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Lee S, Haraga H, Satoh T, Mutoh N, Watanabe K, Hamada N, Tani-Ishii N. Effect of periodontitis induced by Fusobacterium nucleatum on the microbiota of the gut and surrounding organs. Odontology 2024; 112:177-184. [PMID: 37432500 DOI: 10.1007/s10266-023-00827-8] [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: 07/26/2022] [Accepted: 06/06/2023] [Indexed: 07/12/2023]
Abstract
Detection of the oral bacterium Fusobacterium nucleatum in colorectal cancer tissues suggests that periodontitis may alter gut microbiota. The purpose of this study was to analyze the influence and infection route of periodontal inflammation caused by F. nucleatum, and microbiota of the gut and surrounding organs (heart, liver, kidney). Wistar female rats were orally inoculated with F. nucleatum to establish an experimental periodontitis model that was confirmed by X-ray imaging and histopathological analysis. The mandibles, gut, liver, heart, and kidneys were collected from the experimental group at 2, 4, and 8 weeks, and from the uninfected control group at 0 weeks, for DNA extraction for PCR amplification and comprehensive microbiota analysis using the Illumina MiSeq platform. Imaging confirmed the onset of periodontitis at 2 weeks post-inoculation, and histopathology showed inflammatory cell infiltration from 2 to 8 weeks. PCR and comprehensive microbiota analysis showed the presence of F. nucleatum in the heart and liver at 2 weeks, and in the liver at 4 and 8 weeks. There were changes of microbiota of the gut, heart, liver, and kidneys at 4 weeks: namely, decreased Verrucomicrobia and Bacteroidetes, and increased Firmicutes. F. nucleatum induced the onset of periodontitis and infected the heart and liver in rats. As the periodontic lesion progressed, the microbiota of the gut, liver, heart, and kidneys were altered.
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Affiliation(s)
- Sangmin Lee
- Department of Pulp Biology and Endodontics, Kanagawa Dental University, 82. Inaoka-Cho, Yokosuka, Kanagawa, 238-8580, Japan
| | - Hiroshi Haraga
- Department of Pulp Biology and Endodontics, Kanagawa Dental University, 82. Inaoka-Cho, Yokosuka, Kanagawa, 238-8580, Japan
- Ministry of Defense Japan Self-Defense Forces Hospital Yokosuka, 1766-1 Tauraminato-Cho, Yokosuka, Kanagawa, 237-0071, Japan
| | - Takenori Satoh
- Department of Molecular-Biology, Kanagawa Dental University, 82. Inaoka-Cho, Yokosuka, Kanagawa, 238-8580, Japan
| | - Noriko Mutoh
- Department of Pulp Biology and Endodontics, Kanagawa Dental University, 82. Inaoka-Cho, Yokosuka, Kanagawa, 238-8580, Japan
| | - Kiyoko Watanabe
- Department of Oral Microbiology, Kanagawa Dental University, 82. Inaoka-Cho, Yokosuka, Kanagawa, 238-8580, Japan
| | - Nobushiro Hamada
- Department of Oral Microbiology, Kanagawa Dental University, 82. Inaoka-Cho, Yokosuka, Kanagawa, 238-8580, Japan
| | - Nobuyuki Tani-Ishii
- Department of Pulp Biology and Endodontics, Kanagawa Dental University, 82. Inaoka-Cho, Yokosuka, Kanagawa, 238-8580, Japan.
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Ersahan S, Ozcelik F, Sirin DA, Hepsenoglu YE, Ozcelik IK, Topbas C. Is adrenomedullin upregulation due to apical periodontitis independent of periodontal disease? Odontology 2022:10.1007/s10266-022-00767-9. [DOI: 10.1007/s10266-022-00767-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/12/2022] [Indexed: 11/23/2022]
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Haraga H, Satoh T, Watanabe K, Hamada N, Tani-Ishii N. Effect of the progression of Fusobacterium nucleatum-induced apical periodontitis on the gut microbiota. J Endod 2022; 48:1038-1045. [DOI: 10.1016/j.joen.2022.04.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 04/16/2022] [Accepted: 04/17/2022] [Indexed: 12/13/2022]
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Sirin DA, Ozcelik F, Ersahan S, Pence HH. The importance of inflammatory biomarkers, IL-6 and PAPP-A, in the evaluation of asymptomatic apical periodontitis. Odontology 2020; 109:250-258. [PMID: 32594277 DOI: 10.1007/s10266-020-00534-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/16/2020] [Indexed: 02/07/2023]
Abstract
To examine the use of IL-6 and PAPP-A along with the new imaging for scoring methods to determine the severity of apical periodontitis (AP). The scoring of disease severity in 121 patients with AP, using dental radiographs, was based on "The Apical Periodontitis Grading Scale" (APGS), as those having 1 tooth with AP and severity of 3-4 were classified as grade 1 (mild); those having > 1 tooth and severity of 3-4 as grade 2 (moderate) and those with at least one tooth with a severity of 5 as grade 3 (severe). 45 systematically and orally healthy volunteers were selected as the control group (grade 0). Dental demographic data of all participants were recorded. Besides, venous blood samples were collected to study their complete blood count and levels of IL-6 and PAPP-A. Both NLR and PAPP-A levels of the grade 3 AP patients were found significantly higher than those of the control group and grade 1 and grade 2 AP patients (2.55 ± 1.40 vs 1.98 ± 1.05, 1.94 ± 0.58 and 1.86 ± 0.50; 0.606 ± 0.211 vs 0.422 ± 0.273, 0.447 ± 0.224 and 0.436 ± 0.242, p < 0.01, respectively). AP grades identified by the new scoring system were moderately correlated with IL-6 levels (Spearman r = 0.4168, p < 0.001). The risk of patients with IL-6 levels above 12.5 pg/ml to develop AP (relative risk) was found to be 2.19 times higher than that in those with lower IL-6 levels (98% Cl 1.233-3.905, p < 0.0024). APGS classification suggested to determine AP severity was found to be significantly correlated with levels of inflammatory markers IL-6 and PAPP-A.
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Affiliation(s)
- Dursun Ali Sirin
- Department of Endodontics, Faculty of Dentistry, University of Health Sciences Turkey, Istanbul, Turkey
| | - Fatih Ozcelik
- Medical Biochemistry Department, Faculty of Medicine, University of Health Sciences Turkey, Istanbul, Turkey.
| | - Seyda Ersahan
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey
| | - Halime Hanım Pence
- Medical Biochemistry Department, Faculty of Medicine, University of Health Sciences Turkey, Istanbul, Turkey
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Cowan LT, Lakshminarayan K, Lutsey PL, Beck J, Offenbacher S, Pankow JS. Endodontic therapy and incident cardiovascular disease: The Atherosclerosis Risk in Communities (ARIC) study. J Public Health Dent 2020; 80:79-91. [DOI: 10.1111/jphd.12353] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 10/17/2019] [Accepted: 11/13/2019] [Indexed: 11/26/2022]
Affiliation(s)
- Logan T. Cowan
- Department of Biostatistics, Epidemiology and Environmental Health SciencesGeorgia Southern University Statesboro GA USA
| | | | - Pamela L. Lutsey
- Division of Epidemiology and Community HealthUniversity of Minnesota Minneapolis MN USA
| | - James Beck
- Department of Dental Ecology, School of DentistryUniversity of North Carolina Chapel Hill NC USA
| | - Steven Offenbacher
- Department of Periodontology, School of DentistryUniversity of North Carolina Chapel Hill NC USA
| | - James S. Pankow
- Division of Epidemiology and Community HealthUniversity of Minnesota Minneapolis MN USA
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Sirin DA, Ozcelik F, Uzun C, Ersahan S, Yesilbas S. Association between C-reactive protein, neutrophil to lymphocyte ratio and the burden of apical periodontitis: a case-control study. Acta Odontol Scand 2019; 77:142-149. [PMID: 30394169 DOI: 10.1080/00016357.2018.1522447] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Endodontic originated chronic apical periodontitis (AP) is an inflammatory disease of periapical tissue. High-sensitivity C-reactive protein (hsCRP) as an inflammatory marker and hemogram indexes provide valuable information to clinicians for diagnosis, screening and follow-up of various diseases. The aim of this study was to investigate AP in terms of its association with hemogram indices and hsCRP levels. MATERIAL AND METHODS Study includes 104 patients with AP and 40 participants as the control group. 160 teeth were diagnosed as AP through digital radiographic images and scored with respect to Periapical Index (PAI) scoring. Afterwards, patients were categorized into 3 grades in accordance with both the number and the severity of AP. AP grade 0 was considered for the control group with regard to a new scoring system. Patients with only one tooth involved with AP with a PAI score of 3 or 4 were categorized as an AP Grade 1, when a patient had more than one tooth with a PAI score of 3 or 4 he was classified as an AP Grade 2 and a patient with at least one tooth scored as a PAI 5 was rated as an AP Grade 3. Hemograms and hsCRP levels were measured for each individual to establish a correlation with inflammatory markers. RESULTS The neutrophil/lymphocyte ratio (NLR) levels of patients with AP Grade 3 were significantly higher than all other AP grades (p < .05). hsCRP levels in patients with an AP Grade 2 and 3 were higher than both AP Grade 0 and 1 (p < .05). CONCLUSIONS hsCRP levels of patients were reliable predictive indicators for AP severity in correlation with the new proposed scoring system for AP.
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Affiliation(s)
- DA Sirin
- Department of Endodontics, Faculty of Dentistry, University of Health Sciences, Istanbul, Turkey
| | - F Ozcelik
- Medical Biochemistry Department, Sultan Abdülhamid Han Training Hospital, University of Health Sciences, Istanbul, Turkey
| | - C Uzun
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, University of Health Sciences, Istanbul, Turkey
| | - S Ersahan
- Department of Endodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey
| | - S Yesilbas
- Medical Biochemistry Department, Sultan Abdülhamid Han Training Hospital, University of Health Sciences, Istanbul, Turkey
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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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Apical periodontitis in southern Estonian population: prevalence and associations with quality of root canal fillings and coronal restorations. BMC Oral Health 2017; 17:147. [PMID: 29233146 PMCID: PMC5727925 DOI: 10.1186/s12903-017-0429-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 11/19/2017] [Indexed: 12/18/2022] Open
Abstract
Background Apical periodontitis (AP) is an inflammatory disease around the apex of a tooth root. Reported prevalence of AP ranges from 27% to 83% while the data about most post-Soviet countries are still missing. Knowing the prevalence of AP within a certain population helps to plan the treatment need and evaluate the success of endodontic interventions. We aimed to collect data about prevalence and determining factors of AP for the first time in Estonia. Methods The cross-sectional study included 6552 patients (age 35.5±19.2 years). Radiographic examination was applied to investigate the prevalence of AP and quality of endodontic treatment. Results AP was diagnosed in 54.7% of subjects. Endodontically treated teeth were present in 58.2% of subjects. Periapical finding was present in 44.6% of endodontically treated and in 30.8% of untreated teeth. Out of 181,495 teeth, 52.7% were intact. AP was diagnosed in 6.3% of teeth, 6.9% of teeth were endodontically treated. Risk factors for AP included caries (OR = 2.30), male gender (OR = 1.44), too short (OR = 1.76) or too long root canal filling (OR = 2.51), root canal filling of low density (OR = 1.61) while not orthodontic appliance. Lower AP risk was associated with restoration of the tooth – filling (OR = 0.45), crown (OR = 0.34) and bridge (OR = 0.33). Conclusions AP is highly prevalent in Southern Estonian population. Most cases are associated with root canal-treated teeth. The overall quality of root canal fillings tends to be low, consistent with the mediocre outcome of treatment. Considerable efforts are required to improve the standards of endodontic treatment. Electronic supplementary material The online version of this article (10.1186/s12903-017-0429-7) contains supplementary material, which is available to authorized users.
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Maret D, Peters OA, Vigarios E, Epstein JB, van der Sluis L. Dental screening of medical patients for oral infections and inflammation: consideration of risk and benefit. Microbes Infect 2016; 19:84-90. [PMID: 27773850 DOI: 10.1016/j.micinf.2016.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 10/06/2016] [Accepted: 10/09/2016] [Indexed: 12/30/2022]
Abstract
The primary purpose of preoperative dental screening of medical patients is to detect acute or chronic oral conditions that may require management prior to planned medical interventions. The aim of this communication is to discuss the background of preoperative dental screening and the link between dental pathologies and systemic diseases.
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Affiliation(s)
- Delphine Maret
- Laboratoire Anthropologie Moléculaire et Imagerie de Synthèse (AMIS), UMR 5288, CNRS, Toulouse, France; Faculté de Chirurgie Dentaire, Université Paul Sabatier, Centre Hospitalier Universitaire, Toulouse, France.
| | - Ove A Peters
- Department of Endodontics, University of the Pacific, Arthur A Dugoni, School of Dentistry, San Francisco, CA, USA
| | - Emmanuelle Vigarios
- Oral Oncology Department, Comprehensive Cancer Center Institut Claudius-Regaud, Institut Universitaire du Cancer, Toulouse, France
| | - Joel B Epstein
- Department of Surgery, Cedars-Sinai Medical Center, Los Angelès, CA, USA
| | - Lucas van der Sluis
- Center of Dentistry and Oral Hygiene, University Medical Center Groningen, The Netherlands
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Hussein FE, Liew AKC, Ramlee RA, Abdullah D, Chong BS. Factors Associated with Apical Periodontitis: A Multilevel Analysis. J Endod 2016; 42:1441-5. [DOI: 10.1016/j.joen.2016.07.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 06/28/2016] [Accepted: 07/06/2016] [Indexed: 12/19/2022]
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An GK, Morse DE, Kunin M, Goldberger RS, Psoter WJ. Association of Radiographically Diagnosed Apical Periodontitis and Cardiovascular Disease: A Hospital Records–based Study. J Endod 2016; 42:916-20. [DOI: 10.1016/j.joen.2016.03.011] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 03/07/2016] [Accepted: 03/13/2016] [Indexed: 11/25/2022]
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Correia-Sousa J, Madureira AR, Carvalho MF, Teles AM, Pina-Vaz I. Apical periodontitis and related risk factors: Cross-sectional study. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.rpemd.2015.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Cotti E, Mercuro G. Apical periodontitis and cardiovascular diseases: previous findings and ongoing research. Int Endod J 2015; 48:926-32. [DOI: 10.1111/iej.12506] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 07/05/2015] [Indexed: 11/28/2022]
Affiliation(s)
- E. Cotti
- Department of Conservative Dentistry and Endodontics; University of Cagliari; Sardinia Italy
| | - G. Mercuro
- Department of Medical Sciences; University of Cagliari; Sardinia Italy
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Segura-Egea JJ, Martín-González J, Castellanos-Cosano L. Endodontic medicine: connections between apical periodontitis and systemic diseases. Int Endod J 2015; 48:933-51. [DOI: 10.1111/iej.12507] [Citation(s) in RCA: 125] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Accepted: 07/05/2015] [Indexed: 12/13/2022]
Affiliation(s)
- J. J. Segura-Egea
- Endodontic Section; Department of Stomatology; School of Dentistry; University of Sevilla; Sevilla Spain
| | - J. Martín-González
- Endodontic Section; Department of Stomatology; School of Dentistry; University of Sevilla; Sevilla Spain
| | - L. Castellanos-Cosano
- Special Care Dentistry Section; Department of Stomatology; School of Dentistry; University of Sevilla; Sevilla Spain
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BERLINCK T, TINOCO JMM, CARVALHO FLF, SASSONE LM, TINOCO EMB. Epidemiological evaluation of apical periodontitis prevalence in an urban Brazilian population. Braz Oral Res 2015; 29:51. [DOI: 10.1590/1807-3107bor-2015.vol29.0051] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2014] [Accepted: 01/08/2015] [Indexed: 11/21/2022] Open
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Saatchi M, Aminozarbian MG, Hasheminia SM, Mortaheb A. Influence of apical periodontitis on the accuracy of 3 electronic root canal length measurement devices: an in vivo study. J Endod 2013; 40:355-9. [PMID: 24565652 DOI: 10.1016/j.joen.2013.11.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2013] [Revised: 11/08/2013] [Accepted: 11/14/2013] [Indexed: 11/15/2022]
Abstract
INTRODUCTION The aim of this in vivo study was to evaluate the influence of apical periodontitis (AP) on the accuracy of Dentaport ZX (J Morita, Kyoto, Japan), Raypex 5 (VDW, Munich, Germany), and i-Root (S-Denti, Seoul, Korea) electronic root canal length measurement devices (ERCLMDs). METHODS Thirty-two single-rooted teeth scheduled for extraction, consisting of 16 teeth with AP and 16 teeth with normal periapex (NP), were selected. The access cavity was prepared, and the coronal portion of the canal was flared. The electronic working length (EWL) was determined by each ERCLMD according to each manufacturer's instructions. Each tooth was extracted, and the actual working length (AWL) was determined by inserting a size 15 K-file until the tip could be seen at a position tangential to the major foramen and then 0.5 mm was subtracted from the measurement. The distance from the file tip (EWL) to the point 0.5 mm coronal to the major foramen (AWL) was calculated. Data were analyzed using the nonparametric Fisher exact test and the chi-square test. Statistical significance was set at P < .05. RESULTS The accuracies of Dentaport ZX, Raypex 5, and i-Root within ± 0.5 mm in the AP group were 93.8%, 81.3%, and 75.0%; they were 93.3%, 86.7%, and 73.3% in the NP group, respectively. There were no significant differences between the accuracy of each device in the 2 groups (P > .05). Considering the 2 groups of AP and NP, there were no statistically significant differences in the accuracy of the ERCLMDs (P > .05). CONCLUSIONS The presence of AP did not influence the accuracy of ERCLMDs.
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Affiliation(s)
- Masoud Saatchi
- Torabinejad Dental Research Center, Department of Endodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Ghasem Aminozarbian
- Torabinejad Dental Research Center, Department of Endodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Seyed Mohsen Hasheminia
- Torabinejad Dental Research Center, Department of Endodontics, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amin Mortaheb
- Dental Research Center, Department of Endodontics, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
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Association among Oral Health, Apical Periodontitis, CD14 Polymorphisms, and Coronary Heart Disease in Middle-aged Adults. J Endod 2012; 38:1570-7. [DOI: 10.1016/j.joen.2012.08.013] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2011] [Revised: 08/15/2012] [Accepted: 08/21/2012] [Indexed: 11/22/2022]
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Wu MK, Wesselink PR, Shemesh H, Patel S. WITHDRAWN: Endodontic Epidemiologic Investigations and Clinical Outcome Studies with Cone-Beam Computed Tomography. J Endod 2011. [DOI: 10.1016/j.joen.2011.03.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Cotti E, Dessì C, Piras A, Mercuro G. Can a chronic dental infection be considered a cause of cardiovascular disease? A review of the literature. Int J Cardiol 2010; 148:4-10. [PMID: 20851474 DOI: 10.1016/j.ijcard.2010.08.011] [Citation(s) in RCA: 78] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2010] [Revised: 07/24/2010] [Accepted: 08/07/2010] [Indexed: 12/19/2022]
Abstract
Cardiovascular diseases (CVD) have a complex etiology determined by risk factors, which are in turn associated to a strong genetic component and to environmental factors. In the biological background for the development of CVD, low-grade chronic inflammation plays a role as a pathogenetic determinant of atherosclerosis. Dental infections have been associated with CVD. Periodontal disease is a chronic infection of the supporting tissues of the tooth that can lead to teeth loss. In recent years, a number of reports have demonstrated the possible relationship between periodontal disease and CVD. Apical periodontitis, on the other hand, is the late consequence of an endodontic infection, which is caused by the persistence of coronal caries and involves the root canal system of the tooth. Most of the time, it is a chronic infection. Some studies have found a correlation between a "composite status" of oral health (eg. caries, tooth loss, periodontal disease) and CVD, but only a few of them have addressed the association between apical periodontitis and CVD. This "state of the art" paper represents the first stage of an incoming study on the relationship between chronic endodontic infection and CVD.
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Affiliation(s)
- Elisabetta Cotti
- Department of Conservative Dentistry and Endodontics, School of Dentistry, University of Cagliari, Cagliari, Italy
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Friedlander AH, Sung EC, Chung EM, Garrett NR. Radiographic quantification of chronic dental infection and its relationship to the atherosclerotic process in the carotid arteries. ACTA ACUST UNITED AC 2010; 109:615-21. [DOI: 10.1016/j.tripleo.2009.10.036] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2009] [Revised: 10/14/2009] [Accepted: 10/19/2009] [Indexed: 01/17/2023]
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The relationship between self-reported history of endodontic therapy and coronary heart disease in the Atherosclerosis Risk in Communities Study. J Am Dent Assoc 2009; 140:1004-12. [PMID: 19654253 DOI: 10.14219/jada.archive.2009.0311] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Results from numerous studies have suggested links between periodontal disease and coronary heart disease (CHD), but endodontic disease has not been studied extensively in this regard. METHODS The authors evaluated the relationship between self-reported history of endodontic therapy (ET) and prevalent CHD in the Atherosclerosis Risk in Communities (ARIC) Study, aprospective epidemiologic study sponsored by the National Heart, Lung, and Blood Institute. The authors used multivariable logistic regressionto analyze data obtained from oral health questionnaires, medical evaluations and clinical dental examinations. RESULTS Of 6,651 participants analyzed, 50.4 percent reported never having had ET; 21.5 percent reported having had ET one time; and 28.0 percent reported having had ET two or more times. Final multivariable regression models indicated that among participants with 25 or more teeth, those reporting having had ET two or more times had 1.62 (95 percent confidence interval [CI], 1.04-2.53) times the odds of prevalent CHD compared with those reporting never having had ET. Among participants with 24 or fewer teeth, no significant differences in CHD prevalence were observed among groups regardless of their history of ET. CONCLUSIONS Among participants with 25 or more teeth, those with a greater self-reported history of ET were more likely to have CHD than were those reporting no history of ET. CLINICAL IMPLICATIONS More accurate epidemiologic quantification of endodontic infection and inflammation is required before definitive conclusions can be made about potential relationships between endodontic disease and CHD.
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Caplan DJ, Chasen JB, Krall EA, Cai J, Kang S, Garcia RI, Offenbacher S, Beck JD. Lesions of endodontic origin and risk of coronary heart disease. J Dent Res 2007; 85:996-1000. [PMID: 17062738 PMCID: PMC2231806 DOI: 10.1177/154405910608501104] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
A paucity of epidemiologic research exists regarding systemic health consequences of endodontic disease. This study evaluated whether incident radiographically evident lesions of endodontic origin were related to development of coronary heart disease (CHD) among 708 male participants in the VA Dental Longitudinal Study. At baseline and every three years for up to 32 years, participants (who were not VA patients) received complete medical and dental examinations, including full-mouth radiographs. Cox regression models estimated the relationship between incident lesions of endodontic origin and time to CHD diagnosis. Among those < or = 40 years old, incident lesions of endodontic origin were significantly associated with time to CHD diagnosis (p < 0.05), after adjustment for covariates of interest, with hazard ratios decreasing as age increased. Among those > 40 years old, no statistically significant association was observed. These findings are consistent with research that suggests relationships between chronic periodontal inflammation and the development of CHD, especially among younger men.
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Affiliation(s)
- D J Caplan
- Department of Dental Ecology, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599, USA.
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Abstract
The aim of this review was to analyse the literature to assess the possibility of an association between smoking and endodontic disease and the prognosis of endodontically treated teeth. The review of the prognosis of endodontically treated teeth involved taking account of any potential associations with smoking and endodontic disease and marginal periodontitis, and smoking and prosthodontic outcomes. In addition, the role of smoking in implant failure and surgical wound healing was analysed with a view to drawing parallels regarding the possible implications of smoking on the outcome of surgical endodontics. A MEDLINE and Cochrane library search including smoking and various endodontic keyword searches identified three papers which discussed the variables, and did not just mention them separately in the text. The literature demonstrates a paucity of evidence relating smoking with endodontic disease and prognosis, but nevertheless presents evidence of a possible influence on the prognosis of endodontically treated teeth in smokers and a likely increase in surgical complications. The possible merits of a smoking cessation protocol prior to surgical endodontics are also discussed.
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Affiliation(s)
- H F Duncan
- Department of Conservative Dentistry, Dental Institute, King's College London, Guy's Hospital, London, UK.
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Krall EA, Abreu Sosa C, Garcia C, Nunn ME, Caplan DJ, Garcia RI. Cigarette smoking increases the risk of root canal treatment. J Dent Res 2006; 85:313-7. [PMID: 16567550 PMCID: PMC2225991 DOI: 10.1177/154405910608500406] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Few studies have investigated smoking as a risk factor for root canal treatment. We studied the effect of smoking on the incidence of root canal treatment, controlling for recognized risk factors, in 811 dentate male participants in the VA Dental Longitudinal Study. Participants were not VA patients. Follow-up ranged from 2 to 28 years. Root canal treatment was verified on radiographs and evaluated with proportional hazards regression models. Compared with never-smokers, current cigarette smokers were 1.7 times as likely to have root canal treatment (p < 0.001), but cigar and/or pipe use was not significantly associated with root canal treatment. The risk among cigarette smokers increased with more years of exposure and decreased with length of abstinence. These findings suggest that there is a dose-response relationship between cigarette smoking and the risk of root canal treatment.
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Affiliation(s)
- E A Krall
- VA Dental Longitudinal Study, VA Boston Healthcare System, Boston University Goldman School of Dental Medicine, MA 02118, USA.
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Wu MK, Dummer PMH, Wesselink PR. Consequences of and strategies to deal with residual post-treatment root canal infection. Int Endod J 2006; 39:343-56. [PMID: 16640632 DOI: 10.1111/j.1365-2591.2006.01092.x] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Bacterial sampling of prepared root canals is used to determine the presence and character of the remaining microbiota. However, it is likely that current sampling techniques only identify organisms in the main branches of the root canal system whereas it is unlikely that they can sample areas beyond the apical end-point of preparation and filling, or in lateral canals, canal extensions, apical ramifications, isthmuses and within dentinal tubules. Thus, it may be impossible by current techniques to identify residual post-treatment root canal infection. In histologic observations of root apices, bacteria have been found in inaccessible inter-canal isthmuses and accessory canals often in the form of biofilms. There is no in vivo evidence to support the assumption that these bacteria can be entombed effectively in the canal system by the root filling and thus be rendered harmless. As a consequence of this residual root infection, post-treatment apical periodontitis, which may be radiographically undetectable, may persist or develop as a defence mechanism to prevent the systemic spread of bacteria and/or their byproducts to other sites of the body. Histologic observation of root apices with surrounding bone removed from either patients or human cadavers has demonstrated that post-treatment apical periodontitis is associated with 50-90% of root filled human teeth. Thus, if the objective of root canal treatment is to eliminate apical periodontitis at a histological level, current treatment procedures are inadequate. It is essential that our knowledge of the local and systemic consequences of both residual post-treatment root infection and post-treatment apical periodontitis be improved. The continued development of treatments that can effectively eliminate root infection is therefore a priority in clinical endodontic research. Post-treatment disease following root canal treatment is most often associated with poor quality procedures that do not remove intra-canal infection; this scenario can be corrected via a nonsurgical approach. However, infection remaining in the inaccessible apical areas, extraradicular infection including apically extruded dentine debris with bacteria present in dentinal tubules, true radicular cysts, and foreign body reactions require a surgical intervention.
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Affiliation(s)
- M-K Wu
- Department of Cariology Endodontology Pedodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
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Carrotte P. 21st century endodontics. Part 5. Int Dent J 2005; 55:388-94. [PMID: 16379144 DOI: 10.1111/j.1875-595x.2005.tb00052.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
This series of papers has attempted to present the latest principles in root canal treatment. It is hoped that by comparing the techniques described with their own clinical procedures, the reader will have considered whether changes may be appropriate. These may have been immediate, for example introducing an EDTA solution as an additional irrigant, or more long-term, perhaps by planning to attend hands-on courses to perfect a new procedure before using it in vivo. Professor Dick Walker, an excellent and eminent endodontist, once said that he would not even think of doing something to a patient that he had not done at least twenty times, (and probably more), on an extracted tooth. Wise words indeed! Unfortunately even with practice and persistence, problems may arise during or after root canal treatment. The focus of this paper is on some of the more common problems that may be encountered and how endodontic treatment failures may be addressed.
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Affiliation(s)
- Peter Carrotte
- Unit of Adult Dental Care, Glasgow Dental Hospital and School, Glasgow, UK.
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WU MINKAI, WESSELINK PAULR. Timeliness and effectiveness in the surgical management of persistent post-treatment periapical pathosis. ACTA ACUST UNITED AC 2005. [DOI: 10.1111/j.1601-1546.2005.00156.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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