In a world grappling with an escalating diabetes epidemic, researchers have unearthed yet another connection between diabetes mellitus (DM) and the prevalence of apical periodontitis (AP) in patients who have undergone root canal treatment (RCT).
The study sheds light on the potential risks posed by diabetes on recovery after an endodontic procedure and the importance of recognizing this association for improved patient care.
The incidence of diabetes mellitus has been steadily on the rise across the globe, and its repercussions extend beyond metabolic health. The study, undertaken by a team of researchers, aimed to untangle the intricate relationship between diabetes and AP. Despite the lingering uncertainty and controversies surrounding the connection, researchers have long suspected that diabetes might act as a risk factor for the development of AP, especially in teeth that have undergone endodontic treatment.
Pooling and analyzing existing research, the team embarked on a comprehensive meta-analysis. The research material consisted of studies meticulously chosen from databases, with data extracted and analyzed using Stata SE17.0 software. The quality of the included studies was evaluated using the Newcastle-Ottawa Scale (NOS). The findings were based on a total of 1,087 patients and 2,226 teeth that met the criteria for inclusion.
The results of the meta-analysis unveiled a significant association between diabetes mellitus and the prevalence of AP after RCT. At the tooth level, diabetic patients exhibited a 1.51-fold increase in the prevalence of AP after root canal treatment (OR = 1.51, 95% CI = 1.22-1.87, p < 0.01). The risk was even more pronounced at the patient level, with diabetic patients showing over three times the likelihood of developing AP in treated teeth (OR = 3.38, 95% CI = 1.65-6.93, p < 0.01). Subgroup analyses were also conducted, examining factors such as blood glucose status, preoperative AP, and study design. While blood glucose status did not yield statistically significant results, the presence of preoperative AP and study design were strongly correlated with the increased risk (p < 0.05).
The research further underscores the potential impact of diabetes on dental health, especially in cases where preoperative AP is already present. These findings hold profound implications for both patients and healthcare professionals, urging greater attention to oral health in diabetic individuals.
In conclusion, the evidence emerging from this meta-analysis underscores the heightened risk of apical periodontitis in endodontically-treated teeth among individuals with diabetes mellitus. The research suggests that managing diabetes and closely monitoring dental health could be instrumental in mitigating the risk of AP. By shining a light on this previously unclear and controversial association, the study offers a valuable contribution to the understanding of the interplay between systemic health and oral health.
- Source : DOI: 10.1016/j.joen.2023.07.016