# Histological Aspects Regarding Dental Pulp of Diabetic Patients
## 3 Results  
In total, 23 dental pulp specimens of 23 type 2 diabetic patients were evaluated, among them, 80% were women, 42% of the patients were aged between 36-55 years, and 58% were aged between 56-70 years old. We compared the histological aspects of dental pulp specimens of type 2 diabetic patients with the image of the pulp of a healthy 47 year old female, with no clinical signs of pulpitis (Figure 1). In her case, the dental pulp was extracted before the prosthetic preparation of the tooth. The histopathological study of the dental pulp specimens obtained from patients with diabetes showed the presence of chronic or acute inflammatory infiltrate, mainly formed by neutrophils, plasma cells and macrophages. Inflammatory infiltrate appeared most often diffused, dissociating the collagen fibers from the dental pulp. In some cases, the inflammatory infiltrate was much more abundant or associated with pulp microcalcifications. Eight of the histological specimens analyzed are presented below. Figure 2 shows the aspect of the dental pulp of a 36 year old male with type II diabetes since 2015, Hb 193 mg/dl and HbA1c 7.3%. Despite the young age of the patient, the histological aspect of the dental pulp shows diffuse inflammatory infiltrate, fibrosis and small dystrophic calcifications, with numerous neutrophils, relative few eosinophils, lymphocytes and plasma cells. Figure 1: The corono-radicular pulp tissue of a healthy 47 year old female, with discrete leukocyte infiltration, few areas of sclerosis, HE staining, \(\times\)100. Figure 3 illustrates the histological aspect of the dental pulp of a 47 year old female with type II diabetes from 2009, with Hb 188 mg/dl and HbA1c 6.9%. Pulp sclerosis is present with few inflammatory cells, thickened walls of blood vessels, dystrophic calcifications and degeneration of the nerves, probably due to the development of the chronic inflammatory process. Figure 3: Coronal dental pulp aspect of a 47 year old female, type 2 diabetes HE staining, \(\times\)200. Figure 2: Dental pulp aspect (coronal) of a 36 year old male, type 2 diabetes, HE staining, \(\times\)200. Figure 4 shows the aspect of the dental pulp of a 49 year old patient, male with type II diabetes since 2008 and poor oral hygiene, with Hb 229 mg/ml and HbA1c 8.73%, suggesting poorly controlled diabetes at the moment of dental evaluation. There can be noted moderate inflammatory infiltrate with neutrophils and histiocytes, pupal sclerosis and irregular microcalcifications. Figure 5 illustrates the histologic aspect of the dental pulp of a female patient, 57 year old, with type II diabetes from 2006, Hb 296 mg/dl, HbA1c 11.82%, poor oral hygiene and many carious teeth. The histological aspect shows abundant diffuse acute inflammatory infiltrate and degenerated nervous fibers. Figure 6 illustrates the histologic aspect of the dental pulp of a 57 year old female with uncontrolled type II diabetes from 2010, Hb 354 mg/dl and HbA1c 12.02%. The aspect of the dental pulp sections suggests diffuse inflammatory infiltrate, dilated vessels with thickened walls and neutrophils in their lumen. Diffuse pulp calcifications are also present, among small necrotic areas. Figure 7 illustrates the dental pulp aspect of a 65 year old man with poorly controlled type 2 diabetes from 2005, having Hb 278 mg/dl and HbA1c 9.56%. The histological aspect shows important pulp sclerosis and irregular dystrophic calcification. Moreover, it can be noticed that there are abundant diffuse inflammatory infiltrate, a few eosinophils, plasma cells, lymphocytes and histiocytes. Figure 8 shows the coronal histological aspect of the dental pulp of a 67 year old female with type 2 diabetes from 2007, having Hb 198 mg/dl and HbA1c 7.92%. The histological aspect shows acute inflammatory infiltrate, sclerosis and dystrophic calcifications. Figure 9 shows the histological aspect of the dental pulp tissue of a 70 year old female with type II diabetes from 2001, Hb 212 mg/dl and HbA1c 9.46%.