BACKGROUND Diabetes mellitus (DM) may affect the healing and survival of root filled teeth with periapical lesions. AIM To systematically analyse the available clinical literature to evaluate the association between DM and the prevalence of radiolucent periapical lesions in root filled teeth. The review question was 'Is there a difference between the root canal treatment healing outcome (in terms of presence or absence of radiolucent periapical lesions) in diabetic and non-diabetic patients?'. DATA SOURCES A systematic review of cross-sectional studies and prospective clinical trials was conducted according to the PRISMA checklist. The review involved a search of the electronic databases of PubMed, Scopus and EBSCO host. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS The research protocol was previously registered in the International Prospective Register of Ongoing Systematic Reviews (CRD42019130954) and included defined inclusion/exclusion criteria. The included studies were related to the root canal treatment outcome in diabetic patients in terms of periapical radiolucent lesions associated with root filled teeth. STUDY APPRAISAL AND SYNTHESIS The selected studies were critically analysed by two evaluators using the Joanna Briggs Institute Critical Appraisal tool. The pooled odds ratio (OR) was recognized as the primary outcome variable and measure of the effect for the occurrence of periapical lesions associated with root filled teeth of control and diabetic patients. The random-effects Mantel-Haenszel method was used, at a 95% confidence interval, to calculate the pooled OR. A funnel plot was created to evaluate possible sources of heterogeneity. RESULTS Ten studies published between 1989 and March 2019 were selected after thorough analysis and exclusion according to the strict criteria. Seven cross-sectional studies, 1 longitudinal and 2 prospective clinical studies were included. The pooled OR was calculated by comparing 773 diabetic subjects and 1133 control subjects. The pooled OR for the observational studies and clinical studies were 1.42 and 6.36, respectively. This value signified a high prevalence of periapical lesions in root filled teeth in diabetic subjects. LIMITATIONS There are limited prospective clinical trials on this topic. The majority of the included studies are observational. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS The data suggest a strong connection between the presence of periapical radiolucency on root filled teeth amongst diabetics as determined by the pooled OR.

中文翻译：

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糖尿病和根部填充牙根尖周病变的愈合：系统评价和荟萃分析。

背景糖尿病（DM）可能影响根尖周病变的根部填充牙齿的愈合和存活。目的 系统地分析现有的临床文献，以评估 DM 与根部填充牙齿中射线可透性根尖周病变的患病率之间的关系。审查问题是“糖尿病患者和非糖尿病患者的根管治疗愈合结果（就存在或不存在可透性根尖周病变而言）是否存在差异？”。数据来源 根据 PRISMA 检查表对横断面研究和前瞻性临床试验进行了系统评价。审查涉及搜索 PubMed、Scopus 和 EBSCO 主机的电子数据库。学习资格标准，参与者和干预 该研究方案先前已在国际前瞻性系统评价注册库 (CRD42019130954) 中注册，并包括定义的纳入/排除标准。纳入的研究与糖尿病患者的根管治疗结果相关，即根尖周围的射线可透性病变与根填充牙齿相关。研究评估和综合 两位评估员使用 Joanna Briggs Institute 批判性评估工具对选定的研究进行了批判性分析。合并优势比 (OR) 被认为是主要结果变量，并衡量与对照和糖尿病患者的根部填充牙齿相关的根尖周病变发生的影响。使用随机效应 Mantel-Haenszel 方法，置信区间为 95%，计算合并的 OR。创建了一个漏斗图来评估异质性的可能来源。结果 1989 年至 2019 年 3 月发表的 10 项研究经彻底分析和严格标准排除后选出。包括 7 项横断面研究、1 项纵向研究和 2 项前瞻性临床研究。通过比较 773 名糖尿病受试者和 1133 名对照受试者来计算汇总 OR。观察性研究和临床研究的汇总 OR 分别为 1.42 和 6.36。该值表明糖尿病患者根部填充牙齿的根尖周病变的高发率。局限性 关于该主题的前瞻性临床试验有限。大多数纳入的研究是观察性的。