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, reduced 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. • What is known about this research topic? • Diabetes mellitus induces systemic inflammatory and vascular changes that affect multiple organs including dental pulp tissue. • Previous studies have examined isolated aspects of diabetes-related pulp changes, but findings remain fragmented across different research methodologies. • What this study adds and its future implications? • This scoping review comprehensively maps evidence from 30 studies identifying pulpal microangiopathy as a specific microvascular complication of diabetes. • A mineralization paradox is revealed: diabetes promotes pathological calcification while impairing physiological repair processes. • These findings support integrating diabetes status into endodontic treatment planning and inform future targeted therapeutic strategies. New scoping review reveals diabetes significantly impacts dental pulp through microangiopathy & a mineralization paradox. Poor glycemic control worsens outcomes. Clinicians should integrate diabetes status into endodontic treatment planning. #Diabetes #Endodontics #OralHealth