Diabetes tied to increased penetration of rotary instruments into dentin in root canal procedures
Diabetes mellitus (DM) may affect the physical and mechanical properties of dentin, which could potentially have an impact on root canal procedures. The dentin of patients suffering from both diabetic type 1 (D1), diabetic type 2 (D2) exhibited an increased amount of dentin removed compared with the nondiabetic dentin specimens, reported a recent study published in the Journal of Endodontics.
The team of researchers led by Mohammad Ali Saghiri at the Biomaterial and Prosthodontic Laboratory, Department of Restorative Dentistry, Rutgers School of Dental Medicine, Newark, New Jersey aimed to compare the amount of dentin removed by an endodontic rotary file, comparing dentin from diabetic patients with dentin from control patients under laboratory conditions.
The amount of dentin removed was tested using new F3 ProTaper (Dentsply Maillefer, Ballaigues, Switzerland) files applied against the surface of prepared dentin discs for 3 different groups-
a. diabetic type 1 (D1),
b. diabetic type 2 (D2), and
c. nondiabetic (normal).
The dentin removed was determined by measuring the depth of penetration of the file using a digital caliper and by measuring the weight loss.
Data were analyzed using Kolmogorov-Smirnov, analysis of variance, post hoc Tukey, and Pearson correlation tests (P < .05).
The following findings were highlighted-
a. Significantly more dentin was removed, and the penetration of the F3 instrument was significantly higher (P < .05) in diabetes mellitus specimens.
b. The statistical analysis revealed significant differences between the type 1 and type 2 diabetes and normal groups (P < .05) for the weight loss of the specimen as well as the penetration depth at point B (P < .05).
c. Both the weight loss and depth of penetration showed a very high positive correlation (P < .05).
As a result, the authors concluded that the dentin of patients suffering from both D1 and D2 exhibited an increased amount of dentin removed compared with the nondiabetic dentin specimens.
This can be observed by the increased penetration of the rotary instruments into dentin. Under certain circumstances, this may impact instrumentation, increasing procedural accidents and leading to subsequent weakening of root canal–treated teeth in diabetic patients.
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