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Fu WT, Zhu QK, Li N, Wang YQ, Deng SL, Chen HP, Shen J, Meng LY, Bian Z. Clinically Oriented CBCT Periapical Lesion Evaluation via 3D CNN Algorithm. J Dent Res 2024; 103:5-12. [PMID: 37968798 DOI: 10.1177/00220345231201793] [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] [Indexed: 11/17/2023] Open
Abstract
Apical periodontitis (AP) is one of the most prevalent disorders in dentistry. However, it can be underdiagnosed in asymptomatic patients. In addition, the perioperative evaluation of 3-dimensional (3D) lesion volume is of great clinical relevance, but the required slice-by-slice manual delineation method is time- and labor-intensive. Here, for quickly and accurately detecting and segmenting periapical lesions (PALs) associated with AP on cone beam computed tomography (CBCT) images, we proposed and geographically validated a novel 3D deep convolutional neural network algorithm, named PAL-Net. On the internal 5-fold cross-validation set, our PAL-Net achieved an area under the receiver operating characteristic curve (AUC) of 0.98. The algorithm also improved the diagnostic performance of dentists with varying levels of experience, as evidenced by their enhanced average AUC values (junior dentists: 0.89-0.94; senior dentists: 0.91-0.93), and significantly reduced the diagnostic time (junior dentists: 69.3 min faster; senior dentists: 32.4 min faster). Moreover, our PAL-Net achieved an average Dice similarity coefficient over 0.87 (0.85-0.88), which is superior or comparable to that of other existing state-of-the-art PAL segmentation algorithms. Furthermore, we validated the generalizability of the PAL-Net system using multiple external data sets from Central, East, and North China, showing that our PAL-Net has strong robustness. Our PAL-Net can help improve the diagnostic performance and speed of dentists working from CBCT images, provide clinically relevant volume information to dentists, and can potentially be applied in dental clinics, especially without expert-level dentists or radiologists.
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Affiliation(s)
- W T Fu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Q K Zhu
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA
| | - N Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Y Q Wang
- Department of Gynecology, Renmin Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - S L Deng
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, China
| | - H P Chen
- Xiangyang Stomatological Hospital; Affiliated Stomatological Hospital of Hubei University of Arts and Science, Xiangyang, China
| | - J Shen
- Department of International VIP Dental Clinic, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China
| | - L Y Meng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Z Bian
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
- Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
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Annunziata M, Arcadio F, Borriello A, Bencivenga D, Piccirillo A, Stampone E, Zeni L, Cennamo N, Della Ragione F, Guida L. A novel plasmonic optical-fiber-based point-of-care test for periodontal MIP-1α detection. iScience 2023; 26:108539. [PMID: 38089574 PMCID: PMC10711496 DOI: 10.1016/j.isci.2023.108539] [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: 06/14/2023] [Revised: 07/19/2023] [Accepted: 11/20/2023] [Indexed: 04/23/2024] Open
Abstract
The analysis of salivary biomarkers as expression of periodontal health conditions has been proposed as a useful aid to conventional diagnostic approaches. In this study, we present a point-of-care test (POCT) exploiting a surface plasmon resonance (SPR)-based optical biosensor to detect salivary macrophage inflammatory protein (MIP)-1α, a promising marker of periodontitis. A plastic optical fiber (POF) was suitably modified and functionalized by an antibody self-assembled monolayer against MIP-1α for plasmonic detection. The proposed SPR-POF biosensor showed high selectivity and very low limit of detection for MIP-1α of 129 fM (1.0 pg/mL) in phosphate-buffered saline and 346 fM (2.7 pg/mL) in saliva. As a proof of concept, this POCT was also able to discriminate between a periodontitis patient and a healthy subject. The obtained results support the future application of this technology for an on-site detection and real-time monitoring of periodontal health conditions for diagnostic and therapeutic purposes.
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Affiliation(s)
- Marco Annunziata
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via L. De Crecchio, 6, 80138 Naples, Italy
| | - Francesco Arcadio
- Department of Engineering, University of Campania Luigi Vanvitelli, Via Roma 29, 81031 Aversa, Italy
| | - Adriana Borriello
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via L. De Crecchio 7, 80138 Naples, Italy
| | - Debora Bencivenga
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via L. De Crecchio 7, 80138 Naples, Italy
| | - Angelantonio Piccirillo
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via L. De Crecchio, 6, 80138 Naples, Italy
| | - Emanuela Stampone
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via L. De Crecchio 7, 80138 Naples, Italy
| | - Luigi Zeni
- Department of Engineering, University of Campania Luigi Vanvitelli, Via Roma 29, 81031 Aversa, Italy
| | - Nunzio Cennamo
- Department of Engineering, University of Campania Luigi Vanvitelli, Via Roma 29, 81031 Aversa, Italy
| | - Fulvio Della Ragione
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, Via L. De Crecchio 7, 80138 Naples, Italy
| | - Luigi Guida
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Via L. De Crecchio, 6, 80138 Naples, Italy
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Sathyanarayanan K, Ranjana NI, Bhavana M, R M, Sankar A, Mirnalini S. Asymptomatic Apical Periodontitis Lesions and Their Association With Systemic Inflammatory Burden: A Preliminary Prospective Clinical Study. Cureus 2023; 15:e46357. [PMID: 37920638 PMCID: PMC10619333 DOI: 10.7759/cureus.46357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2023] [Indexed: 11/04/2023] Open
Abstract
Background: Apical periodontitis (AP) is an inflammatory disorder of the periapical tissues caused by the persistence of a microbial infection within the root canal system of the affected tooth. Clinically, it is symptomatic or asymptomatic depending on several factors such as the type of microorganisms, bacterial load, immunological reaction, and local tissue mediators. Chronic or asymptomatic infections may initiate and modulate intravascular accumulation of inflammatory cells resulting in endothelial dysfunction which subsequently represents a possible systemic inflammatory burden. Aim: The present study aimed to evaluate the relationship between asymptomatic AP and systemic inflammatory burden by assessing the levels of chronic inflammatory cells. Methodology: A total of 25 patients diagnosed with asymptomatic AP who showed a negative response to the pulp sensitivity test with no history of any systemic diseases were included in this preliminary prospective observational study. Blood samples were collected at each phase of the study, and a complete hemogram was carried out. All hematological parameters were recorded before and after root canal therapy and they were analyzed for statistical significance at p <.05 using IBM SPSS Statistics for Windows, Version 21 (Released 2012; IBM Corp., Armonk, New York, United States). Results: Evaluation of the mean total leukocyte count (TLC), lymphocyte, and eosinophil cell count showed a significant reduction in the number of cells before and after root canal therapy treatment respectively (p<.05). One-way analysis of variance also revealed statistical significance at p < .05 with a weak positive correlation between the TLC, lymphocyte, and eosinophil count before and after treatment. Conclusion: The present study showed that systemically healthy individuals with asymptomatic AP had increased inflammatory burden in the circulation, and thus, it is essential to identify and quantify the risk associated. It was evident that complete healing of the asymptomatic AP lesions results in an overall reduction of systemic inflammatory cells ultimately reducing the burden and risk of associated systemic inflammatory diseases.
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Affiliation(s)
| | - N I Ranjana
- Conservative Dentistry and Endodontics, Sathyabama Dental College and Hospital, Chennai, IND
| | - Mohan Bhavana
- Conservative Dentistry and Endodontics, Sathyabama Dental College and Hospital, Chennai, IND
| | - Megavarnan R
- Conservative Dentistry and Endodontics, Sathyabama Dental College and Hospital, Chennai, IND
| | - Aravinthan Sankar
- Conservative Dentistry and Endodontics, Sathyabama Dental College and Hospital, Chennai, IND
| | - Selvakumar Mirnalini
- Conservative Dentistry and Endodontics, Sathyabama Dental College and Hospital, Chennai, IND
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Georgiou AC, Crielaard W, Ouwerling P, McLean W, Lappin DF, van der Waal SV. The influence of apical periodontitis on the concentration of inflammatory mediators in peripheral blood plasma and the metagenomic profiling of endodontic infections: Study design and protocol. Contemp Clin Trials Commun 2020; 21:100686. [PMID: 33490705 PMCID: PMC7810621 DOI: 10.1016/j.conctc.2020.100686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/10/2020] [Accepted: 12/01/2020] [Indexed: 12/19/2022] Open
Abstract
Increased systemic inflammation has been identified in presence of oral disease, specifically endodontic disease. It is important to investigate whether treatment of the oral disease ameliorates systemic inflammation. Furthermore, there is no information about the extent to which different microorganisms may trigger inflammatory response. Objectives Primarily (i) to compare the plasma concentrations of inflammatory mediators of apical periodontitis (AP) subjects to controls, (ii) to evaluate whether elimination of the endodontic infection reduces systemic inflammation (iii) to investigate the microbiome of root canal infections. Secondarily i) to correlate the inflammatory mediator data with the microbiome data to investigate whether the type of infection influences the type and severity of the inflammatory condition ii) to examine patterns in the inflammatory mediator data before and after tooth extraction in order to establish a biomarker signature of AP/oral disease. This is a multi-centre prospective case-control intervention study. The cohort will consist of 30 healthy human volunteers with one or two teeth with a root-tip inflammation and 30 matched healthy controls. Peripheral blood will be drawn at 6 time points, 3 before and 3 after the extraction of the tooth with apical periodontitis. The teeth will be pulverized, DNA extraction and sequencing will be performed. This study aims to compare the concentration of inflammatory blood plasma proteins in between AP-subjects and controls at different time points before and after the tooth extraction in a systematic and complete way. Additionally the composition of the root canal microbiome in association with the inflammatory response of the host will be assessed.
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Affiliation(s)
- A C Georgiou
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - W Crielaard
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
| | - P Ouwerling
- Tandheelkundig Centrum Molenvliet, Alphen aan den Rijn, the Netherlands
| | - W McLean
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, Glasgow, UK
| | - D F Lappin
- Glasgow Dental School, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life Sciences, Glasgow, UK
| | - S V van der Waal
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands.,Department of Endodontics, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, the Netherlands
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5
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Georgiou AC, Crielaard W, Armenis I, de Vries R, van der Waal SV. Apical Periodontitis Is Associated with Elevated Concentrations of Inflammatory Mediators in Peripheral Blood: A Systematic Review and Meta-analysis. J Endod 2019; 45:1279-1295.e3. [PMID: 31542282 DOI: 10.1016/j.joen.2019.07.017] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 06/18/2019] [Accepted: 07/28/2019] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Apical periodontitis (AP), except for the local known consequences, may also be a systemic burden. Circulating inflammatory mediators that are released to sustain the AP lesion can in theory harm other bodily tissues. The aim of this systematic review was to summarize the existing evidence on the influence of AP on the peripheral blood levels of inflammatory mediators and markers of systemic stress. METHODS A search of MEDLINE-PubMed, Embase, and Cochrane was conducted up to and including February 2019 to identify studies in 5 different languages. The Newcastle-Ottawa Scale was used for quality assessment of the included studies. RESULTS Twelve of the 20 included studies were case-control studies, and 8 were intervention studies. The data of all the included studies were analyzed descriptively, whereas the data of 11 studies were available for meta-analyses. The study designs were heterogeneous. Nevertheless, the meta-analyses revealed statistically significant differences in C-reactive protein, interleukin 6, and asymmetric dimethylarginine levels between AP subjects and controls in peripheral blood. In addition, the concentration of C3 complement fragment in peripheral blood was significantly lower after the treatment and resolution of AP than before. CONCLUSIONS The existing literature indicates that AP adds on to systemic inflammation by elevating C-reactive protein, interleukin 6, asymmetric dimethylarginine, and C3 levels. In order to overcome the issue of large variation between study designs, future studies should have clear inclusion criteria, preferably larger cohorts, adequate follow-up of all subjects, and a thorough presentation of the data to enable further exploration of the possible burden of AP on general human health. Nevertheless, there is now stronger evidence that AP contributes to low-grade systemic inflammation.
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Affiliation(s)
- Athina Christina Georgiou
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands.
| | - Wim Crielaard
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
| | - Iakovos Armenis
- Department of Cardiology, Onassis Cardiac Surgery Centre, Athens, Greece; Department of Internal Medicine, "Laiko" Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Ralph de Vries
- Medical Library, Vrije Universiteit, Amsterdam, the Netherlands
| | - Suzette V van der Waal
- Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands; Department of Endodontics, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, the Netherlands
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6
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Davanian H, Gaiser RA, Silfverberg M, Hugerth LW, Sobkowiak MJ, Lu L, Healy K, Sandberg JK, Näsman P, Karlsson J, Jansson L, Engstrand L, Sällberg Chen M. Mucosal-associated invariant T cells and oral microbiome in persistent apical periodontitis. Int J Oral Sci 2019; 11:16. [PMID: 31068577 PMCID: PMC6506549 DOI: 10.1038/s41368-019-0049-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/04/2019] [Accepted: 03/11/2019] [Indexed: 02/07/2023] Open
Abstract
Opportunistic bacteria in apical periodontitis (AP) may pose a risk for systemic dissemination. Mucosal-associated invariant T (MAIT) cells are innate-like T cells with a broad and potent antimicrobial activity important for gut mucosal integrity. It was recently shown that MAIT cells are present in the oral mucosal tissue, but the involvement of MAIT cells in AP is unknown. Here, comparison of surgically resected AP and gingival tissues demonstrated that AP tissues express significantly higher levels of Vα7.2-Jα33, Vα7.2-Jα20, Vα7.2-Jα12, Cα and tumour necrosis factor (TNF), interferon (IFN)-γ and interleukin (IL)-17A transcripts, resembling a MAIT cell signature. Moreover, in AP tissues the MR1-restricted MAIT cells positive for MR1–5-OP-RU tetramer staining appeared to be of similar levels as in peripheral blood but consisted mainly of CD4+ subset. Unlike gingival tissues, the AP microbiome was quantitatively impacted by factors like fistula and high patient age and had a prominent riboflavin-expressing bacterial feature. When merged in an integrated view, the examined immune and microbiome data in the sparse partial least squares discriminant analysis could identify bacterial relative abundances that negatively correlated with Vα7.2-Jα33, Cα, and IL-17A transcript expressions in AP, implying that MAIT cells could play a role in the local defence at the oral tissue barrier. In conclusion, we describe the presence of MAIT cells at the oral site where translocation of oral microbiota could take place. These findings have implications for understanding the immune sensing of polymicrobial-related oral diseases.
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Affiliation(s)
- Haleh Davanian
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | | | | | - Luisa W Hugerth
- Department of Microbiology, Tumor and Cell Biology and Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden.,Clinical Genomics Facility, Science for Life Laboratory, Solna, Sweden
| | | | - Liyan Lu
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Katie Healy
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | | | - Peggy Näsman
- Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - Jörgen Karlsson
- Clinic of Endodontics and Periodontology, Eastman Institute Stockholm, Stockholm, Sweden
| | - Leif Jansson
- Clinic of Endodontics and Periodontology, Eastman Institute Stockholm, Stockholm, Sweden
| | - Lars Engstrand
- Department of Microbiology, Tumor and Cell Biology and Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden.,Clinical Genomics Facility, Science for Life Laboratory, Solna, Sweden
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Pedro FM, Marques A, Pereira TM, Bandeca MC, Lima S, Kuga MC, Tonetto MR, Semenoff-Segundo A, Borges AH. Status of Endodontic Treatment and the Correlations to the Quality of Root Canal Filling and Coronal Restoration. J Contemp Dent Pract 2016; 17:830-836. [PMID: 27794154 DOI: 10.5005/jp-journals-10024-1939] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
INTRODUCTION This cross-sectional study evaluated the prevalence and quality of root canal treatment in 1,977 digital radiological files. MATERIALS AND METHODS Data were statistically analyzed using descriptive analysis, and the chi-square test was performed with a 5% significance level. RESULTS The mean age of the study population was 34.9 years. The endodontic treatment frequency was 6.14%, significantly higher in premolars. Adequate endodontic treatment was observed in 39.7% of analyzed cases. Molars were significantly more frequent with regard to inadequate filling quality. In 47.6% of cases, the filling's apical limit was classified as adequate, and there was a higher incidence of molars that were inadequate. Restorations were classified as adequate in 79.0% of cases, and molars were responsible for the highest frequency of inadequate restorations. The frequency of teeth with endodontic treatment that showed no periapical changes was 47.7%. There was no significant difference in the presence of periapical change according to gender. An increased presence of periapical change was observed with increasing age. The periapical lesions were observed in 45% of cases and related to inadequate filling quality. The apical limit was considered inadequate and related to periapical changes in 42% of cases. Periapical changes were present in 52% of cases, regardless of the quality of the filling and apical limit. Such changes were present in 42% of cases with adequate coronal restoration. CONCLUSION It can be concluded that apical periodontitis (AP) is associated with the quality of endodontic treatment. The coronal restoration affects significantly the success rate of endodontic treatment. CLINICAL SIGNIFICANCE The quality of the root filling and coronal restoration is closely related to periapical health.
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Affiliation(s)
- Fabio M Pedro
- Department of Post-Graduate Program in Integrated Dental Science, Dental School, University of Cuiabá, Cuiabá, Brazil
| | - Atc Marques
- Department of Post-Graduate Program in Integrated Dental Science, Dental School, University of Cuiabá, Cuiabá, Brazil
| | - Thiago M Pereira
- Department of Post-Graduate Program in Integrated Dental Science, Dental School, University of Cuiabá, Cuiabá, Brazil
| | - Matheus C Bandeca
- Department of Post-Graduate Program in Dentistry, CEUMA University, São Luis, Brazil
| | - Snl Lima
- Department of Post-Graduate Program in Dentistry, CEUMA University, São Luis, Brazil
| | - Milton C Kuga
- Department of Restorative Dentistry, School of Dentistry Universidade Estadual Paulista, Araçatuba, Brazil
| | - Mateus R Tonetto
- Department of Post-Graduate Program in Integrated Dental Science, Dental School, University of Cuiabá, Cuiabá, Brazil
| | - Alex Semenoff-Segundo
- Department of Post-Graduate Program in Integrated Dental Science, Dental School, University of Cuiabá, Cuiabá, Brazil
| | - Alvaro H Borges
- Department of Post-Graduate Program in Integrated Dental Science, Dental School, University of Cuiabá, Cuiabá, Brazil, Phone: +556533631271, e-mail:
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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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9
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Bergenholtz G. Assessment of treatment failure in endodontic therapy. J Oral Rehabil 2016; 43:753-8. [DOI: 10.1111/joor.12423] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2016] [Indexed: 01/02/2023]
Affiliation(s)
- G. Bergenholtz
- Department of Endodontology; Institute of Odontology; The Sahlgrenska Academy; University of Gothenburg; Gothenburg Sweden
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10
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Kimak A, Strycharz-Dudziak M, Bachanek T, Kimak E. Lipids and lipoproteins and inflammatory markers in patients with chronic apical periodontitis. Lipids Health Dis 2015; 14:162. [PMID: 26666260 PMCID: PMC4678471 DOI: 10.1186/s12944-015-0156-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Accepted: 11/16/2015] [Indexed: 01/25/2023] Open
Abstract
Background Since chronic apical periodontitis (CAP) appears to be a risk factor for coronary heart disease, the aim of the study was to determine the relationship between the size of CAP lesion and inflammatory markers (hsCRP, IL-6, TNF-α), as well as lipids and lipoproteins (LpPLA2, apoAI, apoB level) in blood serum of patients with CAP. Methods The patients studied (n = 43) were divided into groups: patients under 50 and over 50 years of age, and a separate subgroup of the oldest age with the largest size of CAP lesions. Apolipoprotein AI (apoAI) above 150 mg/dL and below 150 mg/dL was used as an important criterion for the division of patients into groups. The CAP lesion size was measured using the Kodak digital imaging system software. The control group consisted of clinically healthy volunteers (n = 20) without CAP. Lipids were measured on a Siemens analyzer (Germany), apoAI, apoB, hsCRP levels were determined by immunonephelometric method, using the Health Care Diagnostic Product (Siemens GmbH, Germany), and IL-6, TNF-α and LpPLAG7 assay kits (ELISA, R&D Systems) were used. Results The findings suggested that in patients with CAP and their age increase, the CAP lesion size, the concentration of inflammatory markers and LpPLA2 mass increased. Correlations between the CAP lesion size and LpPLA2 mass and between the CAP lesion size and TG level in patients with apoAI 150 ≤ mg/dL showed increase TG in atherogenic apoB-containing triglyceride-rich lipoprotein and TC in cholesterol-rich lipoprotein. The patients with a low apoAI and high LpPLA2 level can have a higher risk of odontogenic disease and progression of atherosclerosis and coronary heart disease. Conclusion We have found a positive correlation between apoAI level and the CAP lesion size and a negative correlation between LpPLA2 level and the CAP lesion size. The results suggest that apoAI and LpPLA2 in HDL particles have antiinflammatory action and together can limit the CAP lesion size in patient with a higher apoAI level. The literature data on the distribution of lipoprotein particles in subjects are still insufficient, so this problem requires further studies.
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Affiliation(s)
- Aleksandra Kimak
- Department of Conservative Dentistry with Endodontic, Medical University, Karmelicka 7, 20-081, Lublin, Poland.
| | | | - Teresa Bachanek
- Department of Conservative Dentistry with Endodontic, Medical University, Karmelicka 7, 20-081, Lublin, Poland.
| | - Elżbieta Kimak
- Department of Laboratory Diagnostics, Medical University, Street Chodźki 1, 20-093, Lublin, Poland.
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Abella F, Morales K, Garrido I, Pascual J, Duran-Sindreu F, Roig M. Endodontic applications of cone beam computed tomography: case series and literature review. GIORNALE ITALIANO DI ENDODONZIA 2015. [DOI: 10.1016/j.gien.2015.08.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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12
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Webber J. Endodontics: To intervene or not to intervene. Br Dent J 2015; 219:3. [DOI: 10.1038/sj.bdj.2015.544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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