title: Glycated hemoglobin levels and prevalence of apical periodontitis in type 2 diabetic patients.
abstract: BACKGROUND
  The purpose of this investigation was to study the possible association between the prevalence of apical periodontitis (AP) and the glycemic control of type 2 diabetic patients.
  
  
  METHODS
  In a cross-sectional study, the radiographic records of 83 type 2 diabetic patients were examined. Glycemic control was assessed by the mean glycated hemoglobin (HbA1c level). AP was diagnosed as radiolucent periapical lesions (RPLs) using the periapical index score. The Student t test, chi-square test, and logistic regression analysis were used in the statistical analysis.
  
  
  RESULTS
  Based on the HbA1c levels, 2 groups of diabetic patients were established: the HbA1c good control group (GCG, n = 24, HbA1c <6.5%) and the HbA1c poor control group (PCG, n = 59, HbA1c ≥6.5%). In the total sample, RPLs in 1 or more teeth were found in 62.7%, and no significant differences between GCG and PCG groups were observed (P = .13). At least 1 root-filled tooth was found in 32.5% of diabetic patients; this percentage was comparable in both HbA1c groups (P = .68). The prevalence of RPLs in RFT (29.6%) was similar in the GCG compared with the PCG (P = .94). Multivariate logistic regression analysis showed that worse periapical status correlated significantly with HbA1c levels ≥6.5% in type 2 diabetic patients (odd ratio = 3.8; 95% confidence interval, 1.1-13.0; P = .03).
  
  
  CONCLUSIONS
  HbA1c levels of diabetic patients are associated with periapical status. Data reported in the present study, together with the results of previous studies, further support a relationship between glycemic control and periapical inflammation in diabetic patients.
authors: Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain.
authors: Benito
authors: B
authors: Sánchez-Domínguez
authors: Department of Odonto-stomatology, School of Dentistry, University of Barcelona, Barcelona, Spain.
authors: José
authors: J
authors: López-López
authors: Department of Odonto-stomatology, School of Dentistry, University of Barcelona, Barcelona, Spain.
authors: Enric
authors: E
authors: Jané-Salas
authors: Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain.
authors: Lizett
authors: L
authors: Castellanos-Cosano
authors: Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain.
authors: Eugenio
authors: E
authors: Velasco-Ortega
authors: Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain. Electronic address: segurajj@us.es.
authors: Juan José
authors: JJ
authors: Segura-Egea
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000150:complications*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010485:Periapical Periodontitis / Q000150:complications*
chemical_list: D006442:Glycated Hemoglobin
keywords: Apical periodontitis; diabetes mellitus; endodontics; glycemic control; glycosylated hemoglobin; periapical inflammatory response