Diabetes mellitus, periapikal enfeksiyon ve kök kanalı tedavisi ilişkisi

Diabetes mellitus (DM) en yaygın metabolik bozukluklardan biridir. DM, yara iyileşmesinde güçlükler, sistemik ve ağız içinde özellikle pulpa bütünlüğü üzerinde doğrudan etkisi görülen hiperglisemi ile karakterizedir. Yapılan çalışmalar kontrolsüz diyabet hastalarında kök kanal tedavisi ihtiyacının, periapikal lezyon yaygınlığının, kemik kayıplarının ve kök kanal tedavisi sonrası başarısızlığın daha yüksek olduğunu göstermektedir. Hiperglisemi, pulpa dokusunda bozulmuş kan dolaşımı ve iskemi sonucunda nekroz riskinin artmasına, buna ek olarak diş ağrısı ve hassasiyetlerin artmasına neden olmaktadır. Hipergliseminin kemik erimesini arttırıp, osteoblastik aktiviteyi azalttığı moleküler düzeyde açıklansa da DM ve kemik metabolizması arasındaki ilişki tam olarak anlaşılamamıştır. DM’nin sistemik etkilerinin yanı sıra ağız sağlığı ile ilişkisini bilmek, kök kanal tedavisinin teşhis, tedavi ve takibinde büyük önem taşımaktadır.

The relationship between diabetes mellitus, periapical infection and root canal treatment

Diabetes mellitus (DM) is a metabolic disorder that is seen frequently. DM is usually characterised with extended wound healing, systemic and oral conditions linked to hyperglisema that especially affects pulpal integrity. Recent studies have shown that patients not receiving treatment for diabetes show a higher incidence in root canal treatment, spread of periapical lesion, bone loss and low prognosis. Hyperglisemia causes an interrupted blood circulation in the pulpal tissue which leads to ischemia thus, an elevated risk for necrosis. Additionally, DM may increase dental pain and sensitivity. Although it is known that an increase in bone loss related to hyperglisemia was explained through a decrease in osteoblastic activity, the relationship between DM and bone metabolism is yet to be understood. A comprehensive knowledge of the systemical effect of DM along with its effects on oral health is essential for the diagnosis, treatment and follow-up in root canal treatment.

Kaynakça

1. Miller WD. An instruction to the study of the bacteriopathology of the dental pulp. Dent Cosmos 1894; 36: 505-528.

2. Figdor D. Apical periodontitis: a very prevalent problem. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002; 94: 651-652.

3. Jimenez-Pinzon A, Segura-Egea JJ, Poyato-Ferrera M, Velasco-Ortega E, Rios-Santos JV. Prevelance of apical periodontitis and frequency of root-filled teeth in an adult Spanish population. Int Endod 2004; 37: 167-173.

4. Segura-Egea JJ, Castellanos-Cosano L, Machuca G, López-López J, Martín-González J, et al. Diabetes mellitus, periapical inflammation and endodontic treatment outcome. Med Oral Patol Oral Cir Bucal 2012; 17: e356-e361.

5. Soskolne WA, Klinger A. The relationship between periodontal diseases and diabetes: an overview. Ann Periodontol 2001; 6: 91-98.

6. Katz J. Elevated blood glucose levels in patients with severe peri- odontal disease. J Clin Periodontol 2001; 28: 710-712.

7. Beck J, Garcia R, Heiss G, Vokonas PS, Offenbacher S. Periodon- tal disease and cardiovascular disease. J Periodontol 1996; 67: 1123-1137.

8. Grau AJ, Becher H, Ziegler CM, Lichy C, Buggle F, Kaiser C, et al. Periodontal disease as a risk factor for ischemic stroke. Stroke 2004; 35: 496-501.

9. Marín C, Segura-Egea JJ, Martinez-Sahuquillo A, Bullon P. Cor-relation between infant birth weight and mother’s periodontal status. J Clin Periodontol 2005; 32: 299304.

10. Scannapieco FA, Bush RB, Paju S. Associations between peri-odontal disease and risk for nosocomial bacterial pneumonia and chronic obstructive pulmonary disease. A systematic review. Ann Periodontol 2003; 8: 54-69.

11. Bullón P, Goberna B, Guerrero JM, Segura JJ, Perez-Cano R, Martinez-Sahuquillo A. Serum, saliva, and gingival crevicular uid osteocalcin: their relation to periodontal status and bone mineral density in postmenopausal women. J Periodontol 2005; 76: 513-519.

12. Bender IB, Seltzer S, Freedland J. The relationship of systemic diseases to endodontic failures and treatment procedures. Oral Surg Oral Med Oral Pathol 1963; 16: 1102-1115.

13. Joe Editorial Board. Relationship between systemic diseases and endodontics: An online study guide. J Endod 2008; 34: e195-200.

14. Lopez-Lopez J. Periapical and endodontic status of type2 diabetic patients in Catalonia, Spain: A cross-sectional study. J Endod 2011; 37: 598-610.

15. Lima SMF. Diabetes mellitus and inflammatory pulpal and periapical disease: a review. Int Endod J 2013; 46: 700-709.

16. Murray CA, Saunders WP. Root canal treatment and general health: a review of the literatüre. Int Endod J 2000; 33: 1-18.

17. Marotta PS. Type 2 diabetes mellitus and the prevalence of apical periodontitis and endodontic treatment in an adult Brazilian population. J Endod 2012; 38: 297-300.

18. Nagendrababu V, Segura-Egea JJ, Fouad AF, Pulikkotil SJ, Dummer PMH. Association between diabetes and the outcome of root canal treatment in adults: an umbrella review. Int Endod J 2020; 53: 455-466.

19. Segura-Egea JJ, Martín-González J, Cabanillas-Balsera D, Fouad AF, Velasco-Ortega E, López-López J. Association between diabetes and the prevalence of radiolucent periapical lesions in root-filled teeth: systematic review and meta-analysis. Clin Oral Invest 2016; 20: 1133-1141.

20. Segura-Egea JJ, Cabanillas-Balsera D, Jiménez-Sánchez MC, Martín-González J. Endodontics and diabetes: association versus causation. Int Endod J 2019; 52: 790802.

21. Caplan DJ, Chasen JB, Krall EA, Cai J, Kang S, Garcia RI, et al. Lesions of endodontic origin and risk of coronary heart disease. J Dent Res 2006; 85: 996-1000.

22. Caplan DJ, Pankow JS, Cai J, Offenbacher S, Beck JD. The relationship between self-reported history of endodontic therapy and coronary heart disease in the Atherosclerosis Risk in Communities Study. J Am Dent Assoc 2009; 140: 1004-1012.

23. Mindiola MJ, Mickel AK, Sami C, Jones JJ, Lalumandier JA, Nelson SS. Endodontic treatment in an American Indian population: A 10-year retrospective study. J Endod. 2006; 32: 828-832.

24. Segura-Egea JJ, Jimenez-Moreno E, Calvo-Monroy C, Ríos-Santos JV, Velasco-Ortega E, Sánchez-Domínguez B, et al. Hyperten- sion and dental periapical condition. J Endod 2010; 36: 1800-1804.

25. Wang CH, Chueh LH, Chen SC, Feng YC, Hsiao CK, Chiang CP. Impact of diabetes mellitus, hypertension, and coronary artery disease on tooth extraction after nonsurgical endodontic treatment. J Endod 2011; 37: 1-5.

26. Segura-Egea JJ, Jiménez-Pinzón A, Ríos-Santos JV, Velasco-Or- tega E, Cisneros-Cabello R, Poyato-Ferrera MM. High prevalence of apical periodontitis amongst smokers in a sample of Spanish adults. Int Endod J 2008; 41: 310-316.

27. Tierney LM, McPhee SJ, Papadakis MA. Current medical Diagnosis & Treatment. International edition. New York: Lange Medical Books/McGraw-Hill. 2002; 12031215.

28. Mealey BL, Oates TW. American Academy of Periodontology. Diabetes mellitus and periodontal diseases. Review. J Periodontol 2006; 77: 1289-1303.

29. Vernillo AT. Diabetes mellitus: Relevance to dental treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 91: 263-270.

30. Graves DT, Liu R, Oates TW. Diabetes-enhanced inflammation and apoptosis: impact on periodontal pathosis. Review. Periodontol 2000 2007; 45: 128-137.

31. Fouad AF. Endodontic infections and systemic disease. In: Fouad AF, ed. Endodontic Microbiology. Ames, IA: Wiley-Blackwell; 2009: 320-338.

32. Siqueira JF Jr. Treatment of endodontic infections. London: Quintessence Publishing; 2011.

33. Emrich LJ, Shlossman M, Genco RJ. Periodontal disease in insulin-dependent dia- betes mellitus. J Periodontol 1991; 62: 123-130.

34. Cianciola L, Park B, Bruck E, Mosorich L, Genco RJ. Prevalence of periodontal disease in insulin-dependent diabetes mellitus. J Am Dent Assoc 1982; 104: 653-660.

35. Mealey BL, Rose LF. Diabetes mellitus and inflammatory periodontal diseases. Curr Opin Endocrinol Diabetes Obes 2008; 15: 135-141.

36. Kurtiş MB. Diyabetin periodontal dokular üzerindeki etkisi. Türkiye Klin J Periodontol-Special Topics 2015; 1: 1-6.

37. Montoya-Carralero JM, Saura-Pérez M, Canteras-Jordana M, Morata-Murcia IM. Reduction of HbA1c levels following nonsurgical treatment of periodontal disease in type 2 diabetics. Med Oral Patol Oral Cir Bucal 2010; 15: e808-e812.

38. Katz J. Elevated blood glucose levels in patients with severe periodontal disease. J Clin Periodontol 2001; 28: 710-712.

39. Bender IB, Seltzer S, Freedland J. The relationship of systemic diseases to endodontic failures and treatment procedures. Oral Surg Oral Med Oral Pathol 1963; 16: 1102-1115.

40. Bender IB, Bender AB. Diabetes mellitus and the dental pulp. J Endod 2003; 29: 383-289.

41. Catanzaro O, Dziubecki D, Lauria LC, Ceron CM, Rodriguez RR. Diabetes and its effects on dental pulp. J Oral Sci 2006; 48: 195-199.

42. Lima SMF, Grisi DC, Kogawa EM, Franco OL, Peixoto VC, et al. Diabetes mellitus and inflammatory pulpal and periapical disease: a review. Int Endod J 2013; 46: 700709.

43. Segura-Egea JJ, Jiménez-Pinzón A, Ríos-Santos JV, Velasco-Ortega E, Cisneros-Cabello R, et al. High prevalence of apical periodontitis amongst type 2 diabetic patients. Int Endod J 2005; 38: 564-569.

44. Marotta PS, Fontes TV, Armada L, Lima KC, Rocas IN, Siqueira JF Jr. Type 2 diabetes mellitus and the prevalence of apical periodontitis and endodontic treatment in an adult Brazilian population. J Endod 2012; 38: 297-300.

45. Lopez-Lopez J, Jane-Salas E, Estrugo-Devesa A, Velasco-Ortega E, Martin-Gonzalez J, et al. Periapical and endodontic status of type 2 diabetic patients in Catalonia, Spain: a cross-sectional study. J Endod 2011; 37: 598-601.

46. Britto LR, Katz J, Guelmann M, Heft M. Periradicular radiographic assessment in diabetic and control individuals. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003; 96: 449-452.

47. Fouad AF, Burleson J. The effect of diabetes mellitus on endodontic treatment outcome: data from an electronic patient record. J Am Dent Assoc 2003; 134: 43-51.

48. Wu MK, Barkis D, Roris A, Wesselink PR. Does the first f ile to bind correspond to the diameter of the canal in the apical region? Int Endod J 2002; 35: 264-267.

49. Lele GS, Subba Reddy VV. Comparison of antibacterial efficacy of intracanal medicaments in multiple visit pulpectomies in primary molars-an in vivo study. J Indian Soc Pedod Prev Dent 2010; 28: 18-24.

50. Rees TD. Periodontal management of the patient with diabetes mellitus. Periodontol 2000 2000; 23: 63-72.

51. Ship JA. Diabetes and oral health: an overview. J Am Dent Assoc 2003; 134: 4S-10S.

52. Vernillo AT. Dental considerations for the treatment of patients with diabetes mellitus. J Am Dent Assoc 2003; 134: 24S-33S.

53. Takahashi K. Microbiological, pathological, inflammatory, immunological and molecular biological aspects of periradicular disease. Int Endod J 1998; 31: 311-325.

54. Teixeira-Salum TB, Rodrigues DB, Gervasio AM, Souza CJ, Rodrigues V Jr, et al. Distinct Th1, Th2 and Treg cytokines balance in chronic periapical granulomas and radicular cysts. Journal of Oral Pathology and Medicine 2010; 39: 250-256.

55. Fukada SY, Silva TA, Garlet GP, Rosa AL, Silva JS, Cunha FQ. Factors involved in the T helper type 1 and type 2 cell commitment and osteoclast regulation in inflammatory apical diseases. Oral Microbiol Immunol 2009; 24: 25-31.

56. Chang PC, Lim LP. Interrelationships of periodontitis and diabetes: A review of the current literature. J Dent Sci 2012; 7: 272-282.

57. Vestergaard P. Discrepancies in bone mineral density and fracture risk in patients with type 1 and type 2 diabetes a meta-analysis. Osteoporos Int 2007; 18: 427-444.

58. Sánchez-Domínguez B, López-López J, Jané-Salas E, Castellanos-Cosano L, Velasco-Ortega E, Segura-Egea JJ. Glycated hemoglobin levels and prevalence of apical periodontitis in type 2 diabetic patients. J Endod 2015; 41: 601-606.

59. Cheraskin E, Ringsdorf WM Jr. The biology of the endodontic patient. 3. Variability in periapical healing and blood glucose. J Oral Med 1968; 23: 87-90.

60. Segura-Egea JJ, Martín-González J, Castellanos-Cosano L. Endodontic medicine: connections between apical periodontitis and systemic diseases. Int Endod J 2015; 48: 933-951.

61. Mindiola MJ, Mickel AK, Sami C, Jones JJ, Lalumandier JA, Nelson SS. Endodontic treatment in an American Indian population: a 10-year retrospective study. J Endod 2006; 32: 828-832.

62. Doyle SL, Hodges JS, Pesun IJ, Baisden MK, Bowles WR. Factors affecting outcomes for single-tooth implants and endodontic restorations. J Endod 2007; 33: 399-402.

63. Wang CH, Chueh LH, Chen SC, Feng YC, Hsiao CK, Chiang CP. Impact of diabetes mellitus, hypertension, and coronary artery disease on tooth extraction after nonsurgical endodontic treatment. J Endod 2011; 37: 1-5.

64. Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of non-surgical root canal treatment: part 2: tooth survival. Int Endod J 2011; 44: 610-625.

Kaynak Göster

313 220

Arşiv
Sayıdaki Diğer Makaleler

Türk popülasyonundaki çocuklarda kronolojik yaş, dişsel yaş ve iskelet yaşı arasındaki ilişkinin değerlendirilmesi

Derya İÇÖZ, Hilal ÖZBEY, Burak Kerem APAYDIN

Periodontitis ve tip 2 diyabetli bireylerdeki glisemik kontrolün salya antimikrobiyal peptid seviyesine olan etkisinin incelenmesi

Doğukan YILMAZ, Ali Orkun TOPÇU, Emine Ülke AKÇAY, Ali TAMER, MUSTAFA ALTINDİŞ

Farkli cila sistemlerinin kompozit rezinlerin yüzey pürüzlülükleri üzerine etkisi

Dilber BİLGİLİ, Ayşe DÜNDAR, Çağatay BARUTÇUGİL, İsmail Burak ÖCAL

Diabetes mellitus, periapikal enfeksiyon ve kök kanalı tedavisi ilişkisi

Güher BARUT, Beliz ÖZEL, Rabia Figen KAPTAN

Çocuklarda bilişsel seviye ve ağız diş sağlığı: Bir pilot çalışma

Müesser Ahu DURHAN, Seda ÖZSALİH, Mısra ÖZALP, Ömer Birkan AĞRALI, Hanife Nuray YILMAZ, Betül ŞEN YAVUZ, Betül KARGÜL

Aksesuar mezial kanala sahip alt büyük azı dişlerine endodontik yaklaşım: Olgu Serisi

Vahide Hazal YARGICI, Meriç KARAPINAR KAZANDAĞ, Rabia Figen KAPTAN

Ortognatik cerrahi tedavinin burun üzerine etkilerinin 3 boyutlu fotografik yöntemle incelenmesi

Gökhan ÇOBAN, İbrahim YAVUZ

Farklı kahve türlerinde bekletilen kompozit rezinlerin renk stabilitelerinin incelenmesi

Suzan CANGÜL, ÖZKAN ADIGÜZEL, Server ÜNAL, Samet TEKİN, Ezgi SONKAYA, Begüm ERPAÇA

CAD/CAM sistemiyle hazırlanan üç üyeli monolitik zirkonya ve zirkonyum destekli restorasyonların FDI kriterlerine göre değerlendirilmesi: Bir yıllık klinik split-mouth çalışması

Elçin KESKİN ÖZYER, ERKUT KAHRAMANOĞLU, Yasemin KULAK ÖZKAN

Rize ilinde görev yapmakta olan diş hekimlerinin dental travma yönetimi konusunda bilgi, tutum ve davranışlarının değerlendirilmesi

Sema AYDINOĞLU, İpek ARSLAN, Zeynep DEMİREZ