背景:目前,糖尿病(DM)的发病率在全球范围内逐渐增加。在临床实践中,许多糖尿病伴根尖周炎(AP)患者的根尖周病变愈合不良且缓慢。然而,2之间的潜在关系仍不清楚和有争议。共识是DM可以被认为是牙髓治疗牙齿中AP的危险因素。因此,我们汇集了现有的研究,并进行了一项荟萃分析,以探讨2项之间的潜在关联.
方法:从数据库中选择符合纳入标准的研究,并提取相关数据。采用StataSE17.0软件对相关数据进行分析,使用纽卡斯尔-渥太华量表评估文献质量。具有95%置信区间(CI)的合并比值比(OR)用于确定DM与根管治疗(RCT)后AP患病率之间的关联强度。
结果:搜索后,检索到262项相关研究,其中15个符合纳入标准。该荟萃分析共包括1087例2226颗牙齿的患者。根据调查结果,糖尿病患者在RCT后的AP患病率高于对照组(OR=1.51,95%CI=1.22-1.87,P<0.01)。在患者层面,DM使RCT牙齿发生AP的概率增加3倍以上(OR=3.38,95%CI=1.65~6.93,P<.01)。此外,通过血糖状态进行亚组分析,术前AP,和研究设计。除了血糖的状态,其他2组比较差异有统计学意义(P<0.05)。
结论:现有的科学证据表明,在牙髓治疗的牙齿中,DM可能会增加AP的风险。在患有术前AP的牙齿中,DM可能会促进AP的发展。
BACKGROUND: At present, the incidence of diabetes mellitus (DM) is gradually increasing globally. In clinical practice, many patients with diabetes with apical periodontitis (AP) have poor and slow healing of periapical lesions. However, the potential relationship between the 2 is still unclear and controversial. The consensus is that DM can be deemed a risk factor for AP in endodontically-treated teeth. Therefore, we pooled existing studies and carried out a meta-analysis to explore the potential association between the 2.
METHODS: Studies that met the inclusion criteria were selected from the database, and relevant data were extracted. Stata SE 17.0 software was used to analyze the relevant data, and the Newcastle-Ottawa Scale was used to assess the literature\'s quality. The pooled odds ratio (OR) with a 95% confidence interval (CI) was used to determine the strength of the association between DM and the prevalence of AP after root canal treatment (RCT).
RESULTS: After searching, 262 relevant studies were retrieved, fifteen of which met the inclusion criteria. A total of 1087 patients with 2226 teeth were included in this meta-analysis. According to the findings, diabetics showed a higher prevalence of AP after RCT than controls at the tooth level (OR = 1.51, 95% CI = 1.22-1.87, P < .01). At the patient level, DM increased the probability of developing AP in RCT teeth more than 3 times (OR = 3.38, 95% CI = 1.65-6.93, P < .01). Additionally, subgroup analysis was performed by blood glucose status, preoperative AP, and study design. Except for the status of blood glucose, the results were significant in the other 2 groups (P < .05).
CONCLUSIONS: Available scientific evidence suggests that DM may increase the risk of AP in endodontically-treated teeth. In teeth with preoperative AP, DM might promote the development of AP.