Sudden Improvement of Insulin Sensitivity Related to an Endodontic Treatment

• Autores: M. Busse, M. Schönauer, A. Schulze
• Localización: Journal of periodontology, ISSN 0022-3492, Vol. 78, Nº. 12, 2007, págs. 2380-2384
• Idioma: inglés
• Texto completo no disponible (Saber más ...)
• Resumen

  • Sudden Improvement of Insulin Sensitivity Related to an Endodontic Treatment A. Schulze,* M. Schönauer,* and M. Busse* *Institute of Sports Medicine, University of Leipzig, Leipzig Sachsen, Germany.

    Correspondence: Dr. Antina Schulze, Institute of Sports Medicine, Section Sports Dentistry, University of Leipzig, Marschner Str. 29, Leipzig Sachsen D-04109, Germany. Fax: 49-341-9731669; e-mail: A.Schulze@uni-leipzig.de.

    Background: Inflammation contributes to the pathogenesis of diabetes. A reciprocal relationship exists between diabetes and chronic periodontitis. This report describes the effects of an acute focal dental inflammation and subsequent endodontic treatment on the required insulin dosage of a 70-year-old man who had moderately controlled diabetes.

    Methods: Following an exacerbation of a combined endodontic-periodontic (endo-perio) lesion of tooth #3, the patient noticed a sudden increase in his insulin demand. After 3 weeks, the required dosage was ∼100% greater. In association with hyperglycemic incidents, he reported a prickling sensation in this tooth. The radiograph showed circular bone loss around the tooth.

    Results: Just 1 day after the root-canal preparation, the insulin need decreased to ∼50% of that required prior to treatment. Subsequently, an incision and systemic antibiotics were necessary because of the formation of a periodontal abscess. The insulin demand remained low despite this complication. Forty days after endodontic treatment, the insulin dosage was at a level comparable to that taken 4 weeks before the root-canal preparation.

    Conclusions: This clinical case revealed a highly relevant correlation between insulin resistance and a local dental inflammation. To avoid an increase in insulin resistance, it seems important to attend to radically non-vital teeth as well as any other dental inflammation in diabetic patients.

    KEYWORDS: Diabetes, inflammation, insulin, periodontal diseases, systemic disease Cited by Benito Sánchez-Domínguez, José López-López, Enric Jané-Salas, Lizett Castellanos-Cosano, Eugenio Velasco-Ortega and Juan José Segura-Egea. (2015) Glycated Hemoglobin Levels and Prevalence of Apical Periodontitis in Type 2 Diabetic Patients. Journal of Endodontics.

    Online publication date: 1-Feb-2015.

    CrossRef Jean-Pierre Dibart. 2013. Diabetes and Periodontitis. Practical Osseous Surgery in Periodontics and Implant Dentistry, 11-16.

    CrossRef Luciano Tavares Angelo Cintra, Aguinaldo Cândido Silva Facundo, Mariane Maffei Azuma, Dóris Hissako Sumida, Rafael Dias Astolphi, Suely Regina Mogami Bomfim, Luís Gustavo Narciso and João Eduardo Gomes-Filho. (2013) Pulpal and periodontal diseases increase triglyceride levels in diabetic rats. Clinical Oral Investigations 17, 1595-1599.

    Online publication date: 1-Jul-2013.

    CrossRef S. M. F. Lima, D. C. Grisi, E. M. Kogawa, O. L. Franco, V. C. Peixoto, J. F. Gonçalves-Júnior, M. P. Arruda and T. M. B. Rezende. (2013) Diabetes mellitus and inflammatory pulpal and periapical disease: a review. International Endodontic Journal, n/a-n/a.

    Online publication date: 1-Feb-2013.

    CrossRef Martin G. Lazenby and Martin A. Crook. (2010) The innate immune system and diabetes mellitus: the relevance of periodontitis? A hypothesis. Clinical Science 119, 423-429.

    Online publication date: 5-Aug-2010.