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BIBTEX RIS

Diabetes mellitus and inflammatory pulpal and periapical disease: a review

2013; Wiley; Volume: 46; Issue: 8 Linguagem: Inglês

10.1111/iej.12072

1365-2591

Stella Maris de Freitas Lima, Daniela Corrêa Grisi, Evelyn Mikaela Kogawa, Octávio Luiz Franco, V. C. Peixoto, J. F. Gonçalves‐Júnior, Marcos Arruda, Taia Maria Berto Rezende,

Dental Radiography and Imaging

Diabetes mellitus (DM) is one of the most common metabolic disorders. DM is characterized by hyperglycaemia, resulting in wound healing difficulties and systemic and oral manifestations, which have a direct effect on dental pulp integrity. Experimental and clinical studies have demonstrated a higher prevalence of periapical lesions in patients with uncontrolled diabetes. The influence of DM on periapical bone resorption and its impact on dental intervention of such patients are reviewed, and its aetiology and pathogenesis are analysed at molecular level. Pulps from patients with diabetes have the tendency to present limited dental collateral circulation, impaired immune response, increased risk of acquiring pulp infection (especially anaerobic ones) or necrosis, besides toothache and occasional tendency towards pulp necrosis caused by ischaemia. In regard to molecular pathology, hyperglycaemia is a stimulus for bone resorption, inhibiting osteoblastic differentiation and reducing bone recovery. The relationship between poorly controlled diabetes and bone metabolism is not clearly understood. Molecular knowledge about pulp alterations in patients with diabetes could offer new therapeutic directions. Knowledge about how diabetes affects systemic and oral health has an enduring importance, because it may imply not only systemic complications but also a higher risk of oral diseases with a significant effect on pulp and periapical tissue.