Periapical status and prevalence of apical periodontitis in patients with type 2 Diabetes mellitus
DOI:
https://doi.org/10.33448/rsd-v10i12.20135Keywords:
Apical periodontitis; Diabetes mellitus; Endodontics.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.
References
Abbott, P. V. (2004). Classification, diagnosis and clinical manifestations of apical periodontitis. Endodontic topics, 8(1), 36-54.
Aguiar, F. L. X. D. S., Ramos, L. F. P., & Bichara, C. N. C. (2018). Detection of pain with neuropathic characteristics in patients with diabetes mellitus assisted in primary care units. BrJP, 1, 15-20.
Ahmed N. (2005). Advanced glycation endproducts--role in pathology of diabetic complications. Diabetes research and clinical practice, 67(1), 3–21. https://doi.org/10.1016/j.diabres.2004.09.004
American Association of Clinical Endocrinologists Board of, D., & American College of Endocrinologists Board of, T. (2010). American Association of Clinical Endocrinologists/American College of Endocrinology statement on the use of hemoglobin A1c for the diagnosis of diabetes. Endocr Pract, 16(2), 155-156. doi:10.4158/EP.16.2.155
American Diabetes, A. (2013). Diagnosis and classification of diabetes mellitus. Diabetes Care, 36 Suppl 1, S67-74.
Arya, S., Duhan, J., Tewari, S., Sangwan, P., Ghalaut, V., & Aggarwal, S. (2017). Healing of Apical Periodontitis after Nonsurgical Treatment in Patients with Type 2 Diabetes. J Endod, 43(10), 1623-1627. doi:10.1016/j.joen.2017.05.013
Bender, I. B., & Bender, A. B. (2003). Diabetes mellitus and the dental pulp. J Endod, 29(6), 383-389. doi:10.1097/00004770-200306000-00001
Bender, I. B., Seltzer, S., & Freedland, J. (1963). The Relationship of Systemic Diseases to Endodontic Failures and Treatment Procedures. Oral Surg Oral Med Oral Pathol, 16, 1102-1115. doi:10.1016/0030-4220(63)90226-3
Britto, L. R., Katz, J., Guelmann, M., & Heft, M. (2003). Periradicular radiographic assessment in diabetic and control individuals. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 96(4), 449-452. doi:10.1016/s1079-2104(03)00034-9
Cabanillas-Balsera, D., Martin-Gonzalez, J., Montero-Miralles, P., Sanchez-Dominguez, B., Jimenez-Sanchez, M. C., & Segura-Egea, J. J. (2019). Association between diabetes and nonretention of root filled teeth: a systematic review and meta-analysis. Int Endod J, 52(3), 297-306. doi:10.1111/iej.13011
Correia-Sousa, J., Madureira, A. R., Carvalho, M. F., Teles, A. M., & Pina-Vaz, I. (2015). Apical periodontitis and related risk factors: Cross-sectional study. Revista Portuguesa de Estomatologia, Medicina Dentária e Cirurgia Maxilofacial, 56(4), 226-232. doi:https://doi.org/10.1016/j.rpemd.2015.08.004
de Morais Santos, M. P., da Silva, T. C. L., Barbosa, L. M., de Arruda, C. V. B., da Silva Batista, R. C., Negreiros, J. H. C. N., ... & Laureano Filho, J. R. (2020). Associação entre periodontite apical crônica e diabetes mellitus tipo II. Research, Society and Development, 9(9), e936998002-e936998002.
DeFronzo, R. A., Ferrannini, E., Groop, L., Henry, R. R., Herman, W. H., Holst, J. J., . . . Weiss, R. (2015). Type 2 diabetes mellitus. Nat Rev Dis Primers, 1, 15019. doi:10.1038/nrdp.2015.19
Doyle, S. L., Hodges, J. S., Pesun, I. J., Baisden, M. K., & Bowles, W. R. (2007). Factors affecting outcomes for single-tooth implants and endodontic restorations. J Endod, 33(4), 399-402. doi:10.1016/j.joen.2006.12.025
Falk, H., Hugoson, A., & Thorstensson, H. (1989). Number of teeth, prevalence of caries and periapical lesions in insulin-dependent diabetics. Scand J Dent Res, 97(3), 198-206. doi:10.1111/j.1600-0722.1989.tb01603.x
Gillen, B. M., Looney, S. W., Gu, L. S., Loushine, B. A., Weller, R. N., Loushine, R. J., . . . Tay, F. R. (2011). Impact of the quality of coronal restoration versus the quality of root canal fillings on success of root canal treatment: a systematic review and meta-analysis. J Endod, 37(7), 895-902. doi:10.1016/j.joen.2011.04.002
Graunaite, I., Lodiene, G., & Maciulskiene, V. (2012). Pathogenesis of apical periodontitis: a literature review. J Oral Maxillofac Res, 2(4), e1. doi:10.5037/jomr.2011.2401
Helal, O., Gostemeyer, G., Krois, J., Fawzy El Sayed, K., Graetz, C., & Schwendicke, F. (2019). Predictors for tooth loss in periodontitis patients: Systematic review and meta-analysis. J Clin Periodontol, 46(7), 699-712. doi:10.1111/jcpe.13118
Huumonen, S., & Ørstavik, D. J. E. T. (2002). Radiological aspects of apical periodontitis. Endodontic Topics, 1(1), 3-25.
Ilea, A., Babtan, A. M., Bosca, B. A., Crisan, M., Petrescu, N. B., Collino, M., . . . Campian, R. S. (2018). Advanced glycation end products (AGEs) in oral pathology. Arch Oral Biol, 93, 22-30. doi:10.1016/j.archoralbio.2018.05.013
International Diabetes Federation. (2019). IDF Diabetes Atlas (9th ed.). Brussels, Belgium.
Jakovljevic, A., & Duncan, H. F. (2020). Diabetes Mellitus May Negatively Influence the Outcome of Conventional Nonsurgical Root Canal Treatment. J Evid Based Dent Pract, 20(3), 101467. doi:10.1016/j.jebdp.2020.101467
Lamster, I. B., Lalla, E., Borgnakke, W. S., & Taylor, G. W. (2008). The relationship between oral health and diabetes mellitus. J Am Dent Assoc, 139 Suppl, 19S-24S. doi:10.14219/jada.archive.2008.0363
Lopez-Lopez, J., Jane-Salas, E., Estrugo-Devesa, A., Velasco-Ortega, E., Martin-Gonzalez, J., & Segura-Egea, J. J. (2011). Periapical and endodontic status of type 2 diabetic patients in Catalonia, Spain: a cross-sectional study. J Endod, 37(5), 598-601. doi:10.1016/j.joen.2011.01.002
Marotta, P. S., Fontes, T. V., Armada, L., Lima, K. C., Rocas, I. N., & Siqueira, J. F., Jr. (2012). Type 2 diabetes mellitus and the prevalence of apical periodontitis and endodontic treatment in an adult Brazilian population. J Endod, 38(3), 297-300. doi:10.1016/j.joen.2011.11.001
Orstavik, D., Kerekes, K., & Eriksen, H. M. (1986). The periapical index: a scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol, 2(1), 20-34. doi:10.1111/j.1600-9657.1986.tb00119.x
Preshaw, P. M., Alba, A. L., Herrera, D., Jepsen, S., Konstantinidis, A., Makrilakis, K., & Taylor, R. (2012). Periodontitis and diabetes: a two-way relationship. Diabetologia, 55(1), 21-31. doi:10.1007/s00125-011-2342-y
Ray, H. A., & Trope, M. (1995). Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration. Int Endod J, 28(1), 12-18.
Rudranaik, S., Nayak, M., & Babshet, M. (2016). Periapical healing outcome following single visit endodontic treatment in patients with type 2 diabetes mellitus. J Clin Exp Dent, 8(5), e498-e504. doi:10.4317/jced.52859
Segura-Egea, J. J., Jimenez-Pinzon, A., Rios-Santos, J. V., Velasco-Ortega, E., Cisneros-Cabello, R., & Poyato-Ferrera, M. (2005). High prevalence of apical periodontitis amongst type 2 diabetic patients. Int Endod J, 38(8), 564-569. doi:10.1111/j.1365-2591.2005.00996.x
Smadi, L. (2017). Apical Periodontitis and Endodontic Treatment in Patients with Type II Diabetes Mellitus: Comparative Cross-sectional Survey. J Contemp Dent Pract, 18(5), 358-362. doi:10.5005/jp-journals-10024-2046
Ugur Aydin, Z., Ocak, M. G., Bayrak, S., Goller Bulut, D., & Orhan, K. (2021). The effect of type 2 diabetes mellitus on changes in the fractal dimension of periapical lesion in teeth after root canal treatment: a fractal analysis study. Int Endod J, 54(2), 181-189. doi:10.1111/iej.13409
Zimmet, P., Alberti, K. G., Magliano, D. J., & Bennett, P. H. (2016). Diabetes mellitus statistics on prevalence and mortality: facts and fallacies. Nat Rev Endocrinol, 12(10), 616-622. doi:10.1038/nrendo.2016.105
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Copyright (c) 2021 Juliana Érnica Bernardo; Caroline Loureiro; Ana Paula Fernandes Ribeiro; Júlia Guerra de Andrade; Gladiston William Lobo Rodrigues; Rogério de Castilho Jacinto
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