Diabetes mellitus and reparative response of dental pulp

Abstract

Anatomically, dental pulp is connective tissue and specific microcirculatory system with significant reparatory abilities intending to preserve pulp vitality. Various therapeutic approaches in the treatment of affected pulp may be compromised by various factors leading to treatment failure. Due to microcirculatory system disorders, treatment of affected dental pulp in patients with diabetes mellitus (DM) is additional challenge. The function and levels of growth factors could be altered in various diabetic tissues including dental pulp. Among them are growth factors important for reparative response of the pulp. There are experimental evidences that DM impede dental pulp reparation. Therefore, clinical procedures aiming to preserve vitality of diabetic dental pulp should be applied with caution. The aim of this paper is to present basic factors and parameters that affect reparative response of dental pulp in patients with DM.

Zubna pulpa je vezivno tkivo i poseban mikrocirkulatorni sistem sa značajnim reparatornim sposobnostima u cilju očuvanja njenog vitaliteta. Terapijski postupci u lečenju obolele pulpe mogu da budu kompromitovani delovanjem brojnih faktora koji mogu uticati na ishod lečenja. Zubna pulpa kod pacijenata sa dijabetes melitusom (DM), zbog mikrocirkulatornih poremećaja često predstavlja poseban terapijski izazov. Poznato je da funkcije i nivoi faktora rasta mogu biti promenjeni u dijabetičnim tkivima, pa samim tim i u zubnoj pulpi. Ovde su od najveće važnosti faktori rasta značajni za regulaciju reparatornog odgovora pulpe. Postoje eksperimentalni dokazi da DM umanjuje reparativnu aktivnost zubne pulpe, pa zbog toga kliničke procedure vezane za očuvanje vitaliteta dijabetične zubne pulpe treba realizovati uz značajne mere opreza. Cilj ovog rada je da se predstave osnovni faktori i parametri koji utiču na reparatorni odgovor pulpe zuba kod obolelih od DM.