Internal Resorption in the Dentin-Pulpal Complex: An Etiological Link to the Metabolic Acidosis of Diabetes

Abstract

The etiology of internal resorption is not by bacteria or caries but most likely initiated from chronic pulpal inflammation (i.e., chronic pulpitis) following intrusive injury to the dental pulp by one or more of the following means: (1) Traumatic injury (i.e., the most likely etiology) which often involves the oral cavity and teeth. (2) Chemical injury may be by elevated dose fluoride use or from caustic products used in bleaching. (3) Thermal injury can be from habitual ingestion of very hot foods or regular rinsing with liquids at elevated temperature. (4) Mechanical injury is often the result of occlusal problems associated with clenching, grinding of the teeth, or TMJ dysfunction. (5) Systemic disease is implicated; most prominently diabetes producing a system-wide, low-grade, metabolic acidosis that can damage cellular systems of the dentin-pulpal complex. Changes in glucose metabolism of diabetes cause chronic release of low pH (acidic) mediators. The subsequent acidic environment suppresses odontoblasts and other cells that morph into them. Nonetheless, dentinogenesis by odontoblasts is the key controlling factor in the cellular metabolism of the dental pulp. However, alveolar bone and the activity of the osteoblast are more documented than with its parallel processes in the dental pulp. Decreasing the activity of these formative cells serves as the “control point” in supporting cellular equilibrium of both alveolar bone and the dental pulp.

Keywords: Internal resorption, diabetes, dental pulp, alveolar bone

Cite this Article

Flaer Paul J, Diehl Roberta L, Kirsh Edward R. Internal Resorption in the Dentin-Pulpal Complex: An Etiological Link to the Metabolic Acidosis of Diabetes. Research and Reviews: Journal of Dentistry (RRJoD). 2015; 6(2): 1–6p.