Department of Conservative Dentistry and Endodontics, Manav Rachna University, Faridabad, India.
Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Jamia Milia Islamia, New Delhi, India.
Int Endod J. 2020 Nov;53(11):1472-1484. doi: 10.1111/iej.13366. Epub 2020 Aug 15.
Diabetes mellitus (DM) may affect the healing and survival of root filled teeth with periapical lesions.
To systematically analyse the available clinical literature to evaluate the association between DM and the prevalence of radiolucent periapical lesions in root filled teeth. The review question was 'Is there a difference between the root canal treatment healing outcome (in terms of presence or absence of radiolucent periapical lesions) in diabetic and non-diabetic patients?'.
A systematic review of cross-sectional studies and prospective clinical trials was conducted according to the PRISMA checklist. The review involved a search of the electronic databases of PubMed, Scopus and EBSCO host.
STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS: The research protocol was previously registered in the International Prospective Register of Ongoing Systematic Reviews (CRD42019130954) and included defined inclusion/exclusion criteria. The included studies were related to the root canal treatment outcome in diabetic patients in terms of periapical radiolucent lesions associated with root filled teeth.
The selected studies were critically analysed by two evaluators using the Joanna Briggs Institute Critical Appraisal tool. The pooled odds ratio (OR) was recognized as the primary outcome variable and measure of the effect for the occurrence of periapical lesions associated with root filled teeth of control and diabetic patients. The random-effects Mantel-Haenszel method was used, at a 95% confidence interval, to calculate the pooled OR. A funnel plot was created to evaluate possible sources of heterogeneity.
Ten studies published between 1989 and March 2019 were selected after thorough analysis and exclusion according to the strict criteria. Seven cross-sectional studies, 1 longitudinal and 2 prospective clinical studies were included. The pooled OR was calculated by comparing 773 diabetic subjects and 1133 control subjects. The pooled OR for the observational studies and clinical studies were 1.42 and 6.36, respectively. This value signified a high prevalence of periapical lesions in root filled teeth in diabetic subjects.
There are limited prospective clinical trials on this topic. The majority of the included studies are observational.
The data suggest a strong connection between the presence of periapical radiolucency on root filled teeth amongst diabetics as determined by the pooled OR.
糖尿病（DM）可能会影响有根尖病变的根管填充牙齿的愈合和存活。
系统分析现有临床文献，评估 DM 与根管填充后牙齿出现放射性透亮根尖病变的患病率之间的关系。综述问题为“糖尿病患者和非糖尿病患者根管治疗的愈合结果（是否存在放射性透亮根尖病变）是否存在差异？”。
根据 PRISMA 清单，对横断面研究和前瞻性临床试验进行了系统综述。综述包括对 PubMed、Scopus 和 EBSCOhost 电子数据库的检索。
研究入选标准、参与者和干预措施：研究方案之前已在国际前瞻性注册持续系统评价（CRD42019130954）中注册，并纳入了明确的纳入/排除标准。纳入的研究与糖尿病患者根管治疗的根尖透射线病变结果相关，涉及根管填充后牙齿的根尖放射状透明病变。
两位评估员使用 Joanna Briggs 研究所的批判性评估工具对选定的研究进行了批判性分析。汇总的比值比（OR）被视为主要结局变量，用于衡量控制组和糖尿病组患者与根管治疗后牙齿相关的根尖病变的发生。使用随机效应 Mantel-Haenszel 方法，在 95%置信区间内计算汇总 OR。绘制漏斗图以评估可能的异质性来源。
经过彻底分析和根据严格标准排除后，在 1989 年至 2019 年 3 月期间共选择了 10 项研究。纳入了 7 项横断面研究、1 项纵向研究和 2 项前瞻性临床研究。通过比较 773 名糖尿病患者和 1133 名对照组患者，计算汇总 OR。观察性研究和临床研究的汇总 OR 分别为 1.42 和 6.36，这表明糖尿病患者根管填充后牙齿的根尖病变发生率较高。
关于这个主题的前瞻性临床研究有限。纳入的大多数研究为观察性研究。
数据表明，通过汇总 OR，糖尿病患者根管填充后牙齿出现放射性透亮根尖病变之间存在很强的关联。
