Diabetes mellitus: An endodontic perspective

Abstract

Diabetes mellitus (DM) is a complex metabolic disease, characterised by hyperglycaemia resulting from defects in insulin secretion, insulin action or both. In patients with DM, several aspects of the immune system are compromised and wound healing is impaired. Studies indicate increased prevalence, severity of periapical lesions and a decreased success rate of endodontic treatment in diabetics, suggesting that diabetes may serve as a disease modifier of periapical lesions. A reciprocal relationship exists between glycaemic control and chronic periapical lesions. Treating infections of pulp and periodontium will improve glycaemic control and help in healing of lesions similar to non-diabetics. To provide competent care to patients with DM, dental clinicians must understand the disease, its treatment, and its impact on the patients′ ability to undergo and respond to endodontic treatment. This review article is a detailed assessment of the literature on DM and its implication on pulp and periapical diseases, and their treatment outcome.