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Ideo F, Mercuro G, Sanna S, Bardini G, Niazi S, Mannocci F, Cotti E. Evidence of an effect of statins on lesions originating from dental infection. A retrospective clinical investigation. Int J Cardiol 2024; 415:132458. [PMID: 39154756 DOI: 10.1016/j.ijcard.2024.132458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 08/08/2024] [Accepted: 08/13/2024] [Indexed: 08/20/2024]
Abstract
BACKGROUND Apical periodontitis (AP) is an inflammatory dental disease caused by bacterial infections of the endodontic system. The correlation between AP and cardiovascular diseases. (CVD) has been consistently investigated. Statins are a class of drugs that are used to treat hypercholesterolemia and prevent atherosclerotic vascular diseases. They have other beneficial pleiotropic effects such as anti-inflammatory, antithrombotic, and antioxidant activities. The aim of this study was to evaluate the oral health status and prevalence of AP in patients treated with statins (Group S) in comparison with untreated patients (Group C) to understand whether the anti-inflammatory action of these drugs can influence the prevalence of AP. METHODS The records of seventy-nine patients (43 men and 36 women, mean age 68 ± 11 years, 1716 teeth) treated with statins and referred to the University clinic for dental evaluation were reviewed. Seventy patients free from systemic diseases and without therapy (39 men and 31 women, mean age 62 ± 9 years, 1720 teeth) constituted the control group. All subjects underwent complete oral, dental, and radiographic examinations to determine the presence and severity of AP. Periapical index (PAI) and decayed, missed, and filled teeth (DMFT) scores were obtained. RESULTS AP was significantly less common in Group S (22,8%) than in Group C (50%) (P < 0.05). Furthermore, the mean value of the qualitative rank of the severity of AP (PAI score) was higher in Group C than in Group S (P ≤ 0.05). CONCLUSIONS Our results suggest that statins can attenuate the prevalence of AP, which is associated to CVD.
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Affiliation(s)
- Francesca Ideo
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy.
| | - Giuseppe Mercuro
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Silvia Sanna
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Giulia Bardini
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Sadia Niazi
- Department of Endodontology, Centre for Oral, Clinical & Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's college of London, London, United Kingdom
| | - Francesco Mannocci
- Department of Endodontology, Centre for Oral, Clinical & Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's college of London, London, United Kingdom
| | - Elisabetta Cotti
- Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
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Kytridou V, Gkikas I, Garcia MN, Cepeda O, Hildebolt CF. A literature review of local and systemic considerations for endodontic treatments in older adults. Gerodontology 2023; 40:410-421. [PMID: 36971290 DOI: 10.1111/ger.12679] [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: 09/02/2022] [Revised: 12/09/2022] [Accepted: 12/28/2022] [Indexed: 11/17/2023]
Abstract
OBJECTIVES The aim of this literature review was to summarise the clinical important findings on the endodontic treatment outcome in older patients (≥60 years old) with pulpal/periapical disease considering local and systemic factors from a body of knowledge that is heterogeneous in methods or disciplines. BACKGROUND Due to the increasing number of older patients in the endodontic practice, and the current trend for tooth preservation, the need for clinicians to have a better understanding of age-related implications that may influence the required endodontic treatment in older adults to retain their natural dentition is indispensable. METHODS PubMed/Medline and Embase was searched by a medical librarian using specific terms based on inclusion/exclusion criteria. The reference list was hand-seached for additional relevant publications between 2005-2020. A combination of these terms was performed uing Boolean operators and MeSH terms. RESULTS Of the 1577 publications identified manually and electronically, 25 were included to be fully reviewed by the examiners. The data was derived from three systematic reviews, one systematic and meta-analysis, three case series, four prospective and 14 retrospective cohorts. Overall, there was heterogeneity in reporting as well as limitations in most studies. CONCLUSIONS The outcome of endodontic treatment (ET) either nonsurgical or surgical or combination of these is not affected by older age. ET can be the treatment of choice in older patients wiht pulpal/periapical disease. There is no evidence that older age per se affects the outcome of any type of endodontic treatment.
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Affiliation(s)
- Vasiliki Kytridou
- Section Head of Endodontics, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
| | - Ioannis Gkikas
- Section of Oral and Maxillofacial Surgery, Department of Applied Dental Medicine, Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
| | - Miryam Nathalia Garcia
- Applied Dental Medicine Department, Section of Periodontics, Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
| | - Oscar Cepeda
- Division of Geriatric Medicine, St. Louis VA Medical Center, Washington University School of Medicine, Saint Louis, Missouri, USA
| | - Charles F Hildebolt
- Washington University School of Medicine, Saint Louis, Missouri, USA
- Southern Illinois University School of Dental Medicine, Alton, Illinois, USA
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Ideo F, Manca MF, Niazi S, Mannocci F, Bardini G, Cotti E. The role of systemic statins in the inception and healing of apical periodontitis: a systematic review. BMC Oral Health 2023; 23:730. [PMID: 37805447 PMCID: PMC10560424 DOI: 10.1186/s12903-023-03472-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/28/2023] [Indexed: 10/09/2023] Open
Abstract
OBJECTIVES Statins are a category of medications widely used to reduce plasma LDL-cholesterol levels, that also possess antibacterial, anti-inflammatory, and immunomodulatory action. The aim of this systematic review was to explore the effects of systemic statins therapy on the development and treatment of apical periodontitis (AP) on humans and animals. MATERIAL AND METHODS Three electronic databases (PubMed, Web of Science, and Scopus) and grey literature were searched from their inception until February, 20 2023 (PROSPERO CRD42021246231). For the quality assessment and risk of bias, different guidelines were used according to the typology of the studies considered (Animal Research Reporting of In Vivo Experiments, Newcastle-Ottawa Quality Assessment Form for Cohort Studies, Systematic Review Centre for Laboratory animal Experimentation Risk of Bias tool and Tool to assess risk of bias in cohort studies of CLARITY Group). RESULTS Seven hundred eleven records were screened, and six articles were included for this qualitative review. The eligible studies showed a moderate overall quality and risk of bias. Human patients in treatment with statins exhibited a higher healing rate of AP following root canal treatment. In experimental animal models, statins had a beneficial effect on the development of AP. CONCLUSIONS Despite the limited number of studies and considering that most of them are on animals, our findings suggest that systemically administered statins make a positive contribution to prevent the development and help healing of AP. CLINICAL RELEVANCE There is an increased evidence that a pharmacologic adjunct to endodontic treatment may be considered to enhance healing of AP. Among other medications, statins seem to have a positive impact on the disease.
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Affiliation(s)
- Francesca Ideo
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - Matteo Francesco Manca
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - Sadia Niazi
- Department of Endodontology, Centre for Oral, Clinical & Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Hospital, London, UK
| | - Francesco Mannocci
- Department of Endodontology, Centre for Oral, Clinical & Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Hospital, London, UK
| | - Giulia Bardini
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - Elisabetta Cotti
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy.
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Yang C, Kok S, Wang H, Chang JZ, Lai EH, Shun C, Yang H, Chen M, Hong C, Lin S. Simvastatin alleviates bone resorption in apical periodontitis possibly by inhibition of mitophagy‐related osteoblast apoptosis. Int Endod J 2018; 52:676-688. [DOI: 10.1111/iej.13055] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 12/04/2018] [Indexed: 12/15/2022]
Affiliation(s)
- C.‐N. Yang
- Department of Dentistry School of Dentistry National Taiwan University Taipei Taiwan
| | - S.‐H. Kok
- Department of Dentistry School of Dentistry National Taiwan University Taipei Taiwan
- Department of Dentistry National Taiwan University Hospital Taipei Taiwan
| | - H.‐W. Wang
- Department of Dentistry National Taiwan University Hospital Taipei Taiwan
| | - J. Z.‐C. Chang
- Department of Dentistry School of Dentistry National Taiwan University Taipei Taiwan
- Department of Dentistry National Taiwan University Hospital Taipei Taiwan
| | - E. H.‐H. Lai
- Department of Dentistry School of Dentistry National Taiwan University Taipei Taiwan
- Department of Dentistry National Taiwan University Hospital Taipei Taiwan
| | - C.‐T. Shun
- Department of Forensic Medicine and Pathology National Taiwan University Hospital Taipei Taiwan
| | - H. Yang
- Department of Dentistry National Taiwan University Hospital Taipei Taiwan
| | - M.‐H. Chen
- Department of Dentistry National Taiwan University Hospital Taipei Taiwan
| | - C.‐Y. Hong
- Department of Dentistry School of Dentistry National Taiwan University Taipei Taiwan
- Department of Dentistry National Taiwan University Hospital Taipei Taiwan
- Department of Prosthodontics School of Dentistry China Medical University Taichung Taiwan
- College of Bio‐Resources and Agriculture National Taiwan University Taipei Taiwan
| | - S.‐K. Lin
- Department of Dentistry School of Dentistry National Taiwan University Taipei Taiwan
- Department of Dentistry National Taiwan University Hospital Taipei Taiwan
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Abstract
Newer research tools and basic science knowledge base have allowed the exploration of endodontic diseases in the pulp and periapical tissues in novel ways. The use of next generation sequencing, bioinformatics analyses, genome-wide association studies, to name just a few of these innovations, has allowed the identification of hundreds of microorganisms and of host response factors. This review addresses recent advances in endodontic microbiology and the host response and discusses the potential for future innovations in this area.
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Affiliation(s)
- Ashraf F Fouad
- Department of Endodontics, School of Dentistry, University of North Carolina at Chapel Hill, 1098 First Dental Building, CB# 7450, Chapel Hill, NC 27599-7450, USA.
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Wang HH, Sarmast ND, Shadmehr E, Angelov N, Shabahang S, Torabinejad M. Application of Enamel Matrix Derivative (Emdogain) in Endodontic Therapy: A Comprehensive Literature Review. J Endod 2018; 44:1066-1079. [DOI: 10.1016/j.joen.2018.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 01/25/2018] [Accepted: 02/10/2018] [Indexed: 01/28/2023]
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de Monès E, Schlaubitz S, Catros S, Fricain JC. Statins and alveolar bone resorption: a narrative review of preclinical and clinical studies. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 119:65-73. [PMID: 25482549 DOI: 10.1016/j.oooo.2014.09.030] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 08/14/2014] [Accepted: 09/10/2014] [Indexed: 02/07/2023]
Abstract
CONTEXT Tooth extraction and periodontal disease are both common clinical situations associated with alveolar bone loss. OBJECTIVE To analyze the reported results of in vivo studies investigating the effectiveness of statins to reduce alveolar bone resorption. STUDY DESIGN Systematic electronic search of the MEDLINE-PubMed database. RESULTS A total of 21 studies met the inclusion criteria. This review showed that the use of statins reduced significantly alveolar bone resorption observed during periodontal disease and after tooth extraction. Oral administration was effective using high statin concentrations, although local administration using a biodegradable carrier was effective with lower concentrations. It was recently reported that statins were effective to reduce alveolar bone loss as an adjunct to scaling and root planing (SRP) in several clinical trials. Further studies are needed to confirm these promising results.
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Affiliation(s)
- Erwan de Monès
- INSERM U1026, Tissue Bioengineering, 146 rue Léo-Saignat, F-33000 Bordeaux, France; University of Bordeaux, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Department of Otolaryngology - Head and Neck Surgery, Univ. Bordeaux, Place Amélie Raba Léon, F-33000 Bordeaux, France.
| | - Silke Schlaubitz
- University of Bordeaux, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Bordeaux University Hospital, CIC 1401, PTIB, Xavier Arnozan Hospital, F-33600 Pessac, France
| | - Sylvain Catros
- INSERM U1026, Tissue Bioengineering, 146 rue Léo-Saignat, F-33000 Bordeaux, France; University of Bordeaux, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Department of Dentistry, University of Bordeaux, Place Amélie Raba Léon, F-33000 Bordeaux, France
| | - Jean-Christophe Fricain
- INSERM U1026, Tissue Bioengineering, 146 rue Léo-Saignat, F-33000 Bordeaux, France; University of Bordeaux, 146 rue Léo-Saignat, F-33000 Bordeaux, France; Department of Dentistry, University of Bordeaux, Place Amélie Raba Léon, F-33000 Bordeaux, France
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Incidence of Cholesterol in Periapical Biopsies among Adolescent and Elderly Patients. J Endod 2013; 39:1477-80. [PMID: 24238432 DOI: 10.1016/j.joen.2013.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2013] [Revised: 08/11/2013] [Accepted: 08/12/2013] [Indexed: 02/03/2023]
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