Sudden improvement of insulin sensitivity related to an endodontic treatment.

Abstract

BACKGROUND:

Inflammation contributes to the pathogenesis of diabetes. A reciprocal relationship exists between diabetes and chronic periodontitis. This report describes the effects of an acute focal dental inflammation and subsequent endodontic treatment on the required insulin dosage of a 70-year-old man who had moderately controlled diabetes.

METHODS:

Following an exacerbation of a combined endodontic-periodontic (endo-perio) lesion of tooth #3, the patient noticed a sudden increase in his insulin demand. After 3 weeks, the required dosage was approximately 100% greater. In association with hyperglycemic incidents, he reported a prickling sensation in this tooth. The radiograph showed circular bone loss around the tooth.

RESULTS:

Just 1 day after the root-canal preparation, the insulin need decreased to approximately 50% of that required prior to treatment. Subsequently, an incision and systemic antibiotics were necessary because of the formation of a periodontal abscess. The insulin demand remained low despite this complication. Forty days after endodontic treatment, the insulin dosage was at a level comparable to that taken 4 weeks before the root-canal preparation.

CONCLUSIONS:

This clinical case revealed a highly relevant correlation between insulin resistance and a local dental inflammation. To avoid an increase in insulin resistance, it seems important to attend to radically non-vital teeth as well as any other dental inflammation in diabetic patients.

• Authors: A Schulze, M Schönauer, M Busse
• Journal: Journal of periodontology (J Periodontol) Vol. 78 Issue 12 Pg. 2380-4 (Dec 2007) ISSN: 0022-3492 [Print] United States
• PMID: 18052712 (Publication Type: Case Reports, Journal Article)

Topics

• Aged
• Dental Care for Chronically Ill
• Diabetes Mellitus, Type 2
• Humans
• Insulin Resistance
• Male
• Periapical Periodontitis (complications, therapy)
• Root Canal Therapy