Viswanath Butta, Priyank Harsh, Shivakumar Sahana, Langaliya Akshayraj, Kumbhar Aravind D, Jakhar Ashima, Cervino Gabriele, Minervini Giuseppe
Department of Conservative, Endodontics and Aesthetic Dentistry, Dental Institute, Rajendra Institute of Medical Sciences, Ranchi.
Public Health Dentistry, Peoples College of Dental Sciences and Research Centre, Peoples University, Bhopal.
Saudi Dent J. 2024 Jan;36(1):52-59. doi: 10.1016/j.sdentj.2023.10.002. Epub 2023 Oct 5.
Periapical diseases are common dental conditions that require non-surgical endodontic intervention (NEI) for successful treatment. However, the impact of diabetes mellitus (DM) on the periapical healing (PH) outcome in diabetic patients remains somewhat unclear. This review aimed to evaluate the PH outcome following endodontic intervention among DM-afflicted individuals.
A comprehensive search was conducted across multiple electronic databases to identify relevant studies. Specifically, a set of selection criteria was applied to select studies that assessed PH outcomes in individuals with DM who underwent different treatment protocols. Data extraction and quality assessment were performed following predetermined protocols. The risk of bias (RoB) 2 assessment tool evaluated the quality of the included studies.
A total of 11 studies met the inclusion criteria and were included in the investigation. Four studies showed a higher incidence of apical periodontitis in diabetic individuals compared to controls, and five studies reported reduced healing and success rates in this group. Overall, nine studies have shown that DM has a negative impact on periapical outcomes. This suggests that DM is an important factor in the prognosis of endodontic intervention. The assessment tools used were PAI, PR, SC, and FD analysis. RoB-2 assessed the included studies as having a moderate RoB.
This review provides compelling evidence that DM patients experienced a noticeable negative impact on PH outcomes compared to the control population. These findings highlight the importance of considering the diabetic status of patients when assessing the prognosis of periapical diseases and planning interventions for NEI. Further research is needed to validate these results and explore potential mechanisms underlying the observed associations.
根尖周疾病是常见的牙科病症，需要通过非手术牙髓治疗干预（NEI）才能成功治愈。然而，糖尿病（DM）对糖尿病患者根尖周愈合（PH）结果的影响仍不太明确。本综述旨在评估糖尿病患者牙髓治疗干预后的根尖周愈合结果。
在多个电子数据库中进行了全面检索，以识别相关研究。具体而言，应用了一套选择标准来挑选评估接受不同治疗方案的糖尿病患者根尖周愈合结果的研究。按照预定方案进行数据提取和质量评估。采用偏倚风险（RoB）2评估工具评估纳入研究的质量。
共有11项研究符合纳入标准并被纳入调查。四项研究表明，与对照组相比，糖尿病患者根尖周炎的发病率更高，五项研究报告该组的愈合率和成功率降低。总体而言，九项研究表明糖尿病会对根尖周结果产生负面影响。这表明糖尿病是牙髓治疗干预预后的一个重要因素。所使用的评估工具包括PAI、PR、SC和FD分析方法。RoB-2评估纳入研究具有中度偏倚风险。
本综述提供了有力证据，表明与对照组相比，糖尿病患者的根尖周愈合结果受到显著负面影响。这些发现凸显了在评估根尖周疾病预后和规划非手术牙髓治疗干预措施时考虑患者糖尿病状况的重要性。需要进一步研究来验证这些结果，并探索观察到的关联背后的潜在机制。
