Impact of endodontic treatment of teeth with pulp necrosis and periapical lesion in patients with type II diabetes mellitus: Microbiological and tomographic evaluation

• Grant number: 24/17193-0
• Support Opportunities: Scholarships in Brazil - Doctorate
• Start date: July 01, 2025
• End date: September 30, 2026
• Field of knowledge: Health Sciences - Dentistry - Endodontics
• Principal Investigator: Flaviana Bombarda de Andrade
• Grantee: Mirela Cesar de Barros
• Host Institution: Faculdade de Odontologia de Bauru (FOB). Universidade de São Paulo (USP). Bauru , SP, Brazil
• Associated research grant: 23/10972-1 - Bacteriological and proteomic condition during endodontic treatment of teeth with necrotic pulps and periapical lesion in patients with type II diabetes mellitus: a randomized clinical trial, AP.R

Abstract

Apical periodontitis is an inflammatory disorder affecting the periradicular tissues in response to a polymicrobial infection in the root canal system (RCS) of the affected tooth. The relationship between oral health and diabetes mellitus (DM) has been widely discussed, and in the endodontic context, studies have shown that DM can influence both the pathogenesis and the prognosis of periapical diseases. This clinical study aims to evaluate differences between patients with type II DM and non-diabetic patients regarding the microbiological profile, lipopolysaccharide (LPS) levels in the root canals, and the reduction of periapical lesion volume after endodontic treatment. Thirty-four patients will be selected and divided into two groups (N=17): a group of patients diagnosed with type II DM and a control group of non-diabetic patients. All selected participants will receive conventional endodontic treatment performed by the same professional. Root canal samples will be obtained in three stages: at the start of treatment, after coronal opening (S1), after chemical-mechanical preparation (S2), and after removal of intracanal medication (S3), which will be performed in the second session. These samples will undergo quantitative microbiological analyses through culture, molecular methods, and LPS evaluation. Cone-beam computed tomography will be performed before treatment and six months and one year after its completion to monitor the regression of periapical lesions, correlating the lesion volume with other results. Data will be analyzed for normality and subsequently subjected to parametric or non-parametric tests to verify the null hypothesis that diabetic patients present the same microbiological conditions and apical healing as non-diabetic patients. (AU)