Impact of diabetes mellitus on dental pulp tissue pathosis - A scoping review

Diabetes mellitus alters dental pulp tissue response through complex inflammatory and calcification processes, yet the full scope of these effects remains incompletely mapped.

To chart the evidence regarding diabetes mellitus' impact on dental pulp tissue pathosis, identify patterns in inflammatory, vascular, and mineralization changes, examine differences between Type 1 Diabetes and Type 2 Diabetes effects, assess the influence of glycemic control on pulpal outcomes, and identify knowledge gaps for future research.

This scoping review followed PRISMA-ScR guidelines and searched Medline, Scopus, Web of Science, and Ebscohost up to August 2024. Two independent reviewers screened studies and extracted data, with a third resolving discrepancies.

Of 609 identified records, 30 met inclusion criteria (13 human, 17 animal studies). Human studies revealed increased inflammatory responses characterized by elevated cytokine levels, thickened blood vessels, and reduced endothelial cells. Older people living with diabetes showed a higher incidence of pulp stones and symptomatic irreversible pulpitis. Animal studies demonstrated severe inflammatory responses, decreased antioxidant activity, and increased calcification. Poorly controlled diabetes was associated with more pronounced pathological changes.

Diabetes mellitus significantly impacts dental pulp through multiple pathways affecting inflammation, vascular structure, and mineralization. Glycemic control emerges as a key modifiable factor, supporting the integration of diabetes status into endodontic treatment planning.