Efeitos sistêmicos da anestesia local odontológica em pacientes portadores de Diabetes Mellitus – revisão sistemática e meta-análise

Abstract

Diabetes Mellitus (DM) is a multifactorial chronic disease, characterized by metabolic alterations and failure in the action and/or production of insulin. Although different classifications are adopted, all forms of diabetes carry risks of complications. In dental practice, the management of these patients mainly refers to pain control with anesthetic solutions during different clinical procedures. Considering the risks associated with the use of these substances with or without vasoconstrictors, it is of great importance to evaluate the effect of these drugs in individuals with systemic alterations. Thus, the aim of this study was to evaluate the systemic effects of local dental anesthesia in patients with Diabetes Mellitus. This is a systematic literature review with meta-analysis, developed in accordance with the PRISMA statement. Randomized clinical trials retrieved from electronic databases and gray literature were included. Risks of study bias were assessed, as well as publication bias and quality of evidence. In total, 2189 studies were retrieved. After evaluation, 11 studies were selected and 9 composed the meta-analysis. There were no significant differences in the systemic parameters of diabetic patients when different anesthetic solutions were

used (local anesthetics with sympathomimetic vasoconstrictors, with non- sympathomimetic vasoconstrictors and without vasoconstrictors) in both evaluated

periods (medial and immediate postoperative period). Despite the limitations of this study and the quality of evidence generated, local dental anesthesia in patients with diabetes is clinically safe, if the reduced administration doses are respected.