Journal of eISSN: 2373-4345 JDHODT

Dental Health, Oral Disorders & Therapy
Volume 4 Issue 1 - 2016
Diabetes Mellitus: It’s Effect on Endodontic Infections
Vineet RV1*, Moksha Nayak2
1Department of Conservative Dentistry & Endodontics, Sree Mookambika Institute of Dental Sciences, India
2Department of Conservative Dentistry & Endodontics, KVG Dental College & Hospital, India
Received: January 01, 2016 | Published: February 04, 2016
*Corresponding author: Vineet RV, Senior Lecturer, Department of Conservative Dentistry & Endodontics, Sree Mookambika Institute of Dental Sciences, India, Tel: 9020449368; Email:
Citation: Vineet RV, Moksha N (2016) Diabetes Mellitus: It’s Effect on Endodontic Infections. J Dent Health Oral Disord Ther 4(1): 00100. 10.15406/jdhodt.2016.04.00100


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 Fig.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.


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