Impact of Type 2 Diabetes Mellitus on Apical Periodontitis Size, Endotoxin Levels, and Bacterial Load in Root Canals with Necrotic Pulp.

IF 3.6 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of endodontics Pub Date : 2025-05-09 DOI:10.1016/j.joen.2025.05.003

Mirela Cesar Barros, Evelyn Giuliana Velasquez-Espedilla, Luciane Dias de Oliveira, Brenda Paula F A Gomes, Marco Antônio Hungaro Duarte, Carlos Antônio Negrato, Flaviana Bombarda Andrade

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引用次数: 0

Abstract

Introduction: This clinical study was conducted to describe the endodontic microbiological profile of teeth with apical periodontitis in patients with type 2 diabetes mellitus (T2DM), focusing on bacterial count and endotoxin levels found in primary infection, as well as the size of periapical lesions, determined by cone-beam computed tomography (CBCT) analysis.

Methods: Thirty-four patients were selected and divided into 2 groups: 17 with T2DM and 17 nondiabetic controls. Anamnesis, clinical examinations, and radiographic evaluations were performed. Root canal samples were collected using sterile/pyrogen-free paper tips. Endotoxins were quantified using limulus amoebocyte lysate assay, and bacterial counts (colony forming units/mL) were determined using anaerobic culture techniques. The periapical status of the teeth was assessed using the CBCT periapical index. Data were analyzed using Pearson correlation, simple linear regression, t-tests, and Chi-square tests (P < .05).

Results: A larger size of periapical lesions (CBCT periapical index ≥4) was observed in patients with T2DM (64.8%) compared to controls (17.7%) (P < .05). There was a significant increase in the number of bacteria by culture and endotoxin levels in diabetic patients. A positive correlation was found between elevated endotoxin levels and the diameter of periapical lesions (P < .05).

Conclusions: This study supports the hypothesis that T2DM is associated with a greater microbial load and higher endotoxin levels, contributing to more severe periapical bone destruction, which may negatively affect endodontic treatment outcomes in these patients.

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2型糖尿病对坏死牙髓根管内牙周炎大小、内毒素水平及细菌负荷的影响。

摘要：本临床研究旨在描述2型糖尿病（T2DM）患者的根尖牙周炎牙齿的根管微生物特征，重点研究在原发性感染中发现的细菌计数和内毒素水平，以及根尖周围病变的大小，这些都是通过锥形束计算机ct （CBCT）分析确定的。方法：34例患者分为2组：2型糖尿病患者17例，非糖尿病对照组17例。进行了记忆、临床检查和影像学评估。根管标本采用无菌/无热原纸尖采集。内毒素采用鲎试剂（LAL）法定量，细菌计数（菌落形成单位CFU/mL）采用厌氧培养技术测定。使用CBCT根尖周指数（CBCTPAI）评估牙齿的根尖周状态。数据分析采用Pearson相关、简单线性回归、t检验和χ2检验（P < 0.05）。结果：T2DM患者根尖周病变（CBCTPAI≥4）的大小（64.8%）大于对照组（17.7%）（P < 0.05）。糖尿病患者培养的细菌数量和内毒素水平显著增加。内毒素水平升高与根尖周围病变直径呈正相关（P < 0.05）。结论：本研究支持T2DM与较高的微生物负荷和较高的内毒素水平相关的假设，导致更严重的根尖周骨破坏，这可能会对这些患者的根管治疗结果产生负面影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of endodontics 医学-牙科与口腔外科

CiteScore

8.80

自引率

9.50%

发文量

224

审稿时长

42 days

期刊介绍： The Journal of Endodontics, the official journal of the American Association of Endodontists, publishes scientific articles, case reports and comparison studies evaluating materials and methods of pulp conservation and endodontic treatment. Endodontists and general dentists can learn about new concepts in root canal treatment and the latest advances in techniques and instrumentation in the one journal that helps them keep pace with rapid changes in this field.