Prevalence and Recurrence of Multiple Periapical Cysts in Uncontrolled Diabetic Patients: A Retrospective Observational Study

Objective: This study aims to examine the prevalence and clinical characteristics of multiple periapical cysts in patients with uncontrolled diabetes, and to assess the association between poor glycemic control, oral hygiene, and cyst recurrence. Methods: A retrospective observational survey was conducted on 5000 diabetic patient records, identifying 2759 individuals with uncontrolled diabetes (HbA1c > 7%). Data were collected on patient demographics, oral hygiene status, presence and recurrence of periapical cysts, and relevant medical history. Oral hygiene was evaluated using DMFT and plaque index scores. Results: Among the 2759 uncontrolled diabetic patients, 2183 (79.1%) demonstrated poor oral hygiene, as indicated by low DMFT and high plaque index scores. Periapical cysts were identified in 983 patients (35.6%), with many exhibiting multiple cysts, particularly in posterior mandibular and maxillary regions. Additionally, 649 patients had a history of periapical cyst surgery, with 45.8% experiencing cyst recurrence, likely due to impaired healing associated with hyperglycemia. Patients also reported high rates of pain, swelling, and tooth mobility linked to cysts. Conclusion: Uncontrolled diabetes is strongly associated with poor oral hygiene, a higher prevalence of multiple periapical cysts, and an elevated rate of cyst recurrence post-surgery. These findings suggest that diabetic patients with poor glycemic control require targeted oral health interventions and close monitoring to prevent complications and improve outcomes. Further research on interventions to enhance wound healing and reduce recurrence in diabetic patients is warranted.