Diabetes Mellitus and the Prevalence of Periapical Periodontitis in a Scottish Subpopulation

  • Ryan F. Higgins

Student thesis: Master's ThesisMaster of Dental Science


Aim: To assess the prevalence of periapical periodontitis in patients with diabetes mellitus, compare this against patients without a diagnosis of diabetes mellitus, and to evaluate the relationship between periapical periodontitis and glycosylated haemoglobin levels.

Methodology: This is a cross-sectional case-controlled study which has examined the medical and dental records for 503 patients with diabetes mellitus (DM) and 503 control patients. Dental panoramic radiographs (DPRs) were assessed for periapical periodontitis (PP) using a modified periapical index score. Number of teeth, horizontal alveolar bone level, and number of root canal fillings were also assessed from these radiographs. In the diabetic group, glycosylated haemoglobin (HbA1c) levels were reviewed and analysed with the data obtained from the radiographs. Statistical analyses were undertaken using Cohen’s κ test, analysis of variance, independent t-tests (95% CI), and multiple regression.

Results: In the diabetic group there was a mean number of teeth with periapical periodontitis of 1.14 (95% CI; 0.92, 1.32) per patient, compared with 0.87 (95% CI; 0.75, 0.99) in the control group (p = 0.021). In diabetic patients with HbA1c levels ≥ 9% the mean number of teeth with periapical periodontitis was 1.8, compared with 1.0 in diabetic patients with HbA1c levels < 9% (p = 0.002). The mean number of teeth per patient was 18.57 in the diabetic group and 20.51 in the control group (p = 0.003).

Conclusion: On average, patients with diabetes mellitus have fewer teeth, but a greater proportion of teeth with periapical periodontitis, when compared with non-diabetic patients. As a group, diabetic patients with high levels of glycosylated haemoglobin (HbA1c ≥9%) have a greater number of teeth with periapical periodontitis than those with lower levels.
Date of Award2017
Original languageEnglish
SupervisorDavid Ricketts (Supervisor), Michaelina Macluskey (Supervisor) & William Saunders (Supervisor)

Cite this