Glycated hemoglobin levels and prevalence of apical periodontitis in type 2 diabetic patients.

Introduction: The purpose of this investigation was to study the possible association between the prevalence of apical periodontitis (AP) and the glycemic control of type 2 diabetic patients.

Methods: In a cross-sectional study, the radiographic records of 83 type 2 diabetic patients were examined. Glycemic control was assessed by the mean glycated hemoglobin (HbA1c level). AP was diagnosed as radiolucent periapical lesions (RPLs) using the periapical index score. The Student t test, chi-square test, and logistic regression analysis were used in the statistical analysis.

Results: Based on the HbA1c levels, 2 groups of diabetic patients were established: the HbA1c good control group (GCG, n = 24, HbA1c <6.5%) and the HbA1c poor control group (PCG, n = 59, HbA1c ≥6.5%). In the total sample, RPLs in 1 or more teeth were found in 62.7%, and no significant differences between GCG and PCG groups were observed (P = .13). At least 1 root-filled tooth was found in 32.5% of diabetic patients; this percentage was comparable in both HbA1c groups (P = .68). The prevalence of RPLs in RFT (29.6%) was similar in the GCG compared with the PCG (P = .94). Multivariate logistic regression analysis showed that worse periapical status correlated significantly with HbA1c levels ≥6.5% in type 2 diabetic patients (odd ratio = 3.8; 95% confidence interval, 1.1-13.0; P = .03).

Conclusions: HbA1c levels of diabetic patients are associated with periapical status. Data reported in the present study, together with the results of previous studies, further support a relationship between glycemic control and periapical inflammation in diabetic patients.