evaluate the metabolic and systemic conditions of patients diagnosed with apical periodontitis and type 2 diabetes (T2DM)
In the glycemic controlled type 2 diabetes mellitus (T2DM) patient group (n. 11; 41%), it was observed that 45% were female and 82% were older than 55 years
Summary
Diabetes Mellitus (DM) is a heterogeneous group of metabolic disorders characterized by hyperglycemia resulting from defects in insulin action, insulin secretion or both [1]. The most common form of DM is type 2 diabetes (T2DM), which affects about 90-95% of diabetes cases. This disease affects about 347 million people worldwide and is considered a public health problem, reaching about 471 million people by 2035, in which two-thirds of patients will be affected in developing countries [2]. T2DM could be closely associated with several systemic complications such as nephropathy, retinopathy, microangiopathy and healing problems. Diabetes influences oral health [1]. Chronic hyperglycemia can cause decreased salivary flow rate and/ or xerostomia, burning mouth syndrome, glossodynia, taste disorders, oral mucosa ulcers, enamel hypocalcification, impaired healing, ketone breath, lichen planus and periodontal disease [4]. Several studies have demonstrated a direct relationship between periodontal disease and DM [4,7,8] and a significant increase in the prevalence of apical periodontitis (AP) in diabetic patients, compared to non-diabetic patients [9,10,11]
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