Effect of diabetes and hyperglycaemia on the physical and mechanical properties of dentine: a systematic review.

Objectives: The aim of this systematic review was to assess the effect of DM (Type 1 and Type 2 Diabetes) and hyperglycaemia on the physical and mechanical properties of dentine which is critical for successful endodontic treatment.

Method: An electronic search of the following databases: PubMed, MEDLINE, Web of Science and the grey literature was performed up until July 2024. In vitro and in vivo studies on the effect of DM or hyperglycaemia on the mechanical and physical properties of dentine were included. Non-English language literature was excluded.

Results: Of the 234 articles identified, 15 met the inclusion criteria. Four studies evaluated how artificially induced glycation or natural glycation of dentine due to aging affects the mechanical properties of dentine. Five studies investigated the influence of Type 2 Diabetes (T2D) on dentine's mechanical properties, while two studies focused on the effects of Type 1 Diabetes (T1D). A further, four studies compared the effects of both T1D and T2D on the dentine. The studies were heterogeneous and a range of mechanical and physical properties were evaluated.

Conclusion: DM and AGEs negatively influence the physical and mechanical properties of dentine however, there remains a paucity of evidence and further studies are needed.

Clinical significance: Diabetes Mellitus (DM) is a chronic metabolic disease characterised by hyperglycaemia, an altered immune response and complications associated with collagen connective tissues. DM can influence bone metabolism and alter its physical and mechanical properties via glycation processes within collagen and changes to osteoblast activities. While bone and dentine share similarities, dentine is unique as it is intimately associated with the dental pulp. Inflammation within the pulp can induce calcification and tertiary dentine deposition and so exploring the influence of DM on the mechanical properties of dentine is warranted to understand the clinical significance.