ASSOCIATION BETWEEN THE SEVERITY OF PERIODONTITIS AND THE PREVALENCE OF PERIAPICAL LESIONS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Abstract

This study addresses the interaction between the chronic metabolic condition of Type 2 Diabetes Mellitus (T2DM) and the progression of oral pathologies, specifically apical periodontitis (AP) and periapical lesions (PL), aiming to improve clinical management. The objective was to analyze and integrate the most recent scientific findings investigating the association between T2DM and the prevalence and severity of AP and PL, providing an updated understanding of this relationship. This is an integrative literature review conducted through searches in PubMed/MEDLINE, SciELO, LILACS, and Google Scholar, using descriptors such as “Type 2 Diabetes Mellitus” and “Apical Periodontitis.” A total of 15 full-text articles published between 2015 and 2025 and directly addressing the relationship between T2DM and periapical lesions were selected. The findings consistently demonstrate that T2DM is associated with a higher prevalence of AP/PL, with poor glycemic control (HbA1c > 8.0%) being a significant risk factor. Although untreated teeth show an elevated risk, high-quality endodontic treatment can mitigate the negative effects of diabetes. Diabetic patients also exhibit a greater likelihood of persistent lesions due to proteomic alterations that promote chronic inflammation. It is concluded that T2DM is an independent risk factor that directly affects periapical health, making strict metabolic control essential. Technical quality in endodontic treatment and adequate systemic management work together to ensure a favorable prognosis, demanding an integrated approach between dental and medical care.