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Segura-Sampedro JJ, Jiménez-Giménez C, Jane Salas E, Cabanillas-Balsera D, Martín-González J, Segura-Egea JJ, López-López J. Periapical and Endodontic Status of Patients with Inflammatory Bowel Disease: Age- and Sex- matched Case-control Study. Int Endod J 2022; 55:748-757. [PMID: 35403728 PMCID: PMC9325481 DOI: 10.1111/iej.13747] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 11/28/2022]
Abstract
AIM Crohn's disease (CD) and ulcerative colitis (UC) are two chronic recurrent inflammatory processes of the gastrointestinal tract, grouped under the name Inflammatory Bowel Disease (IBD), causing clinical episodes of intestinal inflammation. The aim of this study was to investigate the possible association between IBD and the prevalence of apical periodontitis and root canal treatment. METHODOLOGY A case-control study design matched to age and sex was used. The study group (SG) included 28 patients with IBD (13 with CD, 15 with UC). Another 28 healthy subjects, without IBD and age- and sex- matched, were included in the control group (CG). Radiographic records were analyzed and apical periodontitis (AP) was diagnosed as radiolucent periapical lesions (RPLs), using the periapical index score (PAI). Student's t test, χ2 test and multivariate logistic regression were used in the statistical analysis. RESULTS In the CG, only 17 subjects (61%) had at least one tooth with AP, while in the SG group they were 23 patients (82%) (OR = 2.98; CI 95% = 0.87 - 10.87; p = 0.08). The number of subjects with one or more root filled teeth (RFT) in the CG was 14 (50%), while in the SG they were 22 (79%) (OR = 3.67; 95% CI = 1.14 - 11.79; p = 0.026). At least one RFT with AP was evident in 3 subjects (10.7%) in the control group, while in the study group 15 patients (53.6%) showed RFT with AP (OR = 9.60; 95% CI = 2.35 - 39.35; p = 0.001). In the multivariate logistic regression analysis, only endodontic status was found to be associated with IBD (OR = 1.86; 95% CI = 1.24 - 2.80; p = 0.003). CONCLUSION IBD, ulcerative colitis and Crohn´s disease, is associated with higher prevalence of RFT and higher percentage of RFT with periapical lesions. Dentists should consider these findings when caring for IBD patients by monitoring the evolution of periapical lesions of endodontically treated teeth.
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Affiliation(s)
- Juan J Segura-Sampedro
- General & Digestive Surgery Unit. Hospital Universitario Son Espases, School of Medicine, University of Balearic Islands. Balearic Islands Health Research Institute, Palma de Mallorca, Spain
| | - Carla Jiménez-Giménez
- Department of Odontostomatology, Faculty of Medicine and Health Sciences [Dentistry]. C / feixa LLarga s / n. Hospitalet de LLobregat, Barcelona, 08907, Spain
| | - Enric Jane Salas
- Department of Odontostomatology, Faculty of Medicine and Health Sciences [Dentistry] - Dentistry Hospital Universidad de Barcelona. C / feixa LLarga s / n. Hospitalet de LLobregat, Barcelona, 08907, Spain
| | - Daniel Cabanillas-Balsera
- Department of Stomatology, School of Dentistry, University of Sevilla, C/ Avicena s/n, 41009, Sevilla, Spain
| | - Jenifer Martín-González
- Department of Stomatology, School of Dentistry, University of Sevilla, C/ Avicena s/n, 41009, Sevilla, Spain
| | - Juan J Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, C/ Avicena s/n, 41009, Sevilla, Spain
| | - José López-López
- Department of Odontostomatology, Faculty of Medicine and Health Sciences [Dentistry] - Dentistry Hospital Universidad de Barcelona. C / feixa LLarga s / n. Hospitalet de LLobregat, Barcelona, 08907, Spain
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Teh LA, Abdullah D, Liew AKC, Soo E. Evaluation of Pulpal Involvement, Ulceration, Fistula, and Abscess Index and Periapical Index in Screening for Endodontic Disease: Reliability and Accuracy. J Endod 2020; 46:748-755. [PMID: 32279884 DOI: 10.1016/j.joen.2020.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2019] [Revised: 02/18/2020] [Accepted: 02/19/2020] [Indexed: 01/12/2023]
Abstract
INTRODUCTION The pulpal involvement, ulceration, fistula, and abscess (PUFA) index was developed to screen for the clinical consequences of untreated dental caries. The aim of this study was to compare the diagnostic accuracy of the PUFA index and the periapical index (PAI) in identifying pulpal and periapical diseases. METHODS A cross-sectional study was conducted using consecutive sampling. Each participant went through screening using the PUFA index, orthopantomography assessment using PAI, and comprehensive clinical examination to derive pulpal and apical diagnoses. The outcomes were dichotomized. Reliability was estimated using the Cohen kappa coefficient. Sensitivity, specificity, and predictive values were calculated. The area under the receiver operating characteristic curve was compared using the chi-square test. RESULTS A total of 165 participants were examined, 98.2% of whom had a decayed, missing, or filled tooth index >0. Of 4115 teeth assessed, 16.2% (n = 666) were diagnosed with pulpal disease and 7.9% (n = 325) with periapical disease. Interexaminer reliability for the PUFA index and PAI was 0.87 and 0.80, respectively. Intraexaminer reliability was 0.83 and 0.76 for the PUFA index and 0.75 and 0.72 for PAI. For pulpal diagnosis, the sensitivity of the PUFA index and PAI was 67.6% and 41.7%, respectively; the specificity of the PUFA index and PAI was 99.8% and 99.2%, respectively. For apical diagnosis, the sensitivity of the PUFA index and PAI was 87.7% and 75.4%, respectively; the specificity of the PUFA index and PAI was 95.4% and 98.4%, respectively. The PUFA index is statistically more accurate than PAI for pulpal diagnosis and apical diagnosis (P < .05). CONCLUSIONS The PUFA index can be used in screening for pulpal and periapical diseases with some limitations.
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Affiliation(s)
- Lay Ann Teh
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Dalia Abdullah
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | - Amy Kia Cheen Liew
- Department of Family Oral Health, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Eason Soo
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Poyato-Borrego M, Segura-Sampedro JJ, Martín-González J, Torres-Domínguez Y, Velasco-Ortega E, Segura-Egea JJ. High Prevalence of Apical Periodontitis in Patients With Inflammatory Bowel Disease: An Age- and Gender- matched Case-control Study. Inflamm Bowel Dis 2020; 26:273-279. [PMID: 31247107 DOI: 10.1093/ibd/izz128] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Deep carious lesions cause pulpitis, pulpal necrosis and, finally, apical periodontitis (AP). Root canal treatment (RCT) is the treatment of choice for AP, changing the tooth into a root-filled tooth (RFT). Several studies have linked AP and RFT to systemic diseases. Likewise, previous studies have also found an association among inflammatory bowel disease (IBD) and periodontal disease. This study aims to analyze the frequency of AP and RCT in IBD patients and healthy control subjects. METHODS An age- and gender-matched case-control study design was used. The study group (SG) included 54 IBD patients (28 with Crohn´s disease, 26 with ulcerative colitis). Another 54 healthy subjects without IBD and age- and gender-matched were included in the control group (CG). The radiographic records were analyzed, and periapical radiolucencies were diagnosed as AP, using the periapical index (PAI). The statistical analysis was carried out using the Student t test, χ 2 test, and multivariate logistic regression. RESULTS The presence of 1 or more teeth with radiolucent periapical lesions (RPLs) was found in 19 patients (35.2%) in the study group and in 9 subjects (16.7%) in the control group (P = 0.03). No differences were found among the 2 groups neither in the amount of teeth with AP nor in the number of RFTs (P > 0.05). However, multivariate logistic regression analysis adjusting for number of teeth and number of RFTs showed that patients with IBD have RPLs with higher likelihood than control patients (odds ratio, 5.7; confidence interval 95%, 1.7-19.1; P = 0.0048). CONCLUSIONS Subjects with inflammatory bowel disease have higher prevalence of apical periodontitis. An oral health protocol should be established to address the higher prevalence of inflammatory oral processes.
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Affiliation(s)
| | - Juan J Segura-Sampedro
- General & Digestive Surgery Unit, Hospital Universitario Son Espases, School of Medicine, University of Balearic Islands, Health Research Institute of Balearic Islands, Palma de Mallorca, Spain
| | - Jenifer Martín-González
- Department of Stomatology, School of Dentistry, University of Sevilla, Calle Avicena s/n, Sevilla, Spain
| | | | - Eugenio Velasco-Ortega
- Department of Stomatology, School of Dentistry, University of Sevilla, Calle Avicena s/n, Sevilla, Spain
| | - Juan J Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, Calle Avicena s/n, Sevilla, Spain
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Glycated Hemoglobin Levels and Prevalence of Apical Periodontitis in Type 2 Diabetic Patients. J Endod 2015; 41:601-6. [DOI: 10.1016/j.joen.2014.12.024] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 10/28/2014] [Accepted: 12/29/2014] [Indexed: 12/26/2022]
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López-López J, Castellanos-Cosano L, Estrugo-Devesa A, Gómez-Vaquero C, Velasco-Ortega E, Segura-Egea JJ. Radiolucent periapical lesions and bone mineral density in post-menopausal women. Gerodontology 2013; 32:195-201. [PMID: 24164489 DOI: 10.1111/ger.12076] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2013] [Indexed: 11/30/2022]
Abstract
PURPOSE To investigate the relationship between radiolucent periapical lesions and bone mineral density in post-menopausal women. MATERIAL AND METHODS Seventy-five post-menopausal women were recruited for the study. Bone mineral density was measured using dual-energy X-ray absorptiometry. Three groups were established: healthy bone group, osteopenic group and osteoporotic group. Periapical radiolucencies were diagnosed on the basis of examination of digital panoramic radiographs. Statistical analysis was carried out using anova and chi-squared tests, and logistic regression analysis. RESULTS In both the osteopenic and osteoporotic groups, 25% of women showed at least one periapical radiolucency, whereas this was only 7.4% in the healthy bone group (odds ratio = 4.2; p = 0.061). After multivariate logistic regression analysis adjusting for covariates (age, number of teeth, number of root-filled teeth and number of teeth with coronal restorations), a marginally significant association was evident between bone mineral density and the presence of periapical radiolucencies (odds ratio = 1.9; CI 95% = 1.0-3.8; p = 0.050). CONCLUSIONS After adjusting for covariates, low bone mineral density is marginally associated with a higher frequency of radiolucent periapical lesions.
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Affiliation(s)
- José López-López
- Department of Odontostomatology, School of Dentistry, University of Barcelona, Barcelona, Spain
| | | | - Albert Estrugo-Devesa
- Department of Odontostomatology, School of Dentistry, University of Barcelona, Barcelona, Spain
| | | | | | - Juan José Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
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Moll MA, Seuthe M, von See C, Zapf A, Hornecker E, Mausberg RF, Ziebolz D. Comparison of clinical and dental panoramic findings: a practice-based crossover study. BMC Oral Health 2013; 13:48. [PMID: 24066660 PMCID: PMC4015768 DOI: 10.1186/1472-6831-13-48] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2013] [Accepted: 09/19/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aim was to compare clinical findings with x-ray findings using dental panoramic radiography (DPR). In addition, type and frequency of secondary findings in x-rays were investigated. METHODS Patients were selected on the basis of available DPRs (not older than 12 months). No therapeutic measures were permitted between the DPR and the clinical findings. The clinical findings were carried out by several investigators who had no knowledge of the purpose of the study. A calibrated investigator established the x-ray findings, independently and without prior knowledge of the clinical findings. The evaluation parameters for each tooth were: missing, healthy, carious, restorative or prosthetically sufficient or insufficient treatment. Type and frequency of additional findings in the DPR were documented, e.g. quality of a root canal filling and apical changes. RESULTS Findings of 275 patients were available. Comparison showed a correspondence between clinical and radiographic finding in 93.6% of all teeth (n = 7,789). The differences were not significant (p > 0.05). Regarding carious as well as insufficiently restored or prosthetically treated teeth, respectively there were significant differences between the two methods (p < 0.05). The DPRs showed additional findings: root fillings in 259 teeth and 145 teeth with periapical changes. CONCLUSIONS With reference to the assessment of teeth, there was no difference between the two methods. However, in the evaluation of carious as well as teeth with insufficiently restorative or prosthetic treatment, there was a clear discrepancy between the two methods. Therefore, it would have been possible to have dispensed with x-rays. Nevertheless, additional x-ray findings were found.
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Affiliation(s)
- Marc A Moll
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Centre, Robert-Koch Str, 40, Goettingen D-37075, Germany.
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Castellanos-Cosano L, Machuca-Portillo G, Segura-Sampedro JJ, Torres-Lagares D, López-López J, Velasco-Ortega E, Segura-Egea JJ. Prevalence of apical periodontitis and frequency of root canal treatments in liver transplant candidates. Med Oral Patol Oral Cir Bucal 2013; 18:e773-9. [PMID: 23722148 PMCID: PMC3790651 DOI: 10.4317/medoral.19148] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 03/27/2013] [Indexed: 12/13/2022] Open
Abstract
Aim: The purpose of this study was to investigate the prevalence of apical periodontitis (AP) and endodontic treatment in liver transplant candidates and control healthy subjects.
Material and Methods: A descriptive cross-sectional study. Forty two liver transplant candidates (LTC) (study group) and 42 control subjects. Digital panoramic radiographs where used. Periapical status was scored according to the periapical index (PAI). Results were analysed statistically using the Chi-squared test and logistic regression.
Results: Radiographic signs of AP in one or more teeth was found in 79% of patients in the study group and in 50% of control subjects (p = 0.008; OR = 3.7; C. I. 95% = 1.4 - 9.5). One or more root-filled teeth (RFT) were found in 19% and 62% of study and control subjects, respectively (p = 0.0001; OR = 0.14; 95% C. I. = 0.05 - 0.38). Among LTC patients 14.7% of the teeth had AP, whereas in the control subjects 4.2% of teeth were affected (p= 0.0002). The percentage of RFT in the study and control groups was 1.5% and 6.8%, respectively (p = 0.0002). Conclusions: Liver transplant candidates have significantly higher prevalence of radiographic periapical lesions and lower frequency of RFT than controls healthy subjects.
Key words:Apical periodontitis, endodontics, hepatic cirrhosis, liver disease, liver transplant, oral health, root-canal treatment.
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Castellanos-Cosano L, Machuca-Portillo G, Sánchez-Domínguez B, Torrés-Lagares D, López-López J, Segura-Egea JJ. High prevalence of radiolucent periapical lesions amongst patients with inherited coagulation disorders. Haemophilia 2013; 19:e110-5. [DOI: 10.1111/hae.12089] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2012] [Indexed: 02/07/2023]
Affiliation(s)
- L. Castellanos-Cosano
- Department of Stomatology, School of Dentistry; University of Sevilla; Sevilla; Spain
| | - G. Machuca-Portillo
- Department of Stomatology, School of Dentistry; University of Sevilla; Sevilla; Spain
| | | | - D. Torrés-Lagares
- Department of Stomatology, School of Dentistry; University of Sevilla; Sevilla; Spain
| | - J. López-López
- Department of Odontostomatology, School of Dentistry; University of Barcelona; Barcelona; Spain
| | - J. J. Segura-Egea
- Department of Stomatology, School of Dentistry; University of Sevilla; Sevilla; Spain
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López-López J, Jané-Salas E, Estrugo-Devesa A, Castellanos-Cosano L, Martín-González J, Velasco-Ortega E, Segura-Egea JJ. Frequency and distribution of root-filled teeth and apical periodontitis in an adult population of Barcelona, Spain. Int Dent J 2012; 62:40-6. [DOI: 10.1111/j.1875-595x.2011.00087.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
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Choi JW. Assessment of panoramic radiography as a national oral examination tool: review of the literature. Imaging Sci Dent 2011; 41:1-6. [PMID: 21977466 PMCID: PMC3174459 DOI: 10.5624/isd.2011.41.1.1] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Revised: 02/12/2011] [Accepted: 02/23/2011] [Indexed: 01/03/2023] Open
Abstract
Purpose The purpose of this review is to evaluate the possibility of panoramic radiography as a national oral examination tool. Materials and Methods This report was carried out by review of the literatures. Results Panoramic radiography has sufficient diagnostic accuracy in dental caries, periodontal diseases, and other lesions. Also, the effective dose of panoramic radiography is lower than traditional full-mouth periapical radiography. Conclusion Panoramic radiography will improve the efficacy of dental examination in national oral examination. However, more studies are required to evaluate the benefit, financial cost, and operation time and also to make selection criteria and quality management program.
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Affiliation(s)
- Jin-Woo Choi
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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Hidden mandibular pathology in a patient planned for radiotherapy highlighting the need for dental screening. JOURNAL OF RADIOTHERAPY IN PRACTICE 2011. [DOI: 10.1017/s1460396910000166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractDental assessments are important before the commencement of radiotherapy to the head and neck area to assess the teeth and associated structures lying in the treatment field and to inform the patient of the effects of radiotherapy on the oral cavity. This case report documents an incidental radiographic finding of a mandibular cystic lesion and its impact on the radiotherapy planning and decision making to proceed with radiotherapy.
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Gisakis IG, Palamidakis FD, Farmakis ETR, Kamberos G, Kamberos S. Prevalence of impacted teeth in a Greek population. ACTA ACUST UNITED AC 2011; 2:102-9. [DOI: 10.1111/j.2041-1626.2010.00041.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Screening radiographs for new adult patients. Br Dent J 2002. [DOI: 10.1038/sj.bdj.4801352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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