Diabetes mellitus, periapikal enfeksiyon ve kök kanalý tedavisi iliþkisi

Diabetes mellitus (DM) en yaygýn metabolik bozukluklardan biridir. DM, yara iyileþmesinde güçlükler, sistemik ve aðýz içinde özellikle pulpa bütünlüðü üzerinde doðrudan etkisi görülen hiperglisemi ile karakterizedir. Yapýlan çalýþmalar kontrolsüz diyabet hastalarýnda kök kanal tedavisi ihtiyacýnýn, periapikal lezyon yaygýnlýðýnýn, kemik kayýplarýnýn ve kök kanal tedavisi sonrasý baþarýsýzlýðýn daha yüksek olduðunu göstermektedir. Hiperglisemi, pulpa dokusunda bozulmuþ kan dolaþýmý ve iskemi sonucunda nekroz riskinin artmasýna, buna ek olarak diþ aðrýsý ve hassasiyetlerin artmasýna neden olmaktadýr. Hipergliseminin kemik erimesini arttýrýp, osteoblastik aktiviteyi azalttýðý moleküler düzeyde açýklansa da DM ve kemik metabolizmasý arasýndaki iliþki tam olarak anlaþýlamamýþtýr. DM’nin sistemik etkilerinin yaný sýra aðýz saðlýðý ile iliþkisini bilmek, kök kanal tedavisinin teþhis, tedavi ve takibinde büyük önem taþýmaktadýr.

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.