The association of apical periodontitis and type 2 diabetes mellitus

Yip, Nathan; Liu, Chuwen; Wu, Di; Fouad, Ashraf F.

doi:10.1016/j.adaj.2021.01.005

Cited by 23 publications

(21 citation statements)

References 13 publications

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“…There was no significant difference observed in the healing of AP between patients with good or poor glycaemic control (Arya et al, 2017). Contrary, it has been reported that poor glycaemic control was significantly associated with a greater prevalence of AP (Sánchez‐Domínguez et al, 2015; Yip et al, 2021). In addition, the healing of root canal treatment in poor glycaemic control patients was affected negatively (Rudranaik et al, 2016) and resulted in a slower reduction in AP (Cheraskin & Ringsdorf Jr, 1968).…”

Section: Discussionmentioning

confidence: 92%

“…Several studies have shown an increase in the prevalence of AP in T2DM patients than in non‐diabetic ones (López‐López et al, 2011; Marotta et al, 2012; Sánchez‐Domínguez et al, 2015; Segura‐Egea et al, 2005; Tibúrcio‐Machado et al, 2017; Yip et al, 2021). The present study sought to evaluate the bacterial quantity and the expression of IL‐17 in necrotic teeth with AP in patients with T2DM.…”

Section: Discussionmentioning

confidence: 99%

“…Statin medication intake appeared to have a lower bacterial count, approaching the significance level. It was reported that the use of statins in T2DM patients was associated with a significantly lower prevalence of AP (Yip et al, 2021). The metabolic control of diabetes was measured through HbA1c analysis.…”

Section: Discussionmentioning

confidence: 99%

“…Clinical studies have shown several endodontic variables influenced or associated with diabetes. The prevalence of AP is higher in T2DM patients, especially with inadequate glycaemic control (HbA1c ≥ 6.5%) (Sánchez‐Domínguez et al, 2015; Tibúrcio‐Machado et al, 2017; Yip et al, 2021), Importantly, periapical healing in T2DM patients after primary endodontic treatment was substantially less than in non‐diabetic ones (Arya et al, 2017; Gupta et al, 2020; Nagendrababu et al, 2020). The prevalence of residual AP in root filled teeth (RFT) significantly increased in T2DM (Smadi, 2017), especially in men (Britto et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

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Bacterial quantity and interleukin‐17 expression in necrotic teeth with apical periodontitis from type II diabetic patients

2023

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Diabetes mellitus (DM) increases the susceptibility to infection. A plausible association between apical periodontitis (AP) and DM has been reported, but the underlying mechanism is not yet elucidated. Aim To investigate the bacterial quantity and the expression of interleukin‐17 (IL‐17) in necrotic teeth with AP in type 2 DM (T2DM), pre‐diabetic and non‐diabetic control patients. Methodology In all, 65 patients with necrotic pulp and AP [periapical index (PAI) scores ≥3] were included. The age, gender, medical history and medications list, including metformin and statin intake, were recorded. Glycated haemoglobin (HbA1c) was analysed, and the patients were divided into three groups: T2DM (n = 20), pre‐diabetics (n = 23) and non‐diabetic (n = 22). Bacterial samples (S1) were collected by file and paper points. Bacterial DNA was isolated and quantified using 16S ribosomal RNA gene‐targeted quantitative real‐time polymerase chain reaction (qPCR). For IL‐17 expression, (S2) samples were collected from the periapical tissue fluid using paper points passing through the apical foramen. The IL‐17 total RNA was extracted, and reverse transcription (RT‐qPCR) analysis was performed. Comparisons between the three study groups were conducted using one‐way anova and Kruskal–Wallis test to explore the relationship between bacterial cell counts and IL‐17 expression in each group. Results The distributions of PAI scores were equivalent among the groups, p = .289. T2DM patients had higher bacterial counts and IL‐17 expression than other groups, but these differences were not statistically significant, p = .613 and p = .281, respectively. T2DM patients taking statin appear to have lower bacterial cell count than those who do not take statin, approaching the significance level, p = .056. Conclusion T2DM patients had a non‐significant higher bacterial quantity and IL‐17 expression compared to pre‐diabetic and healthy controls. Although these findings indicate a weak association, it may impact the clinical outcome of endodontic diseases in diabetic patients.

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Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Bacterial quantity and interleukin‐17 expression in necrotic teeth with apical periodontitis from type II diabetic patients

2023

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“…Finally, eight studies were selected and included for systematic review and meta‐analysis (Table 2). Six studies analysed the association between HTN and AP (An et al., 2016; Katz & Rotstein, 2021; Khalighinejad et al., 2017; Messing et al., 2019; Segura‐Egea et al., 2010; Yip et al., 2021), and two studies analysed the association between HTN and non‐retention of RFT (Mindiola et al., 2006; Wang et al., 2011). Study design, study sample, diagnosis, main results and evidence level of these studies are summarized in Table 2.…”

Section: Resultsmentioning

confidence: 99%

Prevalence of apical periodontitis and non‐retention of root‐filled teeth in hypertensive patients: Systematic review and meta‐analysis

Cabanillas‐Balsera,

Areal‐Quecuty,

Cantiga‐Silva

et al. 2023

Int Endodontic J

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BackgroundSeveral studies have suggested a relationship between AP, as well as the loss of root‐filled teeth (RFT), and hypertension (HTN).ObjectivesThe aims of this systematic review and meta‐analysis were to investigate the prevalence of AP, and non‐retention of RFT, in hypertensive patients.MethodsA search was performed in PubMed/MEDLINE, Web of Science, Scopus and EMBASE. The inclusion criteria established were studies published until February 2023, comparing hypertensive subjects with controls, assessing the prevalence of AP and/or providing data on the prevalence of non‐retained RFT. Meta‐analysis was performed using the RevMan (analyst) tool to determine the pooled prevalence of AP and loss of RFT. Risk of bias was assessed using the Cochrane Risk‐of‐Bias tool. The quality of evidence was assessed by GRADE.ResultsThe search strategy identified 454 articles, and only eight met the inclusion criteria. Six studies had analysed the association between AP and HTN and two studies had analysed the association between non‐retention of RFT and HTN. Meta‐analysis showed and overall OR = 1.71 (95% CI = 0.92–3.16; p = .09) for the prevalence of AP among patients with HTN. The prevalence of non‐retention of RFT among patients with HTN has an overall OR = 1.78 (95% CI = 1.60–1.98; p = .000001). The risk of bias in the individual studies was low or moderate, and the quality of the overall evidence has shown a level of certainty very low.DiscussionThere is no association between the prevalence of AP and HTN. In addition, hypertensive patients have significantly increased odds of losing RFT. Given the high prevalence of hypertension, it is very common to perform root canal treatments on hypertensive patients. It is imperative to communicate this heightened risk to patients and recommend periodic monitoring of oral health and hypertension, paying special attention to this subset of patients.RegistrationPROSPERO CRD42022302385.

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Evidence of an effect of statins on lesions originating from dental infection. A retrospective clinical investigation

Ideo,

Mercuro,

Sanna

et al. 2024

International Journal of Cardiology

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The association of apical periodontitis and type 2 diabetes mellitus

Cited by 23 publications

References 13 publications

Bacterial quantity and interleukin‐17 expression in necrotic teeth with apical periodontitis from type II diabetic patients

Bacterial quantity and interleukin‐17 expression in necrotic teeth with apical periodontitis from type II diabetic patients

Prevalence of apical periodontitis and non‐retention of root‐filled teeth in hypertensive patients: Systematic review and meta‐analysis

Evidence of an effect of statins on lesions originating from dental infection. A retrospective clinical investigation

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