Investigation of apical periodontitis frequency and alveolar bone defects in type 2 diabetes patients: A retrospective cone-beam computed tomography study

Aim: Diabetes mellitus has been implicated as a factor preventing the healing of endodontic infections with periapical lesions, especially if not controlled. The aim of this study is to investigate the prevelance of AP and alveolar bone defects in T2DM patients and compare the results with healthy individuals. Material and Method: CBCT images of 67 patients with T2DM and 69 healthy individuals were analyzed. Patients' age, gender, total number of teeth in their mouth, teeth with AP, and teeth with root canal fillings were recorded. Teeth with AP were evaluated with COPI, teeth with root canal filling were evaluated with EDTI. Marginal bone loss around the tooth was measured from 6 sites. Marginal and furcation bone loss was measured by CBCT. Likelihood ratio test, continuity corrected chi-square test, Pearson chi-square test and Fisher exact chi-square test were used for comparisons. Compatibility of numerical data with normal distribution was examined with the Shapiro-Wilk test, and Mann-Whitney U test was used for comparison. Results: Patients with AP in at least one tooth were more common in T2DMG (p=0.006). When evaluated in terms of teeth, the frequency of AP was found to be higher in T2DMG (p<0.001). The frequency of root canal filled teeth did not differ between the groups (p=0.578). More AP was found in T2DMG in root canal filled teeth (p=0.002). The frequency of AP in teeth without root canal filling did not differ between the groups (p=0.112). The number of teeth evaluated as insufficient root canal filling was found to be higher in T2DMG than in SG (p=0.004). The S,R,D parameters related to the AP lesion were different between the groups. No difference was found between the two groups when periodontal measurements were compared (p=0.059). Results: The frequency of AP was found to be increased in T2DM patients. However, the success of root canal filled teeth was lower in T2DM patients. Inadequate root canal filling may cause an increase in AP prevalance.