Diabetes in the Pathogenesis of Periapical Lesions

Background: Diabetes mellitus is a chronic metabolic disorder associated with impaired wound healing and increased susceptibility to infections. Its impact on the development and severity of periapical lesions is clinically significant due to altered immune response and inflammatory profiles.Objective: To investigate the relationship between diabetes mellitus and the pathogenesis of periapical lesions and compare lesion characteristics between diabetic and non-diabetic patients.Methods: A comparative cross-sectional study was conducted involving 100 patients divided into diabetic (n=50) and non-diabetic (n=50) groups. Diabetic status was confirmed using HbA1c ≥6.5%. Periapical lesions were evaluated using digital radiographs and graded by the Periapical Index (PAI). Histopathological assessments of tissue samples were performed for inflammation markers CD68 and IL-1β. Statistical analysis included independent t-tests, chi-square tests, and logistic regression using SPSS 26.Results: Diabetic patients showed a significantly higher number (72 vs. 45, p=0.01) and size (5.8 ± 2.1 mm vs. 3.4 ± 1.5 mm, p=0.001) of lesions. HbA1c >8% correlated with lesion size (8.4 ± 2.0 mm). Odds ratio for periapical lesions in diabetics was 3.5 (95% CI: 1.8-7.0, p=0.001).Conclusion: Diabetes mellitus is significantly associated with increased severity and prevalence of periapical lesions, especially in cases of poor glycemic control.