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Zahiu SG, Fratila O. Assessment of Systemic Condition and Smoking Impact Over Incidence of Apical Periodontitis. Cureus 2024; 16:e55250. [PMID: 38558659 PMCID: PMC10981472 DOI: 10.7759/cureus.55250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
This study aimed to assess the prevalence of apical periodontitis in a subset of the population of south-eastern Romania and to analyze the overall health status of the group of patients with apical periodontitis. The medical and dental history, including age, gender, background, presence of smoking, level of education, the total number of teeth present and with apical periodontitis, and the general health status were recorded from a total of 200 patients. The periapical status was analyzed using an orthopantomogram and periapical radiographs of teeth that were diagnosed with periapical lesions by the same dental professional. The periapical status was classified according to the periapical index (PAI), with apical periodontitis being present if the PAI score ≥3. The majority of patients were female (58.5%), with secondary or higher education from urban areas and the mean number of teeth with apical periodontitis was 2.29 ± 1.26, with a median of 2 teeth. A total of 17.1% of patients were smokers, these patients had two more teeth with periapical pathology, and 16% of all patients had general diseases, the most common of which was cardiovascular disease (8.2%). Compared with those without the disease, these patients had a higher number of teeth with apical periodontitis (median = 2.5, IQR = 2-4 vs. median = 2, IQR = 1-3). As a result, this scientific research suggests an association between smoking, cardiovascular disease, and gastritis with apical periodontitis, but no association could be demonstrated between apical periodontitis and other systemic diseases.
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Affiliation(s)
- Sorina G Zahiu
- Doctoral School of Biomedical Sciences, University of Oradea, Oradea, ROU
| | - Ovidiu Fratila
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, ROU
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Paljevic E, Brekalo Prso I, Hrstic JV, Pezelj-Ribaric S, Persic Bukmir R. Impact of Smoking on the Healing of Apical Periodontitis after Nonsurgical Endodontic Treatment. Eur J Dent 2024; 18:124-130. [PMID: 36977477 PMCID: PMC10959606 DOI: 10.1055/s-0043-1761451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVES The aim of this prospective study was to compare the healing of periapical bone between smokers and nonsmokers after root canal therapy. The effects of duration and intensity of smoking on the healing rate of apical periodontitis were analyzed. MATERIALS AND METHODS Fifty-five smokers were included in this study. The control group consisted of healthy nonsmokers who matched the smoker group in age and sex. Only teeth with a favorable periodontal prognosis and adequate coronal restoration were included in the study. The periapical status of treated teeth was assessed using the periapical index system at follow-ups after 6 and 12 months. STATISTICAL ANALYSIS The chi-squared test and Mann-Whitney U test were used to assess the changes in periapical index score at baseline and in subsequent time intervals between the two groups examining dichotomized and ordinal data, respectively. Multivariate logistic regression analysis was used to test the association of independent variables age, gender, tooth type, arch type, and smoking index with the outcome variable. The outcome variable was set as the presence versus absence of apical periodontitis. RESULTS The analysis at 12-month follow-up revealed a significantly higher healing rate in control group than in smokers (90.9 vs. 58.2; χ2 = 13.846; p < 0.001). Smokers had significantly higher periapical index scores than the control group (p = 0.024). The multivariate logistic regression analysis demonstrated that an increase in the value of the smoking index significantly increases the risk of apical periodontitis persistence (odds ratio [OR] =7.66; 95% confidence interval [CI]: 2.51-23.28; p < 0.001) for smoking index < 400 and (OR = 9.65; 95% CI: 1.45-64.14; p = 0.019) for smoking index 400 to 799. CONCLUSION The results from this study show a lower rate of apical periodontitis healing in a group of smokers at 1-year follow-up. Delayed periapical healing seems to be associated with the cigarette smoking exposure.
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Affiliation(s)
- Ema Paljevic
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Ivana Brekalo Prso
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
- Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
| | - Jelena Vidas Hrstic
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Sonja Pezelj-Ribaric
- Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
- Department of Oral Medicine, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
| | - Romana Persic Bukmir
- Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Rijeka, Croatia
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Camponogara JG, de Ferreira TGM, Pelissari TR, Anversa AM, Moreira CHC, Bier CAS. Demographics, smoking status, and systemic health factors associated with apical periodontitis in a Brazilian rural population: a cross-sectional study. Clin Oral Investig 2023; 27:7319-7325. [PMID: 37857733 DOI: 10.1007/s00784-023-05322-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 10/10/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVE To determine whether the systemic diseases diabetes mellitus (DM) and arterial hypertension (AH), and smoking status are associated with apical periodontitis (AP) in a representative rural population. MATERIALS AND METHODS Cross-sectional study using a representative sample of individuals obtained from a population-based epidemiological survey carried out in the rural area of the city of Rosário do Sul, RS, Brazil, from March 2015 to May 2016. Data were collected through structured questionnaires and clinical examination. Binary logistic regression analysis was performed to identify variables independently associated with AP. RESULTS Of the 584 individuals included in the study, 353 (60.4%) had AP. The presence of AP was independently associated with age ≥ 40 years (odds ratio [OR] = 1.867, 95% confidence interval [CI]: 1.193-2.923, p = 0.006), non-white ethnicity (OR = 1.509, 95% CI: 1.029-2.115, p = 0.035), active or former smoker (OR = 2.087, 95% CI: 1.241-3.510, p = 0.006) and DM or prediabetes (OR = 1.676, 95% CI: 1.150-2.443, p = 0.007). CONCLUSION The study identified significant associations between AP and demographics, smoking status, and systemic disease in a Brazilian rural population. CLINICAL RELEVANCE The study emphasized the significance of comprehending and managing associated factors in preventing and treating AP.
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Affiliation(s)
- Jeanni Gonçalves Camponogara
- Graduate Program in Dental Science, Federal University of Santa Maria, Avenida Roraima, 1000, Bairro Camobi, Prédio 26F (Odontologia), Santa Maria, RS, 97105-900, Brazil
| | - Ticiane Góes Mário de Ferreira
- Graduate Program in Dental Science, Federal University of Santa Maria, Avenida Roraima, 1000, Bairro Camobi, Prédio 26F (Odontologia), Santa Maria, RS, 97105-900, Brazil
| | - Thayná Regina Pelissari
- Graduate Program in Dental Science, Federal University of Santa Maria, Avenida Roraima, 1000, Bairro Camobi, Prédio 26F (Odontologia), Santa Maria, RS, 97105-900, Brazil
| | - Alessandro Meneghetti Anversa
- Graduate Program in Health Science, Federal University of Santa Maria, Avenida Roraima, 1000, Bairro Camobi, Prédio 26A (Medicina), Santa Maria, RS, 97105-900, Brazil
| | - Carlos Heitor Cunha Moreira
- Graduate Program in Dental Science, Federal University of Santa Maria, Avenida Roraima, 1000, Bairro Camobi, Prédio 26F (Odontologia), Santa Maria, RS, 97105-900, Brazil
| | - Carlos Alexandre Souza Bier
- Graduate Program in Dental Science, Federal University of Santa Maria, Avenida Roraima, 1000, Bairro Camobi, Prédio 26F (Odontologia), Santa Maria, RS, 97105-900, Brazil.
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de Paula KM, Gomes CC, Valente MIB, Pires FR, Batistela Rodrigues Thuller KA, Salles L, Armada L. Evaluation of Receptor Activator of Nuclear Factor Kappa B Ligand, Osteoprotegerin, Osteopontin, and Tumor Necrosis Factor Alpha on Chronic Apical Periodontitis in Smokers. J Endod 2023; 49:137-143. [PMID: 36414095 DOI: 10.1016/j.joen.2022.11.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/06/2022] [Accepted: 11/07/2022] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Smoking can be considered a risk factor for chronic apical periodontitis (CAP). This study compared the immunoexpression of biomarkers receptor activator of nuclear factor kappa B ligand (RANKL), osteoprotegerin (OPG), osteopontin (OPN), and tumor necrosis factor alpha (TNF-α) in CAP in smokers and nonsmokers. METHODS Twelve smokers and 12 nonsmokers diagnosed with CAP and indicated for tooth extraction were selected. Exclusion factors were teeth with a diagnosis of root fracture, previous endodontic treatment, or endoperiodontal injury, in addition to individuals with systemic diseases, under 18 years of age, users of anti-inflammatory and/or antibiotics in the last 3 months, and drug users. Specimens were processed for histopathologic and immunohistochemical analysis. RESULTS Qualitative analysis of RANKL expression showed 66.66% weak/moderate and 33.33% strong in smokers and 100% weak/moderate in nonsmokers. OPG and OPN expressions were 100% negative to focal in the smoker group and 50% negative to focal and 50% weak/moderate in the nonsmoker group. TNF-α was 25% negative to focal and 75% weak/moderate in the smoker group and 33.33% negative to focal and 66.66% weak/moderate in the nonsmoker group. Quantitative analysis of the data using the Mann-Whitney U test showed that there was a significant difference in the immunoexpression of RANKL (P < .05), OPG (P < .05), and OPN (P < .05), but there was no statistical difference in the immunoexpression of TNF-α (P > .05) between the 2 groups. CONCLUSIONS These findings suggest that smoking is capable of altering the inflammatory response, influencing the evolution of CAP.
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Affiliation(s)
- Karoline Magalhães de Paula
- Postgraduate Program in Dentistry, Dental Clinic Concentration Area, Department of Specific Formation, Nova Friburgo Health Institute, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Cinthya Cristina Gomes
- Postgraduate Program in Dentistry, Dental Clinic Concentration Area, Department of Specific Formation, Nova Friburgo Health Institute, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil.
| | - Maria Isabel Bastos Valente
- Postgraduate Program in Dentistry, Dental Clinic Concentration Area, Department of Specific Formation, Nova Friburgo Health Institute, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Fabio Ramoa Pires
- Postgraduate Program in Dentistry, Endodontics, Estácio de Sá University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Katherine Azevedo Batistela Rodrigues Thuller
- Postgraduate Program in Dentistry, Dental Clinic Concentration Area, Department of Specific Formation, Nova Friburgo Health Institute, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Letícia Salles
- Postgraduate Program in Dentistry, Dental Clinic Concentration Area, Department of Specific Formation, Nova Friburgo Health Institute, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Luciana Armada
- Postgraduate Program in Dentistry, Endodontics, Estácio de Sá University, Nova Friburgo, Rio de Janeiro, Brazil
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Ríos-Osorio N, Muñoz-Alvear HD, Jiménez-Castellanos FA, Quijano-Guauque S, Jiménez-Peña O, García-Perdomo HA, Caviedes-Bucheli J. Association between cigarette smoking and the prevalence of post-endodontic periapical pathology: a systematic review and meta-analysis. Restor Dent Endod 2022; 47:e27. [PMID: 36090507 PMCID: PMC9436652 DOI: 10.5395/rde.2022.47.e27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/07/2021] [Accepted: 11/12/2021] [Indexed: 11/11/2022] Open
Affiliation(s)
- Néstor Ríos-Osorio
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
| | | | | | - Sara Quijano-Guauque
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
| | - Oscar Jiménez-Peña
- Research Department COC-CICO, Institución Universitaria Colegios de Colombia UNICOC, Bogotá, Colombia
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Thuller KABR, Armada L, Valente MI, Pires FR, Vilaça CMM, Gomes CC. Immunoexpression of Interleukin 17, 6, and 1 Beta in Primary Chronic Apical Periodontitis in Smokers and Nonsmokers. J Endod 2021; 47:755-761. [PMID: 33548327 DOI: 10.1016/j.joen.2021.01.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 01/14/2021] [Accepted: 01/25/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The purpose of this study was to compare the immunoexpression of biomarkers interleukin (IL)-17, IL-6, and IL-1β in primary chronic apical periodontitis in smokers and nonsmokers. METHODS Teeth with primary chronic apical periodontitis indicated for extraction in 16 cigarette smokers and 16 nonsmokers were selected. Silanized sections of tissue were used for immunohistochemical analysis after being stained with hematoxylin-eosin for histopathologic categorization. Subsequently, the images were analyzed with an optical microscope, and each slide was subdivided into 5 high-magnification fields, with scores (0-2) being assigned according to the amount of staining for each antibody. RESULTS The qualitative analysis of IL-17 cytokine expression showed no focal expression in 5.8%, weak to moderate expression in 17.6%, and strong expression in 76.4% of the smokers and no focal expression in 78.5% and weak to moderate expression in 21.4% of the nonsmokers. IL-6 expression was negative to focal in 13.3%, weak to moderate in 53.3%, and strong in 33.3% of the smokers and negative to focal in 33.3%, weak to moderate in 25%, and strong in 41.6% of the nonsmokers. IL-1β expression was weak to moderate in 87.5% and negative to focal expression in 12.5% of the smokers and negative to focal expression in 100% of the nonsmokers. Quantitative evaluation of the data using the Mann-Whitney U test showed a significant difference in the immunoexpression of IL-17 (P < .0001) and IL-1β (P < .0001) and no significant difference in the immunoexpression of IL-6 (P = .46) between the 2 groups (P < .05). CONCLUSIONS The cytokines IL-17 and IL-1β were more highly expressed in smokers than nonsmokers, whereas IL-6 expression was similar in the 2 groups.
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Affiliation(s)
- Katherine A B R Thuller
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Luciana Armada
- Postgraduate Program, School of Dentistry, Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Isabel Valente
- Department of Specific Formation, School of Dentistry, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Fábio Ramoa Pires
- Postgraduate Program, School of Dentistry, Department of Endodontics, Faculty of Dentistry, Estácio de Sá University, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cristiano M M Vilaça
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil
| | - Cinthya Cristina Gomes
- Department of Specific Formation, School of Dentistry, Fluminense Federal University, Nova Friburgo, Rio de Janeiro, Brazil.
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Tibúrcio-Machado CS, Michelon C, Zanatta FB, Gomes MS, Marin JA, Bier CA. The global prevalence of apical periodontitis: a systematic review and meta-analysis. Int Endod J 2021; 54:712-735. [PMID: 33378579 DOI: 10.1111/iej.13467] [Citation(s) in RCA: 198] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Accepted: 12/24/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Apical periodontitis (AP) frequently presents as a chronic asymptomatic disease. To arrive at a true diagnosis, in addition to the clinical examination, it is mandatory to undertake radiographic examinations such as periapical or panoramic radiographs, or cone-beam computed tomography (CBCT). Thus, the worldwide burden of AP is probably underestimated or unknown. Previous systematic reviews attempted to estimate the prevalence of AP, but none have investigated which factors may influence its prevalence worldwide. OBJECTIVES To assess: (i) the prevalence of AP in the population worldwide, as well as the frequency of AP in all teeth, nontreated teeth and root filled teeth; (ii) which factors can modify the prevalence of AP. METHODS A search was conducted in the PubMed-MEDLINE, EMBASE, Cochrane-CENTRAL, LILACS, Google scholar and OpenGrey databases, followed by hand searches, until September 2019. Cross-sectional, case-control and cohort studies reporting the prevalence of AP in humans, using panoramic or periapical radiograph or CBCT as image methods were included. No language restriction was applied. An adaptation of the Newcastle-Ottawa Scale was used to evaluate the quality of the studies. A meta-analysis was performed to determine the pooled prevalence of AP at the individual level. Secondary outcomes were the frequency of AP in all teeth, nontreated teeth and rootfilled teeth. Subgroup analyses using random-effect models were carried out to analyse the influence of explanatory covariables on the outcome. RESULTS The search strategy identified 6670 articles, and 114 studies were included in the meta-analysis, providing data from 34 668 individuals and 639 357 teeth. The prevalence of AP was 52% at the individual level (95% CI 42%-56%, I2 = 97.8%) and 5% at the tooth level (95% CI 4%-6%; I2 = 99.5%). The frequency of AP in root-filled teeth and nontreated teeth was 39% (95% CI 36%-43%; I2 = 98.5%) and 3% (95% CI 2%-3%; I2 = 99.3%), respectively. The prevalence of AP was greater in samples from dental care services (DCS; 57%; 95% CI 52%-62%; I2 = 97.8%) and hospitals (51%; 95% CI 40%-63%; I2 = 95.9%) than in those from the general population (GP; 40%; 95% CI 33%-46%; I2 = 96.5%); it was also greater in people with a systemic condition (63%; 95% CI 56%-69%, I2 = 89.7%) compared to healthy individuals (48%; 95% CI 43%-53%; I2 = 98.3%). DISCUSSION The subgroup analyses identified explanatory factors related to the variability in the prevalence of AP. However, the high clinical heterogeneity and high risk of bias across the primary studies indicate that the findings must be interpreted with caution. CONCLUSIONS Half of the adult population worldwide have at least one tooth with apical periodontitis. The prevalence of AP is greater in samples from the dental care services, but it is also high amongst community representative samples from the general population. The present findings should bring the attention of health policymakers, medical and dental communities to the hidden burden of endodontic disease in the population worldwide.
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Affiliation(s)
- C S Tibúrcio-Machado
- Graduate Program in Dental Science, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - C Michelon
- Medical and Dental Center of the Brazilian Army, Santa Maria, Brazil
| | - F B Zanatta
- Graduate Program in Dental Science, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.,Department of Stomatology, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
| | - M S Gomes
- Graduate Program in Dentistry, School of Health and Life Sciences, Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), Porto Alegre, Brazil.,Medical and Dental Center of the Military Police, Porto Alegre, Brazil
| | - J A Marin
- Universidade Franciscana (UFN), Santa Maria, Brazil
| | - C A Bier
- Graduate Program in Dental Science, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.,Department of Stomatology, Federal University of Santa Maria (UFSM), Santa Maria, Brazil
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Cabanillas-Balsera D, Segura-Egea JJ, Bermudo-Fuenmayor M, Martín-González J, Jiménez-Sánchez MC, Areal-Quecuty V, Sánchez-Domínguez B, Montero-Miralles P, Velasco-Ortega E. Smoking and Radiolucent Periapical Lesions in Root Filled Teeth: Systematic Review and Meta-Analysis. J Clin Med 2020; 9:E3506. [PMID: 33138302 PMCID: PMC7692336 DOI: 10.3390/jcm9113506] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/22/2020] [Accepted: 10/27/2020] [Indexed: 12/23/2022] Open
Abstract
AIM This systematic review and meta-analysis aimed to investigate the association between smoking habits and the prevalence of radiolucent periapical lesions (RPLs) in root-filled teeth (RFT). METHODS The Population, Intervention, Comparison, and Outcome (PICO) question was: in adult patients who have RFT, does the absence or presence of a smoking habit affect the prevalence of RPLs associated with RFT? Systematic MEDLINE/PubMed, Wiley Online Database, Web of Science, Scopus, and PRISMA protocol were used to evaluate and present the results. Studies comparing smokers with control non-smoker subjects, including RFT, and providing data on the prevalence of RFT with RPLs, were included. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used for certainty in the evidence. The risk of bias was assessed according to Cochrane Collaboration common scheme for bias and ROBINS-I tool. Cumulative meta-analysis was performed with a random effects model. PROSPERO registration code: CRD42020165279. RESULTS Four studies reported data on inclusion criteria, representing data from 9257 root-filled teeth-4465 from non-smokers and 4792 from smoker patients. The meta-analysis provided an odds ratio indicating a significant association between smoking and higher prevalence of root filled teeth with radiolucent periapical lesions (OR = 1.16; 95% CI = 1.07-1.26; p = 0.0004). The certainty of the literature assessment was moderate per GRADE. The ROBINS-I tool classified three studies as low risk of bias, and the fourth as moderate risk of bias. CONCLUSIONS Moderate, quality scientific evidence indicates a weak but significant relationship between smoking and the prevalence of RPLs in RFT. Smoking can be considered a negative prognostic factor for the outcome of root canal treatment. Endodontic providers should be aware of the relationship between smoking and persistent apical periodontitis, assessed as RPLs, in RFT.
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Affiliation(s)
- Daniel Cabanillas-Balsera
- Department of Stomatology, Section of Endodontics, School of Dentistry, University of Sevilla, 41009 Sevilla, Spain; (D.C.-B.); (M.B.-F.); (J.M.-G.); (V.A.-Q.); (B.S.-D.); (P.M.-M.)
| | - Juan J. Segura-Egea
- Department of Stomatology, Section of Endodontics, School of Dentistry, University of Sevilla, 41009 Sevilla, Spain; (D.C.-B.); (M.B.-F.); (J.M.-G.); (V.A.-Q.); (B.S.-D.); (P.M.-M.)
| | - María Bermudo-Fuenmayor
- Department of Stomatology, Section of Endodontics, School of Dentistry, University of Sevilla, 41009 Sevilla, Spain; (D.C.-B.); (M.B.-F.); (J.M.-G.); (V.A.-Q.); (B.S.-D.); (P.M.-M.)
| | - Jenifer Martín-González
- Department of Stomatology, Section of Endodontics, School of Dentistry, University of Sevilla, 41009 Sevilla, Spain; (D.C.-B.); (M.B.-F.); (J.M.-G.); (V.A.-Q.); (B.S.-D.); (P.M.-M.)
| | | | - Victoria Areal-Quecuty
- Department of Stomatology, Section of Endodontics, School of Dentistry, University of Sevilla, 41009 Sevilla, Spain; (D.C.-B.); (M.B.-F.); (J.M.-G.); (V.A.-Q.); (B.S.-D.); (P.M.-M.)
| | - Benito Sánchez-Domínguez
- Department of Stomatology, Section of Endodontics, School of Dentistry, University of Sevilla, 41009 Sevilla, Spain; (D.C.-B.); (M.B.-F.); (J.M.-G.); (V.A.-Q.); (B.S.-D.); (P.M.-M.)
| | - Paloma Montero-Miralles
- Department of Stomatology, Section of Endodontics, School of Dentistry, University of Sevilla, 41009 Sevilla, Spain; (D.C.-B.); (M.B.-F.); (J.M.-G.); (V.A.-Q.); (B.S.-D.); (P.M.-M.)
| | - Eugenio Velasco-Ortega
- Department of Stomatology, Section of Comprehensive Dentistry, School of Dentistry, University of Sevilla, 41009 Sevilla, Spain
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Pinto KP, Ferreira CMA, Guimarães AFC, Lima CO, Pires FR, Sassone LM, Silva EJNL. Effects of alcohol and nicotine consumption on the development of apical periodontitis in rats: a correlative micro-computed tomographic, histological and immunohistochemical study. Int Endod J 2020; 53:1238-1252. [PMID: 32516436 DOI: 10.1111/iej.13344] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 06/02/2020] [Indexed: 12/17/2022]
Abstract
AIM To evaluate the effects of alcohol and nicotine, when used alone or simultaneously, in the development of apical periodontitis induced in rats, using a correlative analytic approach with micro-CT, histological and immunohistochemical analysis. METHODOLOGY Twenty-eight male Wistar rats were arranged into four groups: Control, Nicotine, Alcohol and Alcohol + Nicotine. The alcohol groups were exposed to self-administration of a 25% alcohol solution, whilst the other groups drunk only filtered water. The nicotine groups received daily intraperitoneal injections of a solution with 0.19 μL of nicotine per mL, whilst the other groups received saline solution. The pulps of the left mandibular first molars were exposed for 28 days to induce periapical lesions. Throughout the experiment, drug administration was maintained, and the animals had their weight and solid and liquid consumption measured. After euthanasia, the mandibles were removed and the area, volume and major diameter of the periapical lesions were measured using micro-computed tomography images. The samples were submitted to histopathological evaluation and immunohistochemistry for RANKL and PTHrP. Statistical analysis was undertaken with a significance level of 5%. Nonparametric data were analysed using the Kruskal-Wallis test followed by Dunn's test, whilst one-way anova followed by Tukey's test was performed for parametric data. RESULTS The alcohol groups had lower solid and liquid consumption and gained less weight when compared to the nonalcohol groups (P < 0.05). The Alcohol + Nicotine group had lesions with significantly larger volume and area when compared to the other groups (P < 0.05), whilst the Alcohol or Nicotine groups had significantly larger lesions than the control group (P < 0.05). There was no significant difference in the largest diameter of the lesions amongst groups (P > 0.05). The experimental groups had greater inflammatory response scores than the control group (P < 0.05), and the representative samples had more pronounced immunoreaction against RANKL and PTHrP antibodies. CONCLUSIONS Alcohol and nicotine consumption exacerbated the inflammatory response and the development of periradicular lesions in rats. The association of both substances enhanced their harmful effects.
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Affiliation(s)
- K P Pinto
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - C M A Ferreira
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - A F C Guimarães
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - C O Lima
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - F R Pires
- Department of Oral Pathology, School of Dentistry, Estácio de Sá University (UNESA), Rio de Janeiro, Brazil
| | - L M Sassone
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - E J N L Silva
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil.,Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
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Pinto KP, Ferreira CM, Maia LC, Sassone LM, Fidalgo TKS, Silva EJNL. Does tobacco smoking predispose to apical periodontitis and endodontic treatment need? A systematic review and meta-analysis. Int Endod J 2020; 53:1068-1083. [PMID: 32344459 DOI: 10.1111/iej.13316] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 04/24/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND Controversial findings exist in the literature regarding the association between tobacco smoking and development of apical periodontitis or need for root canal treatment, with some studies reporting an increase in the prevalence of these outcomes in smokers, whilst others reporting no association. AIM To evaluate if there is scientific evidence to support an association between tobacco smoking and a greater prevalence of apical periodontitis and/or root canal treatments. DATA SOURCES A systematic search was performed using MeSH terms and free terms in the PubMed, Scopus, Virtual Health Library (VHL), Cochrane library and Open Gray databases. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS AND INTERVENTIONS Observational studies that evaluated the association between smoking and the development or healing of periapical lesion and/or the prevalence of root canal treatment in humans were included. STUDY APPRAISAL AND SYNTHESIS METHODS A quality assessment of included studies was performed, and the relevant information and findings were evaluated. A meta-analysis using nine included studies was performed through RevMan software, and the certainty of evidence was evaluated through GRADE. RESULTS Fifteen studies were included, of which 10 were classified as low risk of bias, 4 were considered as moderate risk of bias and 1 as high risk of bias. Ten studies reported that smoking was associated with a greater prevalence of periapical periodontitis and/or root canal treatment. Five studies reported no association. Nine studies were included in the pooled meta-analysis, comprising two subgroups: apical periodontitis and root canal treatment. From these nine studies, eight studies were included in the apical periodontitis subgroup meta-analysis and demonstrated that this condition was significantly more prevalent in smokers when compared to the nonsmokers (odds ratio = 2.78[CI: 1.60, 4.85], P < 0.001; I2 = 79%; no adjusted odds ratio). Three studies were included in the root canal treatment subgroup meta-analysis and demonstrated an increased prevalence in smokers when compared to the nonsmokers (odds ratio = 2.73 [CI: 1.06, 2.83], P < 0.001; I2 = 72%; no adjusted odds ratio). The pooled meta-analysis demonstrated that smokers had twice the chance of having apical periodontitis and/or root canal treatment when compared to nonsmokers (odds ratio of 2.42 [CI: 1.59, 3.68], P < 0.01; I2 = 85%). The GRADE analysis demonstrated moderate certainty of evidence. LIMITATIONS Several confounding factors were identified such as misinformation regarding the period of time subjects had smoked, as well as the frequency of smoking and the number of cigarettes consumed. No adjustment in odds ratio data for confounding was performed. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS This systematic review and meta-analysis indicate that tobacco smokers have an increased prevalence of periapical periodontitis and root canal treatments with moderate certainty of evidence.
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Affiliation(s)
- K P Pinto
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - C M Ferreira
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - L C Maia
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - L M Sassone
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - T K S Fidalgo
- Department of Community and Preventive Dentistry, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
| | - E J N L Silva
- Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil.,Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Brazil
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Oñate-Sánchez RE, Pérez-Díaz S, Rodríguez-Lozano FJ, Guerrero-Gironés J. Prevalence of Apical Periodontitis in patients with Multiple Myeloma. Med Oral Patol Oral Cir Bucal 2020; 25:e383-e387. [PMID: 32134898 PMCID: PMC7211371 DOI: 10.4317/medoral.23416] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 02/17/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Aim Previous reports have been analyzed the prevalence/association of apical periodontitis (AP) with systemic diseases. The present study aims to analyze the prevalence of healthy/diseased periapex and endodontic treatments in patients with Multiple Myeloma (MM) and compare the results with those of control subjects. MATERIAL AND METHODS Methodology Panoramic radiographs of 50 individuals with MM were evaluated and compared with 50 controls that were sex and age matched exactly with the diseased group. Radiographic analysis was performed by 2 two experienced endodontists under standardized conditions. The periapical status (presence or not of AP) was assessed using the periapical index (PAI). Data included systemic health, technical quality of root fillings, total number of teeth, quality of restoration, and periapical status. Statistical evaluation of differences between groups included used chi-squared tests and Fisher's exact tests. RESULTS The prevalence of root canal-treated teeth was 10.11% in the MM group and 12.05% in the control group (p=0.90). The average root canal-treated teeth in the test group was 2,34 and 2.48 in the control group, where the difference was statistically significant (p=0.05). AP in 1 or more teeth was found in 86 % and in 78% of the patients in the MM and the control groups, respectively. When analyzed by subject, there was no statistically significant difference in the prevalence of AP (p>0.72). Similarly there was also no statistically significant difference in the prevalence of PA (p=0.85), when analyzed by tooth, AP was found in 63.2% and 62.9% in MM and control groups. CONCLUSIONS The presence of AP and endodontic treatment was not significantly different in individuals with MM compared with control subjects. Future studies are needed to elucidate and confirm the association between MM and AP.
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Affiliation(s)
- R-E Oñate-Sánchez
- School of Medicine and Dentistry, University of Murcia Hospital Morales Meseguer 2 pl. Av. Marqués de los Vélez, s/n 30008, Murcia, Spain
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Mahmood AA, AbdulAzeez AR, Hussein HM. The Effect of Smoking Habit on Apical Status of Adequate Endodontically Treated Teeth with and Without Periodontal Involvement. Clin Cosmet Investig Dent 2019; 11:419-428. [PMID: 31920402 PMCID: PMC6941597 DOI: 10.2147/ccide.s236747] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 12/03/2019] [Indexed: 12/17/2022] Open
Abstract
Background The possible connection between apical periodontitis (AP), periodontal disease (PD) and the bad habit of smoking is among the most interesting aspects faced by the dental scientific community. The aim of this study was to pinpoint the effect of smoking on the status of the apical region, in properly root-filled teeth with and without periodontal involvement of Iraqi males. Materials and methods Total number of 75 patients were chosen, divided into 3 groups of 25’s, teeth were subdivided into 6 subgroups (G-a: Light smokers without Periodontal involvement, G-b: Heavy smokers without Periodontal involvement, G-c: Non-smokers without Periodontal involvement, G-d: Light smokers with Periodontal involvement, G-e: Heavy smokers with Periodontal involvement, G-f: Non-smokers with Periodontal involvement), examination involved: clinical periodontal parameters, coronal restoration fitness. Panoramic and periapical radiographs were used to judge the quality of periodontal tissue in the apical region (AP) of root canal treated teeth. Results Among all the examined teeth (1859), only (89) were found with fitted both coronal and endodontic restorations. Rates of AP were: (G-a: 11.1%, G-b: 25%, G-c: 0%, G-d: 18.8%, G-e: 35.7%, G-f: 4.8%). Statistically, in related to the AP, there was a highly significant difference between heavy smokers’ groups (G-b, G-e). Moreover, heavy smokers with PD (G-e) showed a significant difference with light smokers without PD (G-a) and non-smokers without PD (G-c), also, there was a significant difference between heavy smokers without PD (G-b) and non-smokers with PD (G-f). While, there was a non-significant difference relationship between non–smokers’ groups (G-c, G-f), and light smokers’ groups (G-a, G-d). Conclusion There is a noticeable negative effect of smoking on the severity and prognosis of AP and this negative effect worsens when it is accompanied by lateral periodontitis.
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Affiliation(s)
- Athraa A Mahmood
- Department of Periodontology, College of Dentistry, Mustansiriyah University, Baghdad, Iraq
| | - Ali R AbdulAzeez
- Department of Periodontology, College of Dentistry, Uruk University, Baghdad, Iraq
| | - Hashim M Hussein
- Department of Dentistry, Al-Rafidain University-College, Baghdad, Iraq
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13
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Meinhold L, Krois J, Jordan R, Nestler N, Schwendicke F. Clustering effects of oral conditions based on clinical and radiographic examinations. Clin Oral Investig 2019; 24:3001-3008. [PMID: 31823023 DOI: 10.1007/s00784-019-03164-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 11/21/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The intra-class correlation coefficient (ICC) is a measure of intra-subject clustering effects. A priori estimates of the ICC and the associated design effect (DE) are required for sample size estimation in clustered studies, and should be considered during their analysis, too. We aimed to determine the clustering effects of carious lesions, apical lesions, periodontal bone loss, and periodontal pocketing, assessed in clinical or radiographic examinations. METHODS A subsample of patients (n = 175) enrolled in the fifth German Oral Health Study provided data on clinically determined carious teeth (i.e., with untreated carious lesions, WHO method) as well as teeth with periodontal pocketing (i.e., with maximum probing-pocket-depths ≥ 4 mm). A sample of panoramic radiographs (n = 85) from randomly chosen patients, examined from 2010 to 2017 at the Charité dental hospital, provided data on radiographically determined carious teeth (i.e., with lesions extending into dentine or enamel), teeth with apical lesions (determined by dentists via majority vote), and teeth with periodontal bone loss (≥ 20% of root-length). The ICC and its 95% confidence interval (95% CI) were determined. RESULTS There were 3839 and 1961 teeth assessed in clinical and radiographic evaluations, respectively. For clinically or radiographically determined carious lesions, the ICC (95% CI) was 0.20 (0.16-0.24) or 0.19 (0.14-0.25), respectively. For clinical pocketing or radiographic bone loss, the ICC was 0.40 (0.35-0.46) or 0.30 (0.24-0.38), respectively. The lowest ICC was found for apical lesions at 0.08 (0.06-0.13). CONCLUSIONS The ICC varied between assessment methods and conditions. Clustered trials should account for this during study planning and data analysis. CLINICAL RELEVANCE Within the limitations of this study, and considering the risk of selection bias and the limited sample sizes of both datasets, clustering effects were substantial but varied between dental conditions. Studies not accounting for this during planning and analysis may yield misleading estimates if clustering is present.
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Affiliation(s)
- Leonie Meinhold
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Joachim Krois
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Rainer Jordan
- Institute of German Dentists (IDZ), Cologne, Germany
| | - Norbert Nestler
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany
| | - Falk Schwendicke
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14197, Berlin, Germany.
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The association between smoking and periapical periodontitis: a systematic review. Clin Oral Investig 2019; 24:533-545. [PMID: 31773370 DOI: 10.1007/s00784-019-03094-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 09/22/2019] [Indexed: 02/08/2023]
Abstract
OBJECTIVES The purpose of this systematic review was to examine if, in adult patients, the absence or presence of smoking influenced the prevalence of periapical periodontitis (PP). MATERIALS AND METHODS Databases were searched, and original research manuscripts up to June 2019 were identified by two reviewers. The Newcastle-Ottawa Scale (NOS) was used for risk of bias. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used for certainty in the evidence. A meta-analysis was performed using RevMan 5 software. Risk ratio (RR) was used for the cohort studies, and odds ratio (OR) was used for the case-control studies with 95% confidence interval (CI). RESULTS All the studies had many covariates and confounding variables. Three longitudinal cohort articles discussed radiographic findings as they related to the prevalence of PP in root-filled teeth. The RR of smoking and the prevalence of PP was 2.11 (95% CI 0.88-5.05, p = 0.09). Nine case-control studies focused on the prevalence of PP and smoking. There was a positive association between smoking and the prevalence of PP with an OR of 2.78 and a 95% confidence interval of 2.23-3.48, with p value < 0.05. The quality of the studies was fair per NOS, and the certainty of the literature assessment was moderate per GRADE. CONCLUSIONS The current best available evidence suggests that smoking was associated with the prevalence of PP but more studies are needed to report this association in the longitudinal cohort studies. CLINICAL RELEVANCE Smoking has a positive association with the prevalence of PP.
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Expression of Toll-like receptors 2 and 4 and its association with matrix metalloproteinases in symptomatic and asymptomatic apical periodontitis. Clin Oral Investig 2019; 23:4205-4212. [DOI: 10.1007/s00784-019-02861-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 02/14/2019] [Indexed: 02/06/2023]
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Persic Bukmir R, Vidas J, Mance D, Pezelj‐Ribaric S, Spalj S, Brekalo Prso I. Socio‐economic and health status as a predictor of apical periodontitis in adult patients in Croatia. Oral Dis 2018; 25:300-308. [DOI: 10.1111/odi.12981] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/14/2018] [Accepted: 09/18/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Romana Persic Bukmir
- Department of Endodontics and Restorative Dentistry, Rijeka Clinical Hospital Centre, Faculty of Medicine University of Rijeka Rijeka Croatia
| | - Jelena Vidas
- Department of Endodontics and Restorative Dentistry, Rijeka Clinical Hospital Centre, Faculty of Medicine University of Rijeka Rijeka Croatia
| | - Diana Mance
- Department of Physics University of Rijeka Rijeka Croatia
| | - Sonja Pezelj‐Ribaric
- Department of Oral Medicine and Periodontology, Rijeka Clinical Hospital Centre, Faculty of Medicine University of Rijeka Rijeka Croatia
| | - Stjepan Spalj
- Department of Orthodontics, Rijeka Clinical Hospital Centre, Faculty of Medicine University of Rijeka Rijeka Croatia
| | - Ivana Brekalo Prso
- Department of Endodontics and Restorative Dentistry, Rijeka Clinical Hospital Centre, Faculty of Medicine University of Rijeka Rijeka Croatia
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Balto HA, Alabdulaaly L, Bahammam S, Al-Ekrish AA. Comparative analysis of prevalence of apical periodontitis in smokers and non-smokers using cone-beam computed tomography. Saudi Dent J 2018; 31:52-57. [PMID: 30705569 PMCID: PMC6349893 DOI: 10.1016/j.sdentj.2018.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 08/26/2018] [Accepted: 09/17/2018] [Indexed: 12/21/2022] Open
Abstract
Objective The aim of this study was to compare the prevalence and size of periapical lesions among smokers and non-smokers using cone-beam computed tomography (CBCT). Materials and methods Retrievable CBCT datasets for 46 male patients ≥18 years during a consecutive period from 2008 to 2016 were examined. The medical, smoking history and other clinical findings (signs of previous dental trauma; Decayed Missing Filled Teeth (DMFT) scores; the percentage of root filled teeth; and oral hygiene status) were obtained. Periapical status of all included teeth was assessed by CBCT images. Statistical analysis was conducted using t-test, Pearson correlation and multiple regression. Results The prevalence of apical periodontitis was 13.93% in smokers and 14.26% in non-smokers with no significant difference (p = 0.936). The mean of the average size of lesions between the two groups were almost comparable, 3.50 mm in smokers and 2.89 mm in non-smokers (p = 0.567). Pearson correlation and multiple regression analysis showed that the percentage of lesion present and the average lesion size were not correlated to any independent variable. Conclusions While smoking is considered a risk factor for marginal periodontitis, there was no difference between smokers and non-smokers in terms of apical periodontitis.
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Affiliation(s)
- Hanan A Balto
- Department of Restorative Dental Science, Division of Endodontics, Dental Caries Research Chair, College of Dentistry, King Saud University, P.O. Box 62645, Riyadh 11595, Saudi Arabia.,Department of Clinical Dental Science, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Lama Alabdulaaly
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 88493, Riyadh 11662, Saudi Arabia
| | - Shaima Bahammam
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Department of Dentistry, King Faisal Specialist Hospital and Research Centre, P.O. Box 50514, Riyadh 11533, Saudi Arabia
| | - Asma'a A Al-Ekrish
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, P.O. Box 56810, Riyadh 11564, Saudi Arabia
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Abstract
Conventional root canal therapies yield high success rates. The treatment outcomes are negatively affected by the presence of apical periodontitis (AP), which reflects active root canal infection and inflammatory responses. Also, cross-sectional studies revealed surprisingly high prevalence of AP in the general population, especially in those with prior endodontic treatments. Hence, AP is an ongoing disease entity in endodontics that needs further understanding of the pathogenesis and disease progression. The current Chapter will discuss the basic mechanisms of AP with emphasis on emerging role of epigenetic regulators in regulation of inflammatory mediators.
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AL-Bashaireh AM, Haddad LG, Weaver M, Kelly DL, Chengguo X, Yoon S. The Effect of Tobacco Smoking on Musculoskeletal Health: A Systematic Review. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2018; 2018:4184190. [PMID: 30112011 PMCID: PMC6077562 DOI: 10.1155/2018/4184190] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 05/30/2018] [Indexed: 12/14/2022]
Abstract
This systematic review explored associations between smoking and health outcomes involving the musculoskeletal system. AMSTAR criteria were followed. A comprehensive search of PubMed, Web of Science, and Science Direct returned 243 articles meeting inclusion criteria. A majority of studies found smoking has negative effects on the musculoskeletal system. In research on bones, smoking was associated with lower BMD, increased fracture risk, periodontitis, alveolar bone loss, and dental implant failure. In research on joints, smoking was associated with increased joint disease activity, poor functional outcomes, and poor therapeutic response. There was also evidence of adverse effects on muscles, tendons, cartilage, and ligaments. There were few studies on the musculoskeletal health outcomes of secondhand smoke, smoking cessation, or other modes of smoking, such as waterpipes or electronic cigarettes. This review found evidence that suggests tobacco smoking has negative effects on the health outcomes of the musculoskeletal system. There is a need for further research to understand mechanisms of action for the effects of smoking on the musculoskeletal system and to increase awareness of healthcare providers and community members of the adverse effects of smoking on the musculoskeletal system.
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Affiliation(s)
| | - Linda G. Haddad
- College of Health and Human Services, University of North Carolina Wilmington, Wilmington, NC, USA
| | - Michael Weaver
- College of Nursing, University of Florida, Gainesville, FL, USA
| | | | - Xing Chengguo
- College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Saunjoo Yoon
- College of Nursing, University of Florida, Gainesville, FL, USA
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20
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Diener VN, Gay A, Soyka MB, Attin T, Schmidlin PR, Sahrmann P. What is the influence of tonsillectomy on the level of periodontal pathogens on the tongue dorsum and in periodontal pockets. BMC Oral Health 2018; 18:62. [PMID: 29625605 PMCID: PMC5889595 DOI: 10.1186/s12903-018-0521-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 03/20/2018] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND For periodontal treatment, the full mouth disinfection approach suggests disinfection of oral soft tissues, such as tongue and tonsils concomitant to scaling and root planning since patients might benefit from treatment of these oral niches either. Periodontopathogenes in tonsillar tissue support this hypothesis. This prospective controlled clinical study investigated the change in the oral flora of patients who underwent tonsillectomy. Pockets were tested for eleven bacterial species before and six weeks after the surgical intervention. METHODS Fifty generally healthy adults were included in this study. The test group consisted of 25 patients with tonsillectomy. The control group included 25 patients with otorhinolarynologic surgery without involvement of the oral cavity. Clinical parameters such as probing pocket depth, bleeding-on-probing index and plaque index were registered the evening before surgery. Also bacterial samples from the gingival sulcus and dorsum linguae were taken, and an additional sample from the removed tonsils in the test group. Six weeks after the intervention microbial samples of pockets and tongue were taken again. Data were tested for significant differences using Wilcoxon rank and Whitney-u-test. RESULTS No relevant intra- or intergroup differences were found for the change of the eleven investigated species. CONCLUSION Based on the results of the present study, tonsillectomy does not seem to have an immediate relevant effect on the bacterial flora of tongue or periodontium. This study design was approved by the ethical committee of Zurich (KEK-ZH-Nr.2013-0419). TRIAL REGISTRATION The trial was retrospectively registered in the German Clinical Trials Register ( DRK00014077 ) on February 20, 2018.
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Affiliation(s)
- V N Diener
- Clinic for Preventive Dentistry, Periodontology and Cariologiy, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
| | - A Gay
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland
| | - M B Soyka
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Zurich, Zurich, Switzerland
| | - T Attin
- Clinic for Preventive Dentistry, Periodontology and Cariologiy, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - P R Schmidlin
- Clinic for Preventive Dentistry, Periodontology and Cariologiy, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - P Sahrmann
- Clinic for Preventive Dentistry, Periodontology and Cariologiy, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
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Abstract
Purpose of Review This review describes the recent findings from epidemiological studies on endodontic infections. The recent literature was screened for studies on the prevalence of primary apical periodontitis and posttreatment apical periodontitis in various populations. Recent Findings Twenty-nine articles reporting data on the prevalence of primary or posttreatment apical periodontitis from all over the world were included. The prevalence of apical periodontitis varied between 7 and 86%, while that of posttreatment apical periodontitis varied between 10 and 62%. The quality of the coronal restoration and the root filling appears to be the major predictors of apical periodontitis. Summary The recent findings from epidemiological studies on the prevalence of primary and posttreatment apical periodontitis in various populations are not substantially different from those from earlier years. It appears that the health of periapical tissues has not majorly improved in the general population.
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Grønkjær LL, Holmstrup P, Schou S, Schwartz K, Kongstad J, Jepsen P, Vilstrup H. Presence and consequence of tooth periapical radiolucency in patients with cirrhosis. Hepat Med 2016; 8:97-103. [PMID: 27695370 PMCID: PMC5027950 DOI: 10.2147/hmer.s113485] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Periapical radiolucency is the radiographic sign of inflammatory bone lesions around the apex of the tooth. We determined the prevalence and predictors of periapical radiolucency in patients with cirrhosis and the association with systemic inflammation status and cirrhosis-related complications. Methods A total of 110 cirrhosis patients were consecutively enrolled. Periapical radiolucency was defined as the presence of radiolucency or widening of the periapical periodontal ligament space to more than twice the normal width. Predictors of periapical radiolucency and the association with systemic inflammation markers and cirrhosis-related complications were explored by univariable and multivariable logistic regression analyses. Results Periapical radiolucency was present in one or more teeth in 46% of the patients. Strong predictors were gross caries (odds ratio [OR] 3.12, 95% confidence interval [CI] 1.43–6.79) and severe periodontitis (OR 3.98, 95% CI 1.04–15.20). Also old age (OR 1.10, 95% CI 1.01–1.19) and smoking (OR 3.24, 95% CI 1.02–17.62) were predictors. However, cirrhosis etiology (alcoholic vs nonalcoholic) or severity (Model of End-Stage Liver Disease score) were not predictors. The patients with periapical radiolucency had higher C-reactive protein (15.8 mg/L vs 8.1 mg/L, P=0.02) and lower albumin contents (25 g/L vs 28 g/L, P=0.04) than those without. Furthermore, the patients with periapical radiolucency had a higher prevalence of cirrhosis-related complications such as ascites, hepatic encephalopathy, and/or variceal bleeding (46% vs 27%, P=0.05). Conclusion Periapical radiolucency is often present as an element of poor oral health status and likely has an adverse clinical significance, which should motivate diagnostic and clinical attention to the findings.
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Affiliation(s)
| | - Palle Holmstrup
- Section of Periodontology, Microbiology, and Community Dentistry, Department of Odontology, Faculty of Health and Medical Sciences
| | - Søren Schou
- Section for Oral and Maxillofacial Surgery, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen
| | | | - Johanne Kongstad
- Section of Periodontology, Microbiology, and Community Dentistry, Department of Odontology, Faculty of Health and Medical Sciences
| | - Peter Jepsen
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus; Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Hendrik Vilstrup
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus
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