Effect of Diabetes mellitus on pulp and periradicular infections:A literature review

Diabetes Mellitus (DM) has destructive effects on various tissues and organs including the dental pulp and periodontal tissues. The aim of this study was to collect information about the influence of DM on pulpal and periradicular tissues in healthy and diabetic cases. Data was collected by searching PUBMED and Cochrane databases using keywords such as diabetes, periradicular infection, periradicular lesion, periapical infection, periapical lesion, pulp, periodontium. Selected reference textbooks were searched using the same search strategy. The search results were categorized according to methodological strengths and selected only if qualified for our inclusion criteria. In diabetic patients numerous histopathologic changes happen in dental pulp and periodontium, accompanied by qualitative and quantitative alterations in normal oral microflora and disturbances in immune system. Usually these three factors accompany each other just like the three sides of a triangle. These cases are not only vulnerable to pulpal necrosis and periradicular disease, but also cause the infection to follow an unusual pathway which requires different treatment regimens compared to nondiabetic patients. Pulpal and periapical infections in diabetics have a completely different pattern which affects the treatment outcomes in these cases compared to nondiabetic individual.