From Hyperglycemic Homeostatic Failure to Oral Rehabilitation: A Comprehensive Review of Evidence-Based Protocols for the Prosthodontic, Endodontic, and Orthodontic Management of the Diabetic Patient

Abstract

Diabetes Mellitus (DM) is a chronic, multi-systemic metabolic disorder characterized by persistent hyperglycemia resulting from defects in insulin secretion, insulin action, or both. As of 2024, the global burden of diabetes has reached epidemic proportions, affecting nearly 570 million individuals, with a rising incidence in pediatric and adolescent populations. For the dental practitioner, DM is not merely a background medical condition but a critical determinant of oral health outcomes. The disease shares a bidirectional relationship with periodontal health, influences the success of prosthodontic rehabilitation, complicates endodontic healing, and alters orthodontic force mechanics. This comprehensive review elucidates the pathophysiology of DM, its systemic and oral manifestations, and provides evidence-based protocols for dental management, emphasizing the role of the dentist in the interdisciplinary care team.