title: Association between diabetes and the prevalence of radiolucent periapical lesions in root-filled teeth: systematic review and meta-analysis.
abstract: BACKGROUND
  The question of whether diabetes mellitus can influence the outcome of root canal treatment (RCT) remains unclear. The aim of this systematic review and meta-analysis was to analyze scientific available evidence on the association between diabetes and the presence of radiolucent periapical lesions (RPLs) in root-filled teeth (RFT).
  
  
  METHODS
  The review question was as follows: in adult patients who had endodontically treated teeth, does the absence or presence of diabetes result in an increase in the prevalence of RPL associated to RFT? A systematic MEDLINE/PubMed, Wiley Online Database, Web of Science, and Scopus search was conducted using the following MeSH and keywords: Diabetes Mellitus OR Diabetes OR Diabetic OR Hyperglycemia, AND Endodontics, Periapical Periodontitis, Periapical Diseases, Apical Periodontitis, Periradicular Lesion, Periapical Radiolucency, Radiolucent Periapical Lesion, Root Canal Treatment, Root Canal Preparation, Root Canal Therapy, Root Filled Teeth, Endodontically Treated Teeth. Seven studies reporting data on the prevalence of RPL associated to RFT both in diabetic and control subjects were included.
  
  
  RESULTS
  After the study selection, seven epidemiological studies fulfilled the inclusion criteria, representing data from 1593 root canal treatments, 1011 in non-diabetic control subjects, and 582 in diabetic patients. The calculated pooled odds ratio (OR = 1.42; 95 % CL = 1.11-1.80; p = 0.0058) indicates that diabetic patients have higher prevalence of RFT with RPLs than controls.
  
  
  CONCLUSIONS
  Available scientific evidence indicates that diabetes is significantly associated to higher prevalence of periapical radiolucencies in endodontically treated teeth, being an important putative pre-operative prognostic factor in RCT.
  
  
  CONCLUSIONS
  Taking into account that diabetes is the third most prevalent chronic medical condition among dental patients, endodontic providers should be aware of the relationship between the outcome of endodontic treatment and diabetes.
authors.affiliation: Endodontic Section, Department of Stomatology, School of Dentistry, University of Sevilla, Seville, Spain. segurajj@us.es.|Facultad de Odontología, Universidad de Sevilla, C/ Avicena s/n, 41009, Seville, Spain. segurajj@us.es.
authors.forename: Juan J
authors.identifier: http://orcid.org/0000-0002-0427-9059
authors.initials: JJ
authors.lastname: Segura-Egea
authors.affiliation: Endodontic Section, Department of Stomatology, School of Dentistry, University of Sevilla, Seville, Spain.
authors.forename: Jenifer
authors.initials: J
authors.lastname: Martín-González
authors.affiliation: Endodontic Section, Department of Stomatology, School of Dentistry, University of Sevilla, Seville, Spain.
authors.forename: Daniel
authors.initials: D
authors.lastname: Cabanillas-Balsera
authors.affiliation: Department of Endodontics, University of North Carolina, Chapel Hill, USA.
authors.forename: Ashraf F
authors.initials: AF
authors.lastname: Fouad
authors.affiliation: Comprehensive Dentistry, Department of Stomatology, School of Dentistry, University of Sevilla, Seville, Spain.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Velasco-Ortega
authors.affiliation: Oral Medicine, Department of Odontostomatology, School of Dentistry, University of Barcelona, Barcelona, Spain.
authors.forename: José
authors.initials: J
authors.lastname: López-López
mesh_terms: D003920:Diabetes Mellitus; D006801:Humans; D010483:Periapical Diseases / Q000453:epidemiology*; D015995:Prevalence; D012390:Root Canal Therapy
keywords: Diabetes mellitus; Meta-analysis; Periapical inflammation; Persistent apical periodontitis; Root canal treatment outcome; Root-filled teeth