Non-Cochrane · prognostic · PM41578902
The association between poor glycemic control and apical periodontitis: A systematic review and meta-analysis.
Wang X, Guo S, Yu X, et al. · Medicina oral, patologia oral y cirugia bucal · 2026 · PubMed · doi:10.4317/medoral.27997
Findings
Population Diabetic patients (adults) with apical periodontitis outcomes assessed
4 findings
| Poor glycemic control (HbA1c above about 6.5%, 7% or 8%) as exposure | Good glycemic control in diabetic patients or non-diabetic individuals | Persistence of apical periodontitis in root-filled teeth (AP-RFT) Dental clinics (radiographic assessment) | OR 2.74 [2.03, 3.70] GRADE not reported 8 studies · 4129 participants |
| Poor glycemic control (HbA1c above about 6.5%, 7% or 8%) as exposure | Good glycemic control in diabetic patients or non-diabetic individuals | Prevalence of apical periodontitis (AP) Dental clinics (radiographic assessment) | OR 2.38 [1.98, 2.86] GRADE not reported 6 studies · 3724 participants |
| Poor glycemic control (HbA1c above about 6.5%, 7% or 8%) as exposure | Good glycemic control in diabetic patients or non-diabetic individuals | Persistence of apical periodontitis in root-filled teeth (AP-RFT) Dental clinics (radiographic assessment) · Cross-sectional studies | OR 2.07 [1.43, 2.98] GRADE not reported 5 studies · 3804 participants |
| Poor glycemic control (HbA1c above about 6.5%, 7% or 8%) as exposure | Good glycemic control in diabetic patients or non-diabetic individuals | Persistence of apical periodontitis in root-filled teeth (AP-RFT) 1 year follow-up · Dental clinics (radiographic assessment) · Prospective cohort / 1-year follow-up | OR 4.97 [2.88, 8.55] GRADE not reported 3 studies · 325 participants |
Included primary studies 18
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Silva 2021 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Aldoss 2023 Bacterial quantity and interleukin‐17 expression in necrotic teeth with apical periodontitis from type II diabetic patients DOI:10.1111/iej.13927 | 2023 | this review only | not stated | not extracted yet |
| Arya 2017 Healing of Apical Periodontitis after Nonsurgical Treatment in Patients with Type 2 Diabetes DOI:10.1016/j.joen.2017.05.013 | 2017 | this review only | Persistence of apical periodontitis in root-filled teeth (AP-RFT); PM41578902-P2-O1 | not extracted yet |
| Barros 2025 Impact of Type 2 Diabetes Mellitus on Apical Periodontitis Size, Endotoxin Levels, and Bacterial Load in Root Canals with Necrotic Pulp DOI:10.1016/j.joen.2025.05.003 | 2025 | this review only | Prevalence of apical periodontitis (AP) | not extracted yet |
| Davidovic 2024 Effects of apical periodontitis treatment on hyperglycaemia in diabetes: A prospective cohort study DOI:10.1111/iej.14068 | 2024 | this review only | Persistence of apical periodontitis in root-filled teeth (AP-RFT); PM41578902-P2-O1 | not extracted yet |
| Dhamija 2025 Association of Apical Periodontitis with Glycated Hemoglobin Levels and Systemic Inflammatory Markers in Patients with Type 2 Diabetes: A… DOI:10.1016/j.joen.2024.11.008 | 2025 | this review only | not stated | not extracted yet |
| Lopez-Lopez 2011 Periapical and Endodontic Status of Type 2 Diabetic Patients in Catalonia, Spain: A Cross-sectional Study DOI:10.1016/j.joen.2011.01.002 | 2011 | this review only | Prevalence of apical periodontitis (AP); Persistence of apical periodontitis in root-filled teeth (AP-RFT); PM41578902-P2-O1 | not extracted yet |
| Loureiro 2022 Proteomic analysis of infected root canals with apical periodontitis in patients with type 2 diabetes mellitus: A cross‐sectional study DOI:10.1111/iej.13794 | 2022 | this review only | not stated | not extracted yet |
| Marica 2024 Impact of type 2 diabetes mellitus on the prevalence of apical periodontitis in endodontically treated and untreated teeth DOI:10.25122/jml-2024-0330 | 2024 | this review only | Prevalence of apical periodontitis (AP); Persistence of apical periodontitis in root-filled teeth (AP-RFT); PM41578902-P2-O1 | not extracted yet |
| Perez-Losada 2020 Apical periodontitis and glycemic control in type 2 diabetic patients: Cross-sectional study. PMID:33154799 | 2020 | this review only | Prevalence of apical periodontitis (AP); Persistence of apical periodontitis in root-filled teeth (AP-RFT); PM41578902-P2-O1 | not extracted yet |
| Rudranaik 2016 Periapical healing outcome following single visit endodontic treatment in patients with type 2 diabetes mellitus. PMID:27957260 | 2016 | this review only | Persistence of apical periodontitis in root-filled teeth (AP-RFT); PM41578902-P2-O1 | not extracted yet |
| Salceanu 2025 Influence of Diabetes on Periapical Pathology in Treated and Untreated Teeth: A Cross-Sectional Comparison with Non-Diabetic Patients. PMID:40507669 | 2025 | this review only | not stated | not extracted yet |
| Sanchez-Dominguez 2015 Glycated Hemoglobin Levels and Prevalence of Apical Periodontitis in Type 2 Diabetic Patients DOI:10.1016/j.joen.2014.12.024 | 2015 | this review only | Prevalence of apical periodontitis (AP) | not extracted yet |
| Sarmento 2020 Immunoexpression of bone resorption biomarkers in apical periodontitis in diabetics and normoglycaemics DOI:10.1111/iej.13305 | 2020 | this review only | not stated | not extracted yet |
| Sarmento 2023 Proinflammatory Cytokine Expression in Apical Periodontitis from Diabetic Patients DOI:10.1155/2023/4961827 | 2023 | this review only | not stated | not extracted yet |
| Sisli 2019 Evaluation of the Relationship between Type II Diabetes Mellitus and the Prevalence of Apical Periodontitis in Root-Filled Teeth Using… DOI:10.1159/000500472 | 2019 | this review only | Persistence of apical periodontitis in root-filled teeth (AP-RFT); PM41578902-P2-O1 | not extracted yet |
| Smadi 2017 Apical Periodontitis and Endodontic Treatment in Patients with Type II Diabetes Mellitus: Comparative Cross-sectional Survey DOI:10.5005/jp-journals-10024-2046 | 2017 | this review only | Prevalence of apical periodontitis (AP); Persistence of apical periodontitis in root-filled teeth (AP-RFT); PM41578902-P2-O1 | not extracted yet |
| Wang 2011 Impact of Diabetes Mellitus, Hypertension, and Coronary Artery Disease on Tooth Extraction after Nonsurgical Endodontic Treatment DOI:10.1016/j.joen.2010.08.054 | 2011 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Efficacy of various interventions for the management of white spot lesions associated with fixed orthodontic treatment: a systematic… (2026) | 1 | 0.01 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Diabetic patients (aged 18 years or older) | Patients with type 2 diabetes mellitus (n=18 studies, about 51,070 participants/teeth) |
| Intervention | Exposure: poor glycemic control (HbA1c above 6.5%, 7% or 8%) | Poor glycemic control by HbA1c (about 6.5% in 12 studies, 7.0-7.5% in 5, about 8% in 1) |
| Comparison | Diabetic patients with good glycemic control or non-diabetic individuals | Non-diabetic individuals or diabetic patients with good glycemic control |
| Outcomes | Prevalence of apical periodontitis; persistence of AP in root-filled teeth; local or systemic immune-inflammatory responses | AP prevalence (n=6 pooled); AP-RFT persistence (n=8 pooled); immune, proteomic and microbiological markers (n=6, narrative) |
| Study designs | Cross-sectional, case-control, cohort and longitudinal studies in humans | 4 prospective cohort studies; 14 cross-sectional studies |
| Timing | Published July 2005 to June 2025 | 1-year follow-up (3 cohorts); cross-sectional |