Type 2 diabetes and the clinically normal pulp: An in vitro study.

Area of Science:

• Oral Biology
• Immunology
• Endocrinology

Background:

• Type 2 diabetes (T2D) is a systemic disease with known complications in various organs.
• The effects of T2D on the dental pulp, particularly in clinically normal teeth, are not fully understood.
• Investigating these effects is crucial for understanding pulp health in diabetic patients.

Purpose of the Study:

• To investigate the morphological and immunological changes in clinically normal dental pulp of individuals with T2D compared to non-diabetic individuals.
• To utilize special stains and immunohistochemistry (IHC) to assess pulp tissue and immune marker distribution.

Main Methods:

• Collected 20 extracted molar teeth (10 T2D, 10 non-T2D) with clinically normal pulp status.
• Employed histological stains (H&E, Masson's trichrome, van Gieson) for morphological analysis.
• Utilized IHC to evaluate the expression of immune cell markers (CD68, CD83, FOXP3) and inflammatory cytokines (IL1β, IL6, IL17, TNF-α), and innate inflammation markers (TLR2, TLR4).

Main Results:

• T2D dental pulp showed reduced cellularity, vascularity, increased calcification, and collagen deposition compared to non-T2D pulp.
• Significantly increased expression of macrophage (CD68) and dendritic cell (CD83) markers in T2D pulp.
• Elevated levels of inflammatory cytokines (IL1β, IL6, IL17, TNF-α) and innate inflammation markers (TLR2, TLR4) were observed in T2D samples.
• Decreased expression of the regulatory T-cell marker FOXP3 was noted in T2D pulp.

Conclusions:

• Type 2 diabetes induces significant morphological and immunological alterations in clinically normal dental pulp.
• These changes in the dental pulp mirror complications observed in other body sites affected by T2D.
• Hyperglycemia associated with T2D appears to be a key factor driving these pulp alterations.