Anupam Singh, Srikanth Gadicherla, Kalyana C Pentapati, Mehul Saha, Premalatha K Shetty, Aditya Shetty
There is a lack of scientific evidence to suggest that diabetic patients with well-controlled glycemic status may have poor healing or increased risk of complications after dental extraction. Overall, there is a need for high-quality studies and the need for coordinated, multidisciplinary, and transnational efforts among relevant stakeholders to develop clear, evidence-based guidelines to address this gap and clinical ambiguity. In this context, based on our findings, we have proposed stage-wise recommendations to streamline the management of diabetic patients during routine dental procedures, ensuring seamless and evidence-based workflow.
BACKGROUND: Diabetes mellitus is known to cause long-term microvascular and macrovascular changes. These changes along with compromised inflammatory response have been known to affect the wound healing. However, the influence of diabetes on the healing process after tooth extraction has not been clearly established. With this background, this systematic review was conducted to compare the healing of extraction sockets and postoperative complications between diabetics and nondiabetics (control).
METHODOLOGY: This systematic review was conducted as per the "MOOSE guidelines." A systematic search was performed in "PubMed," "Scopus," "EMBASE," and "Dentistry and Oral Sciences Source" databases. A comprehensive literature search that was conducted across multiple electronic databases yielded a total of 821 results. After removal of duplicates (n = 135) and screening, a total of five publications were included for data extraction.
RESULTS: A total of 500 diabetics and 364 controls were available from five included publications. Adjusted analysis reported that the mean socket size was larger among diabetics than the control group at the end of day 7. There was no significant difference in the distribution of delayed wound healing among diabetics and controls. With regard to complications like dry socket, bony sequestra, and infection, no statistical significance was established. On risk of bias assessment, one study was high quality, one was low quality, and the remaining three were of moderate quality.
CONCLUSION: There is a lack of scientific evidence to suggest that diabetic patients with well-controlled glycemic status may have poor healing or increased risk of complications after dental extraction. Overall, there is a need for high-quality studies and the need for coordinated, multidisciplinary, and transnational efforts among relevant stakeholders to develop clear, evidence-based guidelines to address this gap and clinical ambiguity. In this context, based on our findings, we have proposed stage-wise recommendations to streamline the management of diabetic patients during routine dental procedures, ensuring seamless and evidence-based workflow.