Healing of Apical Periodontitis after Nonsurgical Treatment in Patients with Type 2 Diabetes

J Endod. 2017 Oct;43(10):1623-1627. doi: 10.1016/j.joen.2017.05.013. Epub 2017 Aug 10.

Abstract

Introduction: The purpose of this prospective study was to compare the success of primary root canal treatment between type 2 diabetic and nondiabetic patients and to investigate the effect of periapical healing on glycated hemoglobin (HbA1c) in type 2 diabetic patients with apical periodontitis.

Methods: Sixty mandibular molars with necrotic pulps and apical radiolucency (size ≥ 2 mm × 2 mm) were included in the study. Based on the HbA1c levels, patients were divided into 2 groups: type 2 diabetic (HbA1c ≥6.5%) and nondiabetic (HbA1c <6.5%). Forty-six teeth were evaluated at the 12-month follow-up time period. The primary outcome measure was the change in apical bone density as determined by the periapical index.

Results: Both the diabetic and nondiabetic group depicted a significant reduction in the periapical score after endodontic treatment at the 12-month follow-up (P < .05). Significantly less periapical healing was observed in the diabetic group (43%) compared with the nondiabetic group (80%) at the 12-month follow-up (P < .05). HbA1c levels in the diabetic group increased at each follow-up after endodontic treatment.

Conclusions: Diabetes mellitus may have a negative impact on the outcome of endodontic treatment in terms of periapical healing. Nonsurgical endodontic treatment did not improve HbA1c levels in patients with type 2 diabetes.

Keywords: Apical periodontitis; diabetes mellitus; glycated hemoglobin.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Dental Pulp Necrosis / complications
  • Dental Pulp Necrosis / physiopathology
  • Dental Pulp Necrosis / therapy
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / physiopathology*
  • Female
  • Glycated Hemoglobin / analysis
  • Humans
  • Male
  • Mandible
  • Middle Aged
  • Molar
  • Periapical Periodontitis / complications
  • Periapical Periodontitis / physiopathology*
  • Periapical Periodontitis / therapy
  • Prospective Studies
  • Root Canal Therapy*

Substances

  • Glycated Hemoglobin A