Association Between Diabetes Mellitus and Endodontic Pathosis

ABSTRACT Background Studies have shown that periodontal and periapical diseases are more prevalent among diabetes mellitus (DM) patients. Here, we evaluated the potential relationship between endodontic pathologies and DM through a retrospective analysis of 2,000 electronic health records (EHR) of individuals with/without DM. Methods Records of patients treated at UTHealth School of Dentistry presenting with a history of endodontic treatment with and without DM were randomly selected for analysis of 24 treatment- and patient-centric variables to assess for the association between endodontic disease and DM. Data between groups were compared using Chi-square, Fisher Exact tests, and one-way analysis of variance (ANOVA). Significant differences were set at P<0.05. Results Diabetic patients had significantly less symptomatic pulpal diagnoses, particularly less symptomatic irreversible pulpitis (P<0.00005); whereas they had significantly more symptomatic apical periodontitis (P=0.01) than non-diabetics. Diabetics had a significantly greater number of endodontically-treated teeth (P=2.2 × 10 −16 ), particularly canines and molars (P<0.002). The frequency of active periapical lesions was higher in non-diabetics, although no differences in lesion size were observed. The frequency of periodontal disease and additional systemic disease(s), and smoking was significantly increased in DM patients with endodontic treatment (P0.05). Conclusions Our results continue to support that DM contributes to increased endodontic disease and highlight the complex relationships between oral and systemic diseases. Practical Implications Dental professionals should be cognizant of endodontic pathology as a clinical complication of DM that presents as more chronic in nature, at a greater frequency, and have a tendency toward a nonhealing outcome.