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Editorial Volume 4 Issue 1
Diabetes mellitus: it’s effect on endodontic infections
Vineet RV,1
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Moksha Nayak2
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1Department of Conservative Dentistry & Endodontics, Sree Mookambika Institute of Dental Sciences, India
2Department of Conservative Dentistry & Endodontics, KVG Dental College & Hospital, India
Correspondence: Vineet RV, Senior Lecturer, Department of Conservative Dentistry & Endodontics, Sree Mookambika Institute of Dental Sciences, India
Received: January 01, 2016 | Published: February 4, 2016
Citation: Vineet RV, Nayak M. Diabetes mellitus: it’s effect on endodontic infections. J Dent Health Oral Disord Ther. 2016;4(1):35-36. DOI: 10.15406/jdhodt.2016.04.00100
Editorial
Diabetes mellitus is a metabolic disease characterized by high blood glucose level mainly due to resistance to insulin or its deficiency. It is considered as a complex and pernicious syndrome marked by abnormal carbohydrates, lipid and protein metabolism in the body.1 Risk factor for diabetes may be influenced by both genetic and environmental variables as shown in Figure 1. It is observed by clinical studies that there is a higher incidence of persistent periapical infections as well as resistance to contemporary root canal therapy in diabetic patients.2 The prevalence of type 2 diabetes mellitus for 2010 is found to be 285 million people globally, which is projected to increase to 438 million by 2030; a 65 % increase (Figure 1).3
Figure 1 Pathogenesis of type II diabetes.
Studies have shown that patients with a history of diabetes mellitus and periapical lesions have significantly reduced healing following endodontic therapy compared with that for the non-diabetic population.4 This can be attributed to the altered immune system in diabetic patients with associated delayed healing and compromised immune responses as shown in Figure 2. Periapical pathology triggers the activation of the broad axis of innate immunity through upregulation of pro inflammatory cytokines from monocytes and poly morphonuclear leucocytes. Dysfunction of the immune response in diabetic patients may hamper the secretion of these cytokines that may lead to persistence of periapical pathology in the presence of bacterial biofilm.5 Moreover, previous studies have revealed that ecology of oral micro flora changed in diabetic patients to a more virulent microbial profile compared to non-diabetic patients.
The current evidence of increase in the prevalence of diabetes mellitus world over and the relative resistance to contemporary endodontic therapy in diabetic patients as well as the havoc of developing antibiotic resistance worldwide is leading to an alarming situation. Hence, further research in this field is highly recommended to develop new innovative therapeutic approaches.
Figure 2 Immunomodulation in type II diabetes.
References
- Nayak M, Kotigadde S, Shetty H, et al. Impact of Peptostreptococcus on Type 2 Diabetes Mellitus Related Secondary Root Canal Infections. Int J Pharm Sci Res. 2013;4:4001–4009.
- Doria A, Elizabeth M, Ronald CK. The Emerging Genetic Architecture of Type 2 Diabetes. Cell Metab. 2008;8(3):186–200.
- Mohan V, Sandeep S, Deepa R, et al. Epidemiology of type 2 Diabetes: Indian scenario. Ind J Med Res. 2007;125(3):217–230.
- Fouad AF, Barry J, Russo J, et al. Periapical lesion progression with controlled microbial inoculation in a type I diabetic mouse model. J Endod . 2002;28(1):8–16.
- Roberta ST, Maria CF, Getulio NF. Impact of Periodontitis on the Diabetes-Related Inflammatory Status. J Can Dent Assoc. 2010;76: a35.
©2016 Vineet, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.