Effect of Diabetes on Rotary Instrumentation of Dentin
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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 I (D1) and diabetic type II (D2) exhibited an increased amount of dentin removed when compared to the non-diabetic dentin specimens.

This study by the Journal of Endodontics aimed to compare the amount of dentin removed by an endodontic rotary file, comparing dentin from diabetic patients to dentin from control patients under laboratory conditions.

The amount of dentin removed was tested using new F2 ProTaper files applied against the surface of prepared dentin disks for three different groups; diabetic type I (D1), diabetic type II (D2), and non-diabetic (Normal). Dentin removal 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, ANOVA, Post-Hoc Tukey, and Pearson Correlation tests.

--Significantly more dentin was removed and the penetration of the F2 instrument was significantly higher in DM specimens.

--The statistical analysis revealed significant differences between D1, D2, and Normal groups for the weight loss of the specimen, as well as the penetration depth at point B.

--Both the weight loss and depth of penetration showed a very high positive correlation.

In conclusion, the dentin of patients suffering from both D1 and D2 exhibited an increased amount of dentin removed when compared to the non-diabetic 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 a subsequent weakening of root canal-treated teeth in diabetic patients.

Source: https://doi.org/10.1016/j.joen.2021.03.019
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