The production of reactive oxygen species (ROS) is elevated in diabetes, particularly amongst those who have poor glycemic control, and it has been hypothesized that increased ROS generation in longstanding diabetes might result in oxidative damage to DNA (Wyatt et al. 2006). Excessively high levels of free radicals cause damage to cellular proteins, membrane lipids and nucleic acids and eventually lead to cell death, events related to late diabetic complications (Maritim et al. 2003). Patients with diabetes present with oral manifestations such as xerostomia, taste impairment and salivary changes (Bernardi et al. 2007) that might affect the progression of certain diseases, such as dental caries, periodontal disease, soft tissue lesions and fungal infections (Manfredi et al. 2004). The literature on the pathogenesis, progression and healing of endodontic pathosis in patients with diabetes is scarce.
Diabetes altered the antioxidant system in dental pulp tissue, although astaxanthin partially improved the diabetic complications.
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