Journal of Mazandaran University of Medical Sciences (Oct 2024)
Evaluation of the Relationship between the Pulp and Periapical Lesions with Controlled Type Type 2 Diabetes in Patients Referred to the Dental Clinic: A Radiographic Evaluation
Abstract
Background and Purpose: Diabetes Mellitus is a group of complex, multi-system metabolic disorders that alter many functions of the immune system and are associated with delayed recovery and a reduced immune response. Apical periodontitis is the inflammation and destruction of the periodontium in the apical region of the root, originating from the pulp, and as a result, an inflammatory response creates a radiolucent area at the root apex. In this study, we aimed to investigate the relationship between the presence of pulp and periapical lesions and controlled type 2 diabetes in the radiographic images of patients. Materials and Methods: In this cross-sectional study, 45 patients were included in the case group (patients with controlled diabetes) and 45 in the control group (healthy individuals). Periapical and endodontic status was evaluated based on examinations using panoramic and periapical images. In the dental examinations (excluding third molars), the following were recorded for each patient: the number of teeth in the mouth, the number and location of teeth without root canal treatment with a periapical lesion, the number and location of teeth with root canal treatment, and the number and location of teeth with root canal treatment with a periapical lesion. The periodontal condition was assessed using the periapical index (PAI), with scores greater than 3 considered indicative of periapical pathology. For inferential analysis, chi-square tests and independent t-tests were used. Results: Among the 90 participants, 53 were women and 37 were men. The average age of the participants was 43.6 years, and the average age was higher in the diabetic group. In total, 52.2% of patients had periapical lesions and 63.3% had pulpal lesions, with these two lesions being significantly more common in diabetic individuals(P<0.05). Among all patients, there was a significant relationship between gender and periapical lesions (P=0.022), with women having a higher prevalence of these lesions. In non-diabetic individuals, unlike diabetic individuals, the relationship between gender and periapical lesions was significant, with women having more lesions(P=0.03). Across all patients, there was a significant relationship between age and periapical lesions (P=0.001), with the average age being higher in patients with periapical lesions. In diabetic individuals, unlike non-diabetic individuals, no significant relationship was observed between these two variables (P=0.828). Conclusion: The study results demonstrated a significant relationship between the prevalence of pulp and periapical lesions and factors such as sex, age, and type 2 diabetes. The findings revealed that the prevalence of pulp and periapical lesions is higher in patients with type 2 diabetes compared to those without diabetes. The likelihood of developing these lesions increases with age and is generally higher in women. Additionally, no correlation was found between the prevalence of pulp and periapical lesions in men without type 2 diabetes and increasing age in individuals with type 2 diabetes.
