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Sebring D, Buhlin K, Lund H, Norhammar A, Rydén L, Kvist T. Endodontic Inflammatory Disease and Future Cardiovascular Events and Mortality: A Report from the PAROKRANK Study. J Endod 2024:S0099-2399(24)00283-8. [PMID: 38763484 DOI: 10.1016/j.joen.2024.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 04/23/2024] [Accepted: 05/09/2024] [Indexed: 05/21/2024]
Abstract
INTRODUCTION Prospective studies assessing the relation between endodontic inflammatory disease and subsequent cardiovascular events are few. The present aim was to explore associations between endodontic variables and future cardiovascular events in patients with myocardial infarction and matched controls participating in the PAROKRANK (Periodontitis and Its Relation to Coronary Artery Disease) study. METHODS Eight-hundred five patients hospitalized for a first myocardial infarction and 805 controls were recruited between 2010 and 2014. Signs of endodontic inflammatory disease were assessed in panoramic radiographs taken at baseline. Mortality and morbidity data during the approximately 8 years of follow up were obtained from national registries. The risk for future cardiovascular events (first of mortality and nonfatal myocardial infarction, stroke, or hospitalization for heart failure) was analyzed with the log-rank test and Cox proportional hazards regression adjusted for the following confounders: sex, age, smoking, myocardial infarction, diabetes, education, marital status, family history of cardiovascular disease, and marginal periodontitis. RESULTS In total, 285 future events were observed during the follow-up period. Unadjusted analyses revealed that ≥1 root-filled tooth increased the risk of a future event. After adjustment, the number of remaining teeth and non-root-filled teeth decreased the risk of future events, whereas a higher Decayed, Missing and Filled Teeth score increased the risk and ≥1 primary apical periodontitis decreased the risk of suffering cardiovascular events. A higher Decayed, Missing and Filled Teeth score and decayed teeth increased the risk of all-cause mortality. CONCLUSIONS Tooth loss is a strong indicator of an increased risk for future cardiovascular events. Root-filled teeth seem of limited value as a risk indicator when accounting for other risk factors. The potential effect of dental interventions on future events should be assessed in future research.
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Affiliation(s)
- Dan Sebring
- Department of Endodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Kåre Buhlin
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden; Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland
| | - Henrik Lund
- Department of Oral Maxillofacial Radiology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Anna Norhammar
- Unit of Cardiology, Department of Medicine, MedS Solna, Karolinska Institutet, Stockholm, Sweden; Capio St Görans Hospital, Stockholm, Sweden
| | - Lars Rydén
- Unit of Cardiology, Department of Medicine, MedS Solna, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Kvist
- Department of Endodontology, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Cabanillas-Balsera D, Areal-Quecuty V, Cantiga-Silva C, Cardoso CDBM, Cintra LTA, Martín-González J, Segura-Egea JJ. Prevalence of apical periodontitis and non-retention of root-filled teeth in hypertensive patients: Systematic review and meta-analysis. Int Endod J 2024; 57:256-269. [PMID: 38051279 DOI: 10.1111/iej.14007] [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: 09/14/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Several studies have suggested a relationship between AP, as well as the loss of root-filled teeth (RFT), and hypertension (HTN). OBJECTIVES The aims of this systematic review and meta-analysis were to investigate the prevalence of AP, and non-retention of RFT, in hypertensive patients. METHODS A search was performed in PubMed/MEDLINE, Web of Science, Scopus and EMBASE. The inclusion criteria established were studies published until February 2023, comparing hypertensive subjects with controls, assessing the prevalence of AP and/or providing data on the prevalence of non-retained RFT. Meta-analysis was performed using the RevMan (analyst) tool to determine the pooled prevalence of AP and loss of RFT. Risk of bias was assessed using the Cochrane Risk-of-Bias tool. The quality of evidence was assessed by GRADE. RESULTS The search strategy identified 454 articles, and only eight met the inclusion criteria. Six studies had analysed the association between AP and HTN and two studies had analysed the association between non-retention of RFT and HTN. Meta-analysis showed and overall OR = 1.71 (95% CI = 0.92-3.16; p = .09) for the prevalence of AP among patients with HTN. The prevalence of non-retention of RFT among patients with HTN has an overall OR = 1.78 (95% CI = 1.60-1.98; p = .000001). The risk of bias in the individual studies was low or moderate, and the quality of the overall evidence has shown a level of certainty very low. DISCUSSION There is no association between the prevalence of AP and HTN. In addition, hypertensive patients have significantly increased odds of losing RFT. Given the high prevalence of hypertension, it is very common to perform root canal treatments on hypertensive patients. It is imperative to communicate this heightened risk to patients and recommend periodic monitoring of oral health and hypertension, paying special attention to this subset of patients. REGISTRATION PROSPERO CRD42022302385.
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Affiliation(s)
- Daniel Cabanillas-Balsera
- Department of Stomatology, Section of Endodontics, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Victoria Areal-Quecuty
- Department of Stomatology, Section of Endodontics, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Cristiane Cantiga-Silva
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil
| | - Carolina de Barros Morais Cardoso
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Araçatuba, São Paulo, Brazil
| | - Jenifer Martín-González
- Department of Stomatology, Section of Endodontics, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Juan J Segura-Egea
- Department of Stomatology, Section of Endodontics, School of Dentistry, University of Sevilla, Sevilla, Spain
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León‐López M, Cabanillas‐Balsera D, Martín‐González J, Montero‐Miralles P, Saúco‐Márquez JJ, Segura‐Egea JJ. Prevalence of root canal treatment worldwide: A systematic review and meta-analysis. Int Endod J 2022; 55:1105-1127. [PMID: 36016509 PMCID: PMC9826350 DOI: 10.1111/iej.13822] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/21/2022] [Accepted: 08/22/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND The prevalence of root filled teeth (RFT) worldwide will inform about the amount of clinical activity of dentists dedicated to treat endodontic disease. OBJECTIVES To carry out a systematic review with meta-analysis answering the following question: What is the prevalence of RFT around the world? The percentage of people with at least one RFT was also investigated. METHODS A systematic review including population-based studies using the following databases: PubMed, EMBASE and Scielo. Studies related to prevalence of RFT were included. The outcome of interest of the study was the prevalence of RFT. The meta-analyses were calculated with the Open Meta Analyst software to determine the global prevalence of RFT. Subgroups analyses were performed comparing geographical distribution, radiographic method and year of the study (classified in 20th or 21th century). The prevalence of people with at least one RFT was also analysed. RESULTS Seventy-four population-based studies fulfilled the inclusion criteria. Twenty-eight, forty-four and two studies reported high, moderate and low risk of bias, respectively. No obvious publication bias was observed. Prevalence of RFT was estimated with 1 201 255 teeth and 32 162 patients. The calculated worldwide prevalence of RFT was 8.2% (95% CI = 7.3%-9.1%; p < .001). The global prevalence of people with at least one RFT was 55.7% (95% CI = 49.6%-61.8%; p < .001). In 20th century, the prevalence of RFT was 10.2% (95% CI = 7.9%-12.5%; p < .001), whereas in the 21st century the overall calculated prevalence of RFT was 7.5% (95% CI = 6.5%-8.6%; p < .001). Brazilian people (12%) and the European population (9.3%) showed the highest prevalence of RFT. In Europe, 59.6% (95% CI = 52.4%-66.8%) of people has at least one RFT. CONCLUSIONS This review showed that root canal treatment is a very common therapy throughout the world. More than half of the studied population have at least one RFT. A limitation of the present study is that most of the studies did not consider random sampling for population selection. REGISTRATION PROSPERO Systematic review registration number: (CRD42022329053).
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Affiliation(s)
- María León‐López
- Endodontic Section, Department of Stomatology, School of DentistryUniversity of SevillaSevillaSpain
| | | | - Jenifer Martín‐González
- Endodontic Section, Department of Stomatology, School of DentistryUniversity of SevillaSevillaSpain
| | - Paloma Montero‐Miralles
- Endodontic Section, Department of Stomatology, School of DentistryUniversity of SevillaSevillaSpain
| | - Juan J. Saúco‐Márquez
- Endodontic Section, Department of Stomatology, School of DentistryUniversity of SevillaSevillaSpain
| | - Juan J. Segura‐Egea
- Endodontic Section, Department of Stomatology, School of DentistryUniversity of SevillaSevillaSpain
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The Link between Stroke Risk and Orodental Status-A Comprehensive Review. J Clin Med 2022; 11:jcm11195854. [PMID: 36233721 PMCID: PMC9572898 DOI: 10.3390/jcm11195854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/21/2022] [Accepted: 09/29/2022] [Indexed: 11/17/2022] Open
Abstract
One of the primary causes of disability and mortality in the adult population worldwide is stroke. A person's general health is significantly impacted by their oral and dental health. People who have poor oral health are more susceptible to conditions such as stroke. Stroke risk has long been linked to oral and dental conditions. The risk of stroke and its cost impact on the healthcare systems appear to be significantly reduced as a result of the decline in the incidence and prevalence of oral and dental illnesses. Hypothetically, better management of oral hygiene and dental health lead to reduced stroke risk. To the authors' best knowledge, for the first time, the potential link between dental health and stroke were cross-examined. The most typical stroke symptoms, oral and dental illnesses linked to stroke, and the role of oral healthcare professionals in stroke prevention are revealed. The potential mediating processes and subsequent long-term cognitive and functional neurological outcomes are based on the available literature. It must be noted that periodontal diseases and tooth loss are two common oral health measures. Lack of knowledge on the effects of poor oral health on systemic health together with limited access to primary medical or dental care are considered to be partially responsible for the elevated risk of stroke. Concrete evidence confirming the associations between oral inflammatory conditions and stroke in large cohort prospective studies, stratifying association between oral disease severity and stroke risk and disease effects on stroke survival will be desirable. In terms of clinical pathology, a predictive model of stroke as a function of oral health status, and biomarkers of systemic inflammation could be useful for both cardiologists and dentists.
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Aloutaibi YA, Alkarim AS, Qumri EM, Almansour LA, Alghamdi FT. Chronic Endodontic Infections and Cardiovascular Diseases: Does the Evidence Support an Independent Association? Cureus 2021; 13:e19864. [PMID: 34976491 PMCID: PMC8712192 DOI: 10.7759/cureus.19864] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2021] [Indexed: 01/08/2023] Open
Abstract
Previous studies have shown that endodontic infections might increase the risk of cardiovascular diseases. However, there is no conclusive evidence that endodontic infections are associated with cardiovascular diseases among individuals with cardiac conditions. This systematic review aimed to collect and evaluate the current evidence on the relationship between chronic endodontic infections and cardiovascular diseases. The PubMed, Scopus, and Web of Science databases were searched, and Google Scholar was used to retrieve relevant clinical studies within the past 10 years (2011-2021). Observational studies (prospective cohort, retrospective cohort, cross-sectional, and case-control studies), which investigated the impact of endodontic infections and apical periodontitis in individuals with cardiac conditions at risk of cardiovascular disease, in English were considered. Review papers, duplicates, animal studies, and other irrelevant studies were excluded. Four investigators independently carried out the study selection and data collection processes. Quality assessment was performed in this review. Fourteen studies with 960,652 human subjects were included in this review. No association between endodontic infections and cardiovascular diseases among individuals with cardiac conditions was noted. Most of the studies showed a moderate overall risk of bias by 57.14% (n=8). There is weak evidence regarding the association between cardiovascular diseases and chronic endodontic infections. Further longitudinal clinical studies are required to determine the association between cardiovascular diseases and endodontic infections.
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Affiliation(s)
- Yaser A Aloutaibi
- Advanced General Dentistry, The University Dental Hospital, King Abdulaziz University, Jeddah, SAU
| | - Abdulaziz S Alkarim
- Advanced General Dentistry, The University Dental Hospital, King Abdulaziz University, Jeddah, SAU
| | - Esraa M Qumri
- Advanced General Dentistry, The University Dental Hospital, King Abdulaziz University, Jeddah, SAU
| | - Lolo A Almansour
- Advanced General Dentistry, The University Dental Hospital, King Abdulaziz University, Jeddah, SAU
| | - Faisal T Alghamdi
- Oral Biology, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
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Cintra LTA, Gomes MS, da Silva CC, Faria FD, Benetti F, Cosme-Silva L, Samuel RO, Pinheiro TN, Estrela C, González AC, Segura-Egea JJ. Evolution of endodontic medicine: a critical narrative review of the interrelationship between endodontics and systemic pathological conditions. Odontology 2021; 109:741-769. [PMID: 34240297 DOI: 10.1007/s10266-021-00636-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/04/2021] [Indexed: 12/12/2022]
Abstract
Endodontics has gained emphasis in the scientific community in recent years due to the increase in clinical and in animal models studies focused on endodontic medicine, which aims to evaluate the interrelationship between systemic and periapical tissues pathological conditions. These studies have shown that systemic changes can boost the pathogenesis of endodontic infection, favoring its development and progression. A contrary relationship is reported in numerous studies that affirm the potential of endodontic infection to trigger systemic damage and may lead to the worsening of pre-existing pathologies. Recently, the potential of filling materials to develop systemic changes such as neurological alterations had been evaluated, also showing that systemic diseases can negatively influence tissue responses to filling materials after endodontic treatment. Despite advances in endodontic medicine studies, there are still gaps in knowledge on the mechanisms of interactions between apical periodontitis (AP) and systemic diseases and much research to be done. In this sense, this critical narrative literature review aimed to show the evolution of studies in endodontic medicine to help the endodontist to know the role of systemic diseases in the pathogenesis of AP and the possible interference in the repair of periapical tissues after endodontic treatment, as well as to evidence the systemic complications that can be triggered or aggravated in the presence of endodontic infection.
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Affiliation(s)
- Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil. .,Dental Assistance Center for Disabled Persons (CAOE) of the São Paulo State University (Unesp), School of Dentistry, Araçatuba, SP, Brazil.
| | - Maximiliano Schünke Gomes
- Departament of Odontology, School of Dentistry and Medical and Dental Center, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Cristiane Cantiga da Silva
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil
| | - Flávio Duarte Faria
- Department of Preventive and Restorative Dentistry, Endodontic Section, School of Dentistry, São Paulo State University (Unesp), José Bonifácio, 1193, Vila Mendonça, Araçatuba, SP, CEP 16015-050, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Leopoldo Cosme-Silva
- Department of Clinics and Surgery, School of Dentistry, Federal University of Alfenas (Unifal), Alfenas, MG, Brazil
| | - Renata Oliveira Samuel
- Department of Clinical Dentistry, Dental School, Universidade de Uberaba, Uberaba, MG, Brazil
| | - Tiago Novaes Pinheiro
- Department of Oral Pathology and Oral Medicine, Dental School of Amazonas State University, Manaus, AM, Brazil
| | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, Federal University of Goiás (UFG), Goiânia, GO, Brazil
| | | | - Juan José Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
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Czesnikiewicz-Guzik M, Górska R. Oral health in childhood as a predictor of future cardiovascular risk. Cardiovasc Res 2021; 116:e98-e100. [PMID: 32150260 DOI: 10.1093/cvr/cvz335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
- Marta Czesnikiewicz-Guzik
- Department of Dental Prophylaxis and Experimental Dentistry, Jagiellonian University Medical College, Krakow, Poland
| | - Renata Górska
- Department of Periodontology, Medical University of Warsaw, Warszawa, Poland
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Balto H, Al-Ekrish AA. To the Editor-in-Chief of the International Endodontic Journal. Int Endod J 2021; 53:1742-1743. [PMID: 33448408 DOI: 10.1111/iej.13375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- H Balto
- Department of Restorative Dental Sciences, Division of Endodontics, King Saud University, Riyadh, Saudi Arabia
| | - A A Al-Ekrish
- Department of Oral Medicine and Diagnostic Sciences, Division of Oral and Maxillofacial Radiology, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Liljestrand JM, Salminen A, Lahdentausta L, Paju S, Mäntylä P, Buhlin K, Tjäderhane L, Sinisalo J, Pussinen PJ. Association between dental factors and mortality. Int Endod J 2020; 54:672-681. [PMID: 33275782 DOI: 10.1111/iej.13458] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 11/27/2020] [Accepted: 12/01/2020] [Indexed: 12/12/2022]
Abstract
AIM To study whether oral parameters such as endodontic infections, root canal fillings, number of teeth or wearing removable dentures at baseline are associated with cardiovascular- and all-cause mortality in a follow-up of approximately 8 years. METHODOLOGY The Finnish Parogene cohort consists of 508 Finnish adults (mean age 63.3 years, SD 9.1) with cardiac symptoms, all of whom had undergone coronary angiography for accurate baseline coronary status. Extensive clinical and radiographic oral examinations were performed, and additional data were acquired from medical records and questionnaires. Root canal fillings and endodontic lesions, as well as their co-occurrence, were determined from panoramic radiographs. The mortality data were assessed via record linkage with the Finnish Causes of Death register (mean follow-up time 7.81 years, SD 1.45 years). A total of n = 471 dentate patients were included in the statistical analyses. RESULTS A total of n = 69 deaths were recorded, of which n = 41 were due to cardiovascular diseases (CVDs, ICD-10 I00-I99). The deceased had fewer root canal fillings (mean 1.57; SD 1.64 vs. mean 2.30; SD 2.34, P = 0.03) than the survivors. The number of missing teeth was associated with smoking, occluded coronary arteries and diabetes. Cox regression with Firth's penalized maximum-likelihood method using age as timescale revealed an inverse association (HR; 95%CI) between mortality and number of teeth (all-cause 0.91; 0.86-0.96, CVD mortality 0.89; 0.83-0.96), use of removable dentures (all-cause 0.24; 0.09-0.62, CVD mortality 0.20; 0.06-0.72), root canal fillings (all-cause 0.82; 0.70-0.94, CVD mortality 0.79; 0.63-0.96) and having root canal fillings in all teeth with apical rarefactions (all-cause 0.27; 0.06-0.79, CVD mortality 0.09; 0.01-0.63), when gender, smoking, occluded coronary arteries, periodontal inflammatory burden index and the number of teeth were adjusted for. CONCLUSIONS The number of missing teeth appeared to be the strongest predictor of mortality in this study, whereas endodontic infections per se had no independent association. Nevertheless, signs of professional intervention in these problems, such as root canal fillings and removable dentures, appeared to be associated with improved survival, which might partly be explained by the utilization of healthcare services.
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Affiliation(s)
- J M Liljestrand
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - A Salminen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - L Lahdentausta
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - S Paju
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - P Mäntylä
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Institute of Dentistry, University of Eastern Finland and Kuopio University Hospital, Oral and Maxillofacial Diseases, Kuopio, Finland
| | - K Buhlin
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - L Tjäderhane
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Research Unit of Oral Health Sciences, and Medical Research Center Oulu (MRC Oulu), Oulu University Hospital and University of Oulu, Oulu, Finland
| | - J Sinisalo
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - P J Pussinen
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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González-Navarro B, Segura-Egea JJ, Estrugo-Devesa A, Pintó-Sala X, Jane-Salas E, Jiménez-Sánchez MC, Cabanillas-Balsera D, López-López J. Relationship between Apical Periodontitis and Metabolic Syndrome and Cardiovascular Events: A Cross-Sectional Study. J Clin Med 2020; 9:jcm9103205. [PMID: 33020413 PMCID: PMC7600401 DOI: 10.3390/jcm9103205] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/29/2020] [Accepted: 10/02/2020] [Indexed: 12/23/2022] Open
Abstract
Aim: Both apical periodontitis (AP) and metabolic syndrome (MetS) are associated with atherosclerotic cardiovascular disease (ACVD), the main cause of cardiovascular events. The aim of this study was to investigate the prevalence of AP and the oral inflammatory burden in control subjects and patients suffering cardiovascular events, analyzing the possible association between AP and the oral inflammatory burden with MetS. Materials and Methods: Using a cross-sectional design, 83 patients suffering a cardiovascular event were recruited in the study group (SG), and 48 patients without cardiovascular events were included in the control group (CG). Periapical index (PAI) was used to diagnose AP, and total dental index (TDI) was used to assess the total oral inflammatory burden. Diagnosis of MetS was made by meeting three or more American Heart Association Scientific Statement components. Results: In the multivariate logistic regression analysis, the number of teeth with AP (OR = 2.3; 95% C.I. = 1.3–4.3; p = 0.006) and TDI scores (OR = 1.5; 95% C.I. = 1.2–1.9; p = 0.001), significantly correlated with cardiovascular events. MetS was strongly associated (OR = 18.0; 95% C.I. = 6.5–49.7; p = 0000) with cardiovascular events. Higher TDI scores were significantly associated with MetS (OR = 1.3; 95% C.I. = 1.1–1.6; p = 0.003. Neither the number of root-filled teeth (RFT) (OR = 0.9; 95% C.I. = 0.6–1.3; p = 0.61) nor the number of teeth with apical periodontitis (OR = 1.1; 95% C.I. = 0.8–1.7; p = 0.49) were associated with MetS. Conclusions: Apical periodontitis is significantly associated with cardiovascular events. Total oral inflammatory burden assessed by TDI, but not AP alone, is associated with MetS.
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Affiliation(s)
- Beatriz González-Navarro
- Department of Odontostomatolgy, School of Medicine and Health Sciences (Dentistry)—Dental Hospital, University of Barcelona, 08970 L’Hospitalet de Llobregat, Barcelona, Spain; (B.G.-N.); (A.E.-D.); (E.J.-S.)
- Oral Health and Masticatory System Group, Bellvitge Biomedical Research Institute, (IDIBELL), 08970 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Juan José Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, Calle Avicena s/n, 41009 Sevilla, Spain; (M.C.J.-S.); (D.C.-B.)
- Correspondence: (J.J.S.-E.); (J.L.-L.); Tel.: +34-606457362 (J.L.-L.)
| | - Albert Estrugo-Devesa
- Department of Odontostomatolgy, School of Medicine and Health Sciences (Dentistry)—Dental Hospital, University of Barcelona, 08970 L’Hospitalet de Llobregat, Barcelona, Spain; (B.G.-N.); (A.E.-D.); (E.J.-S.)
- Oral Health and Masticatory System Group, Bellvitge Biomedical Research Institute, (IDIBELL), 08970 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Xavier Pintó-Sala
- Vascular Risk Unit, Department of Internal Medicine, Bellvitge University Hospital, 08970 L’Hospitalet de Llobregat, Barcelona, Spain;
| | - Enric Jane-Salas
- Department of Odontostomatolgy, School of Medicine and Health Sciences (Dentistry)—Dental Hospital, University of Barcelona, 08970 L’Hospitalet de Llobregat, Barcelona, Spain; (B.G.-N.); (A.E.-D.); (E.J.-S.)
- Oral Health and Masticatory System Group, Bellvitge Biomedical Research Institute, (IDIBELL), 08970 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Mari Carmen Jiménez-Sánchez
- Department of Stomatology, School of Dentistry, University of Sevilla, Calle Avicena s/n, 41009 Sevilla, Spain; (M.C.J.-S.); (D.C.-B.)
| | - Daniel Cabanillas-Balsera
- Department of Stomatology, School of Dentistry, University of Sevilla, Calle Avicena s/n, 41009 Sevilla, Spain; (M.C.J.-S.); (D.C.-B.)
| | - José López-López
- Department of Odontostomatolgy, School of Medicine and Health Sciences (Dentistry)—Dental Hospital, University of Barcelona, 08970 L’Hospitalet de Llobregat, Barcelona, Spain; (B.G.-N.); (A.E.-D.); (E.J.-S.)
- Oral Health and Masticatory System Group, Bellvitge Biomedical Research Institute, (IDIBELL), 08970 L’Hospitalet de Llobregat, Barcelona, Spain
- Clinical Head of the Odontological Hospital University of Barcelona, University of Barcelona, 08970 L’Hospitalet de LLobregat, Barcelona, Spain
- Correspondence: (J.J.S.-E.); (J.L.-L.); Tel.: +34-606457362 (J.L.-L.)
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Jiménez-Sánchez MC, Cabanillas-Balsera D, Areal-Quecuty V, Velasco-Ortega E, Martín-González J, Segura-Egea JJ. Cardiovascular diseases and apical periodontitis: association not always implies causality. Med Oral Patol Oral Cir Bucal 2020; 25:e652-e659. [PMID: 32388515 PMCID: PMC7473437 DOI: 10.4317/medoral.23665] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Accepted: 03/02/2020] [Indexed: 12/19/2022] Open
Abstract
Background Several studies published in the last two decades have found an association between the prevalence of apical periodontitis (AP) or root canal treatment (RCT) and cardiovascular diseases (CVDs). However, the demonstration of association does not prove by itself the existence of a cause–effect relationship. Two diseases can appear as statistically related without any of them directly affecting the values of the other, resulting in a non-causal relationship. The aim of this narrative review is to summarize the current state of knowledge regarding the association between AP and CVDs, analysing it according to the Hill's causality criteria.
Material and Methods Epidemiological studies carried out on the association between CVDs and AP or RCT published in English until 8 December 2019 were identified. Forty-four articles were selected and its results were analysed.
Results Numerous cross-sectional epidemiological studies have found significant relationship between CVDs and AP. The odds ratio values range 1.6 - 5.4. However, other studies have not found significant association. Respect to RCT, some studies found correlation, but others found no association or even found that RCT is a protective factor against CVDs.
Conclusions The results are inconsistent and a causal relationship between CVDS and endodontic disease cannot be stablished. The risk factors common to both diseases can act as confounding factors, biasing the results. To reach definitive conclusions about the type of association (causal or non-causal) between both diseases, longitudinal epidemiological studies must be carried out to establish the temporal relationship and the dose-response gradient. Key words:Apical periodontitis, atherosclerosis, cardiovascular disease, coronary heart disease, endodontic medicine, root canal treatment.
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Affiliation(s)
- M-C Jiménez-Sánchez
- School of Dentistry, University of Sevilla C/ Avicena s/n, 41009-Sevilla, Spain
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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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Ehlinger C, Dartevelle P, Zaet A, Kurashige Y, Haïkel Y, Metz-Boutigue MH, Marban C. A New Combination with D-Cateslytin to Eradicate Root Canal Pathogens. Int J Pept Res Ther 2019. [DOI: 10.1007/s10989-019-09911-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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14
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Kim K, Choi S, Chang J, Kim SM, Kim SJ, Kim RJY, Cho HJ, Park SM. Severity of dental caries and risk of coronary heart disease in middle-aged men and women: a population-based cohort study of Korean adults, 2002-2013. Sci Rep 2019; 9:10491. [PMID: 31324851 PMCID: PMC6642137 DOI: 10.1038/s41598-019-47029-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 06/26/2019] [Indexed: 11/09/2022] Open
Abstract
We aimed to evaluate the risk of coronary heart disease (CHD) according to dental caries status in middle-aged patients using a population-based cohort database containing medical/dental claims, health examination, and death records in the Republic of Korea. A total of 234,597 patients were identified in the database who were without history of cardiovascular disease, including 104,638 patients without dental caries, 41,696 with incipient/moderate stage dental caries, and 88,262 advanced/severe dental caries. We used Cox proportional hazards model adjusted for sociodemographic, lifestyle, and medical characteristics to compute hazard ratio (HR) and 95% confidence intervals (95% CI) for CHD according to severity of dental caries. During 1,491,190 person-years of follow-up, there were a total of 6,015 CHD events. After adjustment for potential confounders, patients in the highest quartile of outpatient visits for advanced/severe stage dental caries was associated with an increase in CHD risk (HR = 1.13; 95% CI: 1.04-1.22) as compared with patients without dental caries. When the analysis was restricted to the patients with advanced/severe dental caries, dose-response relationship between number of outpatient visits for dental caries and risk of CHD was observed (Ptrend: <0.001). Prevention and control of dental caries might be worth promoting in clinical practice to prevent CHD.
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Affiliation(s)
- Kyuwoong Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Seulggie Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Jooyoung Chang
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Sung Min Kim
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea
| | - Seon Jip Kim
- Department of Preventive Dentistry and Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Ryan Jin-Young Kim
- Department of Dentistry, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Hyun-Jae Cho
- Department of Preventive Dentistry and Public Oral Health, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea.
| | - Sang Min Park
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Republic of Korea.
- Department of Family Medicine, College of Medicine, Seoul National University, Seoul, Republic of Korea.
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15
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Garrido M, Cárdenas AM, Astorga J, Quinlan F, Valdés M, Chaparro A, Carvajal P, Pussinen P, Huamán-Chipana P, Jalil JE, Hernández M. Elevated Systemic Inflammatory Burden and Cardiovascular Risk in Young Adults with Endodontic Apical Lesions. J Endod 2019; 45:111-115. [PMID: 30711165 DOI: 10.1016/j.joen.2018.11.014] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 11/20/2018] [Accepted: 11/25/2018] [Indexed: 12/31/2022]
Abstract
INTRODUCTION The aim of this study was to assess whether apical lesions are associated with inflammatory serum markers of cardiovascular risk, especially high-sensitivity C-reactive protein (hsCRP), in young adults. METHODS In this cross-sectional study, otherwise healthy individuals with apical lesions of endodontic origin (ALEOs) and a clinical diagnosis of asymptomatic apical periodontitis and controls aged between 18 and 40 years were included. Patients' sociodemographic characteristics, medical history, and classic cardiovascular risk factors were recorded, and the pathobiological determinants of atherosclerosis in youth score was calculated. Oral clinical and radiographic examinations were performed. Blood samples were collected to determine the lipid profile, glycated hemoglobin, hsCRP, immunoglobulin G, interleukin (IL)-6, IL-10, IL-12p70, matrix metalloproteinase 8, soluble vascular cellular adhesion molecule-1, soluble intercellular adhesion molecule-1, and soluble E-selectin. Bivariate and multivariate analyses adjusting for oral and classic cardiovascular risk factors were performed. RESULTS hsCRP levels were significantly higher in ALEO patients versus controls (median = 2.54 vs 0.78), whereas the pathobiological determinants of atherosclerosis in youth score was comparable among the groups. Also, the levels of IL-6, matrix metalloproteinase 8, and soluble E-selectin were significantly higher in ALEO patients. hsCRP, IL-6, and IL-12 correlated with soluble adhesion molecules. Bivariate analysis based on hsCRP serum concentrations ≥1 mg/L showed an odds ratio (OR) = 6.8, and the risk increased 3.3 times for an additional ALEO. In multivariate analysis, ALEO was significantly associated with hsCRP levels ≥1 mg/L (OR = 5.1-12.8) independently of the adjustment model. ALEO also associated with CRP levels >3 mg/L, which was significant after the adjustment for covariates (OR = 4.0). CONCLUSIONS ALEO is associated with the systemic inflammatory burden and cardiovascular risk determined by hsCRP, supporting a mechanistic link for cardiovascular diseases in young adults.
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Affiliation(s)
- Mauricio Garrido
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Angélica M Cárdenas
- Laboratory of Periodontal Biology, Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile; Health Sciences Division, Faculty of Dentistry, Universidad Santo Tomás, Bucaramanga, Colombia
| | - Jessica Astorga
- Laboratory of Periodontal Biology, Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Francisca Quinlan
- Laboratory of Periodontal Biology, Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Macarena Valdés
- Epidemiology Program, Public Health School, Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Alejandra Chaparro
- Department of Periodontology, Faculty of Dentistry, Universidad de los Andes, Santiago, Chile
| | - Paola Carvajal
- Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile
| | - Pirkko Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Patricia Huamán-Chipana
- Department of Periodontology, Faculty of Dentistry, Universidad Nacional Federico Villarreal, Lima, Peru
| | - Jorge E Jalil
- Division of Cardiovascular Diseases, School of Medicine, Pontifical Universidad Católica de Chile, Santiago, Chile
| | - Marcela Hernández
- Laboratory of Periodontal Biology, Department of Conservative Dentistry, Faculty of Dentistry, Universidad de Chile, Santiago, Chile; Dentistry Unit, Faculty of Health Sciences, Universidad Autónoma de Chile, Santiago, Chile.
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Bergandi L, Giuggia B, Alovisi M, Comba A, Silvagno F, Maule M, Aldieri E, Scotti N, Scacciatella P, Conrotto F, Berutti E, Pasqualini D. Endothelial Dysfunction Marker Variation in Young Adults with Chronic Apical Periodontitis before and after Endodontic Treatment. J Endod 2019; 45:500-506. [PMID: 30910354 DOI: 10.1016/j.joen.2019.01.018] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Revised: 01/23/2019] [Accepted: 01/29/2019] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Cardiovascular diseases are the leading cause of mortality worldwide. Apical periodontitis (AP) has been associated with an increased risk of cardiovascular diseases. A correlation has been shown between chronic AP and endothelial dysfunction (ED), but there is no evidence to indicate ED improves after endodontic treatment in patients with periapical lesions. The aim of this study was to investigate vascular and molecular markers of early ED before and after root canal treatment in young adults with chronic AP. METHODS Twenty control subjects and 21 patients with AP were assessed at baseline. The AP patients were also evaluated 2 and 12 months post-treatment. Endothelial flow reserve was assessed via an endothelial function test, and enzyme-linked immunosorbent assays were used to evaluate plasma levels of proinflammatory cytokines interleukin (IL)-1, IL-6, and tumor necrosis factor alpha; vasoconstrictor ED marker endothelin (ET)-1; circulating endothelial adhesion markers intercellular adhesion molecule 1 (ICAM-1)/CD54 and soluble vascular cellular adhesion molecule (sVCAM)-1/CD106; soluble CD14; and the endothelial leukocyte adhesion molecule (E-selectin). RESULTS AP was associated with increased serum levels of ET-1, ICAM-1, E-selectin, IL-1, and sCD14, suggesting early vascular ED, with no macroscopic evidence of a reduction in endothelial flow reserve. Root canal treatment ameliorated inflammation and early ED, lowering plasma levels of IL-1, sCD14, ET-1, ICAM-1/CD54, and E-selectin to those of control subjects. CONCLUSIONS Our findings suggest that AP may drive early vascular ED and that the endodontic therapy of AP ameliorates early ED.
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Affiliation(s)
| | - Beatrice Giuggia
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Mario Alovisi
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Allegra Comba
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | | | - Milena Maule
- Department of Medical Sciences, Division of Cardiology, Città della Salute e della Scienza di Torino, Turin, Italy
| | | | - Nicola Scotti
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Paolo Scacciatella
- Department of Medical Sciences, Cancer Epidemiology Unit, University of Turin, Turin, Italy
| | - Federico Conrotto
- Department of Medical Sciences, Cancer Epidemiology Unit, University of Turin, Turin, Italy
| | - Elio Berutti
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy
| | - Damiano Pasqualini
- Department of Surgical Sciences, Dental School, University of Turin, Turin, Italy.
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Messing M, Souza LCD, Cavalla F, Kookal KK, Rizzo G, Walji M, Silva R, Letra A. Investigating Potential Correlations between Endodontic Pathology and Cardiovascular Diseases Using Epidemiological and Genetic Approaches. J Endod 2019; 45:104-110. [DOI: 10.1016/j.joen.2018.10.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 09/04/2018] [Accepted: 10/28/2018] [Indexed: 12/13/2022]
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FRANCISCATTO GJ, KOPPE BTDF, HOPPE CB, OLIVEIRA JAPD, HAAS AN, GRECCA FS, ROSSI-FEDELE G, GOMES MS. Validation of self-reported history of root canal treatment in a southern Brazilian subpopulation. Braz Oral Res 2019; 33:e007. [DOI: 10.1590/1807-3107bor-2019.vol33.0007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 12/17/2018] [Indexed: 12/28/2022] Open
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19
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Bains R, Bains VK. Lesions of endodontic origin: An emerging risk factor for coronary heart diseases. Indian Heart J 2018; 70 Suppl 3:S431-S434. [PMID: 30595303 PMCID: PMC6309294 DOI: 10.1016/j.ihj.2018.07.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 07/06/2018] [Accepted: 07/06/2018] [Indexed: 01/18/2023] Open
Abstract
A high inflammatory state, such as atherosclerosis, is a major underlying cause of coronary heart diseases (CHDs). Inflammatory mediators are known to lead to endothelial dysfunction and play a key role in initiation, progression, and rupture of atherothrombotic plaque. Chronic inflammatory dental infections such as periodontitis and lesions of endodontic origin or chronic apical periodontitis (CAP) may provide an environment conducive for such events. Atherosclerosis has shown to share a common spectrum of inflammatory markers with apical periodontitis. The possible correlation between CHD and CAP is emerging at microbiological, clinical, inflammatory, and molecular levels. This less recognized fact should be discussed more among the dental and medical fraternity so that more awareness and positive approach toward oral health can be created among patients and health-care providers.
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Affiliation(s)
- Rhythm Bains
- Department of Conservative Dentistry & Endodontics, King George's Medical University, Lucknow, India.
| | - Vivek K Bains
- Department of Periodontology, Saraswati Dental College, Lucknow, India
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20
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Aarabi G, Thomalla G, Heydecke G, Seedorf U. Chronic oral infection: An emerging risk factor of cerebral small vessel disease. Oral Dis 2018; 25:710-719. [DOI: 10.1111/odi.12912] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 05/31/2018] [Accepted: 06/04/2018] [Indexed: 12/26/2022]
Affiliation(s)
- Ghazal Aarabi
- Department of Prosthetic DentistryCenter for Dental and Oral MedicineUniversity Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Götz Thomalla
- Department of NeurologyHead‐ and NeurocenterUniversity Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Guido Heydecke
- Department of Prosthetic DentistryCenter for Dental and Oral MedicineUniversity Medical Center Hamburg‐Eppendorf Hamburg Germany
| | - Udo Seedorf
- Department of Prosthetic DentistryCenter for Dental and Oral MedicineUniversity Medical Center Hamburg‐Eppendorf Hamburg Germany
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Balto HA, Alabdulaaly L, Bahammam S, Al-Ekrish AA. Comparative analysis of prevalence of apical periodontitis in smokers and non-smokers using cone-beam computed tomography. Saudi Dent J 2018; 31:52-57. [PMID: 30705569 PMCID: PMC6349893 DOI: 10.1016/j.sdentj.2018.09.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 08/26/2018] [Accepted: 09/17/2018] [Indexed: 12/21/2022] Open
Abstract
Objective The aim of this study was to compare the prevalence and size of periapical lesions among smokers and non-smokers using cone-beam computed tomography (CBCT). Materials and methods Retrievable CBCT datasets for 46 male patients ≥18 years during a consecutive period from 2008 to 2016 were examined. The medical, smoking history and other clinical findings (signs of previous dental trauma; Decayed Missing Filled Teeth (DMFT) scores; the percentage of root filled teeth; and oral hygiene status) were obtained. Periapical status of all included teeth was assessed by CBCT images. Statistical analysis was conducted using t-test, Pearson correlation and multiple regression. Results The prevalence of apical periodontitis was 13.93% in smokers and 14.26% in non-smokers with no significant difference (p = 0.936). The mean of the average size of lesions between the two groups were almost comparable, 3.50 mm in smokers and 2.89 mm in non-smokers (p = 0.567). Pearson correlation and multiple regression analysis showed that the percentage of lesion present and the average lesion size were not correlated to any independent variable. Conclusions While smoking is considered a risk factor for marginal periodontitis, there was no difference between smokers and non-smokers in terms of apical periodontitis.
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Affiliation(s)
- Hanan A Balto
- Department of Restorative Dental Science, Division of Endodontics, Dental Caries Research Chair, College of Dentistry, King Saud University, P.O. Box 62645, Riyadh 11595, Saudi Arabia.,Department of Clinical Dental Science, College of Dentistry, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Lama Alabdulaaly
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, P.O. Box 88493, Riyadh 11662, Saudi Arabia
| | - Shaima Bahammam
- College of Dentistry, King Saud University, Riyadh, Saudi Arabia.,Department of Dentistry, King Faisal Specialist Hospital and Research Centre, P.O. Box 50514, Riyadh 11533, Saudi Arabia
| | - Asma'a A Al-Ekrish
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, P.O. Box 56810, Riyadh 11564, Saudi Arabia
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Aminoshariae A, Kulild JC, Fouad AF. The Impact of Endodontic Infections on the Pathogenesis of Cardiovascular Disease(s): A Systematic Review with Meta-analysis Using GRADE. J Endod 2018; 44:1361-1366.e3. [DOI: 10.1016/j.joen.2018.06.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 06/18/2018] [Accepted: 06/19/2018] [Indexed: 12/16/2022]
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Roles of Oral Infections in the Pathomechanism of Atherosclerosis. Int J Mol Sci 2018; 19:ijms19071978. [PMID: 29986441 PMCID: PMC6073301 DOI: 10.3390/ijms19071978] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/28/2018] [Accepted: 06/30/2018] [Indexed: 12/14/2022] Open
Abstract
Oral infections occur frequently in humans and often lead to chronic inflammations affecting the teeth (i.e., caries), the gingival tissues surrounding the teeth (i.e., gingivitis and endodontic lesions), and the tooth-supporting structures (i.e., periodontitis). At least four basic pathogenic mechanisms have been proposed that involve oral inflammations in the pathogenesis of atherosclerosis: (1) low level bacteremia by which oral bacteria enter the blood stream and invade the arterial wall; (2) systemic inflammation induced by inflammatory mediators released from the sites of the oral inflammation into the blood stream; (3) autoimmunity to host proteins caused by the host immune response to specific components of oral pathogens; (4) pro-atherogenic effects resulting from specific bacterial toxins that are produced by oral pathogenic bacteria. In this narrative review, we summarize published experimental evidence related to these four mechanisms and discuss their impact on the pathogenesis of atherosclerosis.
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Meurman JH, Janket SJ, Surakka M, Jackson EA, Ackerson LK, Fakhri HR, Chogle S, Walls A. Lower risk for cardiovascular mortality for patients with root filled teeth in a Finnish population. Int Endod J 2017; 50:1158-1168. [DOI: 10.1111/iej.12772] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 03/19/2017] [Indexed: 12/13/2022]
Affiliation(s)
- J. H. Meurman
- Department of Oral and Maxillofacial Diseases; Helsinki University Hospital and University of Helsinki; Helsinki Finland
| | - S.-J. Janket
- Department of Periodontology; Center for Clinical Research, General Dentistry; H. M. Goldman School of Dental Medicine; Boston University; Boston MA USA
| | - M. Surakka
- Otorhinolaryngology/Maxillofacial Surgery; Kuopio University Hospital; Kuopio Finland
| | - E. A. Jackson
- Preventive Cardiology, Internal Medicine; University of Michigan; Ann Arbor MI USA
| | - L. K. Ackerson
- Department of Public Health; University of Massachusetts; Lowell MA USA
| | - H. R. Fakhri
- Department of Periodontology; Center for Clinical Research, General Dentistry; H. M. Goldman School of Dental Medicine; Boston University; Boston MA USA
| | - S. Chogle
- Endodontics; H. M. Goldman School of Dental Medicine; Boston University; Boston MA USA
| | - A. Walls
- Edinburgh Dental Institute; University of Edinburgh; Scotland UK
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Osmenda G, Maciąg J, Wilk G, Maciąg A, Nowakowski D, Loster J, Dembowska E, Robertson D, Guzik T, Cześnikiewicz-Guzik M. Treatment of denture-related stomatitis improves endothelial function assessed by flow-mediated vascular dilation. Arch Med Sci 2017; 13:66-74. [PMID: 28144257 PMCID: PMC5206372 DOI: 10.5114/aoms.2017.64715] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 12/01/2015] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION The presence of oral inflammation has recently been linked with the pathogenesis of cardiovascular diseases. While numerous studies have described links between periodontitis and endothelial dysfunction, little is known about the influence of denture-related stomatitis (DRS) on cardiovascular risk. Therefore, the aim of this study was to determine whether the treatment of DRS can lead to improvement of the clinical measures of vascular dysfunction. MATERIAL AND METHODS The DRS patients were treated with a local oral antifungal agent for 3 weeks. Blood pressure, flow-mediated dilatation (FMD) and nitroglycerine-mediated vascular dilatation (NMD) were measured during three study visits: before treatment, one day and two months after conclusion of antifungal therapy. RESULTS Flow-mediated dilatation measurements showed significant improvement of endothelial function 2 months after treatment (FMD median 5%, 95 CI: 3-8.3 vs. 11%, 95% CI: 8.8-14.4; p < 0.01), while there was no difference in control, endothelium-independent vasorelaxations (NMD; median = 15.3%, 95% CI: 10.8-19.3 vs. 12.7%, 95% CI: 10.6-15; p = 0.3). Other cardiovascular parameters such as systolic (median = 125 mm Hg; 95% CI: 116-129 vs. 120 mm Hg, 95% CI: 116-126; p = 0.1) as well as diastolic blood pressure and heart rate (median = 65.5 bpm, 95% CI: 56.7-77.7 vs. 71 bpm, 95% CI: 66.7-75; p = 0.5) did not change during or after the treatment. CONCLUSIONS Treatment of DRS is associated with improvement of endothelial function. Since endothelial dysfunction is known to precede the development of severe cardiovascular disorders such as atherosclerosis and hypertension, patients should be more carefully screened for DRS in general dental practice, and immediate DRS treatment should be advised.
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Affiliation(s)
- Grzegorz Osmenda
- Department of Internal and Agricultural Medicine, Jagiellonian University Collegium Medicum, Krakow, Poland
| | - Joanna Maciąg
- Department of Dental Prophylaxis and Experimental Dentistry, Dental School, Jagiellonian University, Krakow, Poland
| | - Grzegorz Wilk
- Department of Internal and Agricultural Medicine, Jagiellonian University Collegium Medicum, Krakow, Poland
| | - Anna Maciąg
- Zbigniew Żak Voivodeship Dental Clinic, Krakow, Poland
| | - Daniel Nowakowski
- Department of Dental Prophylaxis and Experimental Dentistry, Dental School, Jagiellonian University, Krakow, Poland
| | - Jolanta Loster
- Department of Prosthodontics, Dental School, Jagiellonian University, Krakow, Poland
| | - Elżbieta Dembowska
- Department of Periodontology, Dental School, Pomeranian Medical University, Szczecin, Poland
| | - Douglas Robertson
- Oral Sciences Research Group, Glasgow Dental School, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Tomasz Guzik
- Department of Internal and Agricultural Medicine, Jagiellonian University Collegium Medicum, Krakow, Poland
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - Marta Cześnikiewicz-Guzik
- Department of Dental Prophylaxis and Experimental Dentistry, Dental School, Jagiellonian University, Krakow, Poland
- Oral Sciences Research Group, Glasgow Dental School, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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Limited Evidence Suggested That Unfinished Root Canal Treatments May Increase the Risk of Cardiovascular Disease. J Evid Based Dent Pract 2016; 16:249-250. [DOI: 10.1016/j.jebdp.2016.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Association between Systemic Diseases and Apical Periodontitis. J Endod 2016; 42:1427-34. [DOI: 10.1016/j.joen.2016.07.007] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 07/07/2016] [Accepted: 07/07/2016] [Indexed: 12/11/2022]
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Garg P, Chaman C. Apical Periodontitis - Is It Accountable for Cardiovascular Diseases? J Clin Diagn Res 2016; 10:ZE08-12. [PMID: 27656588 DOI: 10.7860/jcdr/2016/19863.8253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 05/25/2016] [Indexed: 11/24/2022]
Abstract
The aim of this review was to assess the relationship between apical periodontitis and cardiovascular diseases and the predictive factors regarding this association. Cross sectional and observational studies have been included, which are mostly retrospective. A comprehensive search was performed in the Systematic Electronic Databases, PUBMED and MEDLINE from 1919 till September 2014. Articles were also hand searched. From 86 studies identified, all were read and 58 articles which were relevant were included in the text. Some articles were excluded because they were pertaining to periodontology and other systemic disorders. Some were solely animal studies and were thus excluded. Our results suggest an independent association between cardiovascular diseases and apical periodontitis. A causal relationship could not be established since weak parameters of risk have been assessed in the studies, population taken is difficult to compare and other confounding factors have not been ruled out. Only a more focused and better instituted scientific research can determine this association. Establishing a cause and effect relationship between apical periodontitis and cardiovascular diseases can affect the course of treatment of cardiovascular diseases. It is not only of interest from the scientific point of view but also from public health perspective.
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Affiliation(s)
- Paridhi Garg
- Senior Lecturer, Department of Consevative Dentistry and Endodontics, Inderprastha Dental College and Hospital , Sahibabad, Uttar Pradesh, India
| | - Chandrakar Chaman
- Reader, Department of Consevative Dentistry and Endodontics, Kothiwal Dental College and Research Centre , Moradabad, Uttar Pradesh. India
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Liljestrand J, Mäntylä P, Paju S, Buhlin K, Kopra K, Persson G, Hernandez M, Nieminen M, Sinisalo J, Tjäderhane L, Pussinen P. Association of Endodontic Lesions with Coronary Artery Disease. J Dent Res 2016; 95:1358-1365. [DOI: 10.1177/0022034516660509] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
An endodontic lesion (EL) is a common manifestation of endodontic infection where Porphyromonas endodontalis is frequently encountered. EL may associate with increased risk for coronary artery disease (CAD) via similar pathways as marginal periodontitis. The aim of this cross-sectional study was to delineate the associations between EL and CAD. Subgingival P. endodontalis, its immune response, and serum lipopolysaccharide were examined as potential mediators between these 2 diseases. The Finnish Parogene study consists of 508 patients (mean age, 62 y) who underwent coronary angiography and extensive clinical and radiographic oral examination. The cardiovascular outcomes included no significant CAD ( n = 123), stable CAD ( n = 184), and acute coronary syndrome (ACS; n = 169). EL was determined from a panoramic tomography. We combined data of widened periapical spaces (WPSs) and apical rarefactions to a score of EL: 1, no EL ( n = 210); 2, ≥1 WPS per 1 apical rarefaction ( n = 222); 3, ≥2 apical rarefactions ( n = 76). Subgingival P. endodontalis was defined by checkerboard DNA-DNA hybridization analysis, and corresponding serum antibodies were determined by ELISA. In our population, 50.4% had WPSs, and 22.8% apical rarefactions. A total of 51.2% of all teeth with apical rarefactions had received endodontic procedures. Subgingival P. endodontalis levels and serum immunoglobulin G were associated with a higher EL score. In the multiadjusted model (age, sex, smoking, diabetes, body mass index, alveolar bone loss, and number of teeth), having WPSs associated with stable CAD (odds ratio [OR] = 1.94, 95% confidence interval [95% CI] = 1.13 to 3.32, P = 0.016) and highest EL score were associated with ACS (OR = 2.46, 95% CI = 1.09 to 5.54, P = 0.030). This association was especially notable in subjects with untreated teeth with apical rarefactions ( n = 59, OR = 2.72, 95% CI = 1.16 to 6.40, P = 0.022). Our findings support the hypothesis that ELs are independently associated with CAD and in particular with ACS. This is of high interest from a public health perspective, considering the high prevalence of ELs and CAD.
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Affiliation(s)
- J.M. Liljestrand
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - P. Mäntylä
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - S. Paju
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - K. Buhlin
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Division of Periodontology, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
| | - K.A.E. Kopra
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - G.R. Persson
- Departments of Oral Medicine, and Periodontics, University of Washington, Seattle, Washington, USA
| | - M. Hernandez
- Laboratory of Periodontal Biology and Department of Oral Pathology and Medicine, Faculty of Dentistry, University of Chile, Santiago, Chile
| | - M.S. Nieminen
- Department of Cardiology, Heart and Lung Center, Department of Medicine, Helsinki University Hospital, Helsinki, Finland
| | - J. Sinisalo
- Department of Cardiology, Heart and Lung Center, Department of Medicine, Helsinki University Hospital, Helsinki, Finland
| | - L. Tjäderhane
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Unit of Oral Health Sciences, and Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - P.J. Pussinen
- Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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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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Lin PY, Chien KL, Chang HJ, Chi LY. Unfinished Root Canal Treatments and the Risk of Cardiovascular Disease. J Endod 2015; 41:1991-6. [DOI: 10.1016/j.joen.2015.08.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2015] [Accepted: 08/30/2015] [Indexed: 12/24/2022]
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Vidal F, Fontes TV, Marques TVF, Gonçalves LS. Association between apical periodontitis lesions and plasmatic levels of C-reactive protein, interleukin 6 and fibrinogen in hypertensive patients. Int Endod J 2015; 49:1107-1115. [DOI: 10.1111/iej.12567] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 10/19/2015] [Indexed: 11/29/2022]
Affiliation(s)
- F. Vidal
- Faculty of Dentistry; Estácio de Sá University; Rio de Janeiro Brazil
| | - T. V. Fontes
- Faculty of Dentistry; Estácio de Sá University; Rio de Janeiro Brazil
| | - T. V. F. Marques
- Faculty of Dentistry; Estácio de Sá University; Rio de Janeiro Brazil
| | - L. S. Gonçalves
- Faculty of Dentistry; Estácio de Sá University; Rio de Janeiro Brazil
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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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Aminoshariae A, Kulild JC. Association of Functional Gene Polymorphism with Apical Periodontitis. J Endod 2015; 41:999-1007. [DOI: 10.1016/j.joen.2015.03.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Revised: 02/15/2015] [Accepted: 03/08/2015] [Indexed: 01/08/2023]
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Cotti E, Zedda A, Deidda M, Piras A, Flore G, Ideo F, Madeddu C, Pau VM, Mercuro G. Endodontic Infection and Endothelial Dysfunction Are Associated with Different Mechanisms in Men and Women. J Endod 2015; 41:594-600. [DOI: 10.1016/j.joen.2015.01.037] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Revised: 01/27/2015] [Accepted: 01/30/2015] [Indexed: 10/23/2022]
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Solleveld H, Goedhart A, Vanden Bossche L. Associations between poor oral health and reinjuries in male elite soccer players: a cross-sectional self-report study. BMC Sports Sci Med Rehabil 2015; 7:11. [PMID: 25926988 PMCID: PMC4414372 DOI: 10.1186/s13102-015-0004-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 04/10/2015] [Indexed: 12/01/2022]
Abstract
Background Although it is well known that oral pathogens can enter the systemic circulation and cause disease, it is largely unknown if poor oral health increases the risk of sports injuries. The purpose of this study is to investigate the association between poor oral health and reinjuries in male elite soccer players, adjusted for psychosocial problems and player characteristics. Methods 184 Players in premier league soccer clubs and 31 elite, junior soccer players in the Netherlands, Belgium and England, were enrolled in a retrospective cross-sectional study. The Sports Injury Risk Indicator, a self assessed questionnaire, was used to obtain information on reinjuries, age and player position, oral health and psychosocial problems. The number of different types of oral health problems was used as an indicator of poor oral health. (SumDental, range 0–2: 0 = no oral health problems, 1 = one type of oral health problem and 2 = two or more types of oral health problems). Multivariable logistic regression was used to investigate whether SumDental was associated with reinjuries, after adjustment for psychosocial problems and player characteristics. Results 37% of the players reported no oral health problems, 43% reported one type of oral health problem and 20% reported two or more types of oral health problems. After full adjustment for age, player position and psychosocial problems (i.e. injury anxiety, psychophysical stress, unhealthy eating habits and dissatisfaction with trainer/team), poor oral health (SumDental) was positively associated with all kind of reinjuries whether analyzed as a continuous variable or as a categorical variable. The fully adjusted odds ratios for SumDental analyzed as a continuous variable were: in relation to repeated exercise-associated muscle cramps: 1.82 (95% confidence interval (CI): 1.07, 3.12), in relation to muscle or tendon reinjury 1.57 (95% CI: 1.01, 2.45) and in relation to multiple types of reinjury 1.88 (95% CI: 1.19, 2.97). Conclusion The results from this study justify a thorough examination of the effects of oral health problems on the injury risk of playing elite soccer.
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Affiliation(s)
| | | | - Luc Vanden Bossche
- Physical Rehabilitation and Sports Medicine, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium
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Hernández Vigueras S, Donoso Zúñiga M, Jané-Salas E, Salazar Navarrete L, Segura-Egea JJ, Velasco-Ortega E, López-López J. Viruses in pulp and periapical inflammation: a review. Odontology 2015; 104:184-91. [PMID: 25796386 DOI: 10.1007/s10266-015-0200-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 01/31/2015] [Indexed: 12/16/2022]
Abstract
The presence of viruses in endodontic disease has been studied in the last decade. Their presence is associated with periapical radiolucency and with clinical findings, such as pain. The aim of this review is to analyze the scientific evidence currently published about viruses in pulp and periapical inflammation, and its possible clinical implications. A literature review was carried out using the Medline/Pubmed database. The search was performed, in English and Spanish, using the following keyword combinations: virus AND endodontic; virus AND periapical; virus AND pulpitis; herpesvirus AND periapical; papillomavirus AND periapical. We subsequently selected the most relevant studies, which complied with the search criterion. A total of 21 articles were included, of which 18 detected the present of viruses in the samples. In 3 of the studies, viral presence was not found in the samples studied. The Epstein-Barr virus was found in about 41 % of cases compared to controls, in which it was present in about 2 %. The main association between viruses and endodontic pathosis is between Cytomegalovirus and Epstein-Barr virus; these are found in 114 of the 406 samples of different endodontic pathosis. Some evidence supports that the Epstein-Barr virus is present in a significant number of endodontic diseases, without exact knowledge of their action in these diseases.
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Affiliation(s)
- Scarlette Hernández Vigueras
- Faculty of Medicine, School of Dentistry, Universidad Austral de Chile, Valdivia, Chile.,PhD Program in Odontology Science, Faculty of Dentistry, University of Barcelona, Barcelona, Spain
| | - Manuel Donoso Zúñiga
- Faculty of Medicine, School of Dentistry, Universidad Austral de Chile, Valdivia, Chile
| | - Enric Jané-Salas
- Department of Odonto-Stomatology, School of Dentistry, University of Barcelona, Barcelona, Spain
| | - Luis Salazar Navarrete
- Laboratory of Molecular Biology and Pharmacogenetics, Department of Basic Science, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | | | | | - José López-López
- Department of Odonto-Stomatology, School of Dentistry, University of Barcelona, Barcelona, Spain. .,Department of Odontostomatology, Pabellón de Gobierno 2ª Planta, Bellvitge University Campus, C/Feixa Llarga s/n, L'Hospitalet de Llobregat, 08907, Barcelona, Spain.
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Denture-related stomatitis is associated with endothelial dysfunction. BIOMED RESEARCH INTERNATIONAL 2014; 2014:474016. [PMID: 25045683 PMCID: PMC4090512 DOI: 10.1155/2014/474016] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 05/28/2014] [Accepted: 05/29/2014] [Indexed: 01/17/2023]
Abstract
Oral inflammation, such as periodontitis, can lead to endothelial dysfunction, accelerated atherosclerosis, and vascular dysfunction. The relationship between vascular dysfunction and other common forms of oral infections such as denture-related stomatitis (DRS) is unknown. Similar risk factors predispose to both conditions including smoking, diabetes, age, and obesity. Accordingly, we aimed to investigate endothelial function and major vascular disease risk factors in 44 consecutive patients with dentures with clinical and microbiological features of DRS (n = 20) and without DRS (n = 24). While there was a tendency for higher occurrence of diabetes and smoking, groups did not differ significantly in respect to major vascular disease risk factors. Groups did not differ in main ambulatory blood pressure, total cholesterol, or even CRP. Importantly, flow mediated dilatation (FMD) was significantly lower in DRS than in non-DRS subjects, while nitroglycerin induced vasorelaxation (NMD) or intima-media thickness (IMT) was similar. Interestingly, while triglyceride levels were normal in both groups, they were higher in DRS subjects, although they did not correlate with either FMD or NMD. Conclusions. Denture related stomatitis is associated with endothelial dysfunction in elderly patients with dentures. This is in part related to the fact that diabetes and smoking increase risk of both DRS and cardiovascular disease.
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The association of chronic apical periodontitis and endodontic therapy with atherosclerosis. Clin Oral Investig 2013; 18:1813-23. [PMID: 24338091 PMCID: PMC4145204 DOI: 10.1007/s00784-013-1156-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 11/25/2013] [Indexed: 01/08/2023]
Abstract
Objectives Chronic apical periodontitis (CAP) appears to be a risk factor for coronary heart disease. The aims of the study were to estimate the significance of AP for the atherosclerotic burden and to examine the potential effect of endodontic treatment. Materials and methods The whole-body computed tomography (CT) examinations of 531 patients with a mean age of 50 ± 15.7 years were evaluated retrospectively. The atherosclerotic burden of the abdominal aorta was quantified using a calcium scoring method. The parameters of periodontitis were measured using the CT scan. Results The patients had a total of 11,191 teeth. The volume of the aortic atherosclerotic burden for patients with at least one CAP lesion was 0.32 ± 0.92 ml, higher than for patients with no CAP (0.17 ± 0.51 ml; p < 0.05). The atherosclerotic burden increased with age and number of CAP lesions without root canal treatment, but not with number of CAP lesions with endodontic treatments (p < 0.05 each). In logistic regression models, age (Wald 90.8), CAP without endodontic treatment (Wald 39.9), male gender (Wald 9.8), and caries per tooth (Wald 9.0) correlated positively and the number of fillings (Wald 11) correlated negatively with the atherosclerotic burden (p < 0.05 each). Apical radiolucencies in teeth with endodontic treatment were irrelevant with respect to atherosclerosis. Conclusions CAP correlated positively with the aortic atherosclerotic burden. In regression models, CAP without endodontic treatment was found to be an important factor, not however apical radiolucencies in teeth with endodontic treatment. Clinical relevance Further research is needed to clarify the possible clinical significance of these associations.
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Association between chronic apical periodontitis and coronary artery disease. J Endod 2013; 40:164-7. [PMID: 24461397 DOI: 10.1016/j.joen.2013.10.026] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 10/16/2013] [Accepted: 10/16/2013] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Studies have shown that periodontal disease is independently associated with coronary artery disease. However, this same association has not been demonstrated with chronic apical periodontitis. The goal of this study was to establish the relationship between chronic apical periodontitis and coronary artery disease. METHODS This cross-sectional study included 103 patients who underwent coronary angiography at the University Hospital Presidente Dutra, Federal University of Maranhão, São Luís-Maranhão, Brazil. The patients answered a structured questionnaire and underwent physical and laboratory examinations. For each patient, a full-mouth set of periapical radiographs was taken. To compare numerical data, Student's t test for independent samples or the Mann-Whitney U test (nonparametric) was used. The homogeneity of variance was assessed by using Levene's test. For comparison of categorical data, the chi-square test or Fisher's exact test was used. The logistic regression analysis was performed to identify the independent predictors of coronary artery disease. The criterion for statistical significance was set at 5%. Statistical analysis was conducted by using SAS version 6.11 software. RESULTS The study comprised 103 patients (52 men, 51 women; mean age, 61.9 years); 31.1% were literate, and 55.3% were married. In the study sample, the prevalence of chronic apical periodontitis was 41.7% and of coronary artery disease, it was 65%. The patients with chronic apical periodontitis had a 2.79 times higher risk of developing coronary artery disease. CONCLUSIONS In these study patients, chronic apical periodontitis was independently associated with coronary artery disease.
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Can Apical Periodontitis Modify Systemic Levels of Inflammatory Markers? A Systematic Review and Meta-analysis. J Endod 2013; 39:1205-17. [DOI: 10.1016/j.joen.2013.06.014] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 04/29/2013] [Accepted: 06/29/2013] [Indexed: 01/01/2023]
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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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Gomes MS, Hugo FN, Hilgert JB, Padilha DMP, Simonsick EM, Ferrucci L, Reynolds MA. Validity of self-reported history of endodontic treatment in the Baltimore Longitudinal Study of Aging. J Endod 2012; 38:589-93. [PMID: 22515884 PMCID: PMC3331994 DOI: 10.1016/j.joen.2012.02.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 02/07/2012] [Accepted: 02/09/2012] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Self-reported history of endodontic treatment (SRHET) has been used as a simplified method to estimate the history of endodontic disease and treatment. This study aimed to quantify the validity of SRHET, as reported in the Baltimore Longitudinal Study of Aging (BLSA), as a method to identify individuals who experienced endodontic treatment (ET) and to identify individuals who present with apical periodontitis (AP). METHODS SRHET was collected through the BLSA questionnaire in 247 participants. Data on ET and AP were determined from panoramic radiographs. The total number of ET, AP, and missing teeth were recorded for each individual. The validity of SRHET was determined based on ET and AP separately. Accuracy, efficiency, sensitivity, specificity, positive and negative predictive values (+PV and -PV), and positive and negative likelihood ratios (+LR and -LR) were calculated according to standard methods. RESULTS After exclusions, 229 participants were available for ET analysis and 129 for AP analysis. The SRHET validity values were sensitivity (ET = 0.915, AP = 0.782), specificity (ET = 0.891, AP = 0.689), +PV (ET = 0.824, AP = 0.353), -PV (ET = 0.949, AP = 0.936), +LR (ET = 8.394, AP = 2.514), and -LR (ET = 0.095, AP = 0.316). CONCLUSIONS SRHET was found to be a highly accurate method to predict ET but a weak predictor of the presence of AP among participants in the BLSA.
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Affiliation(s)
- Maximiliano Schünke Gomes
- School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
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Kozarov E. Bacterial invasion of vascular cell types: vascular infectology and atherogenesis. Future Cardiol 2012; 8:123-38. [PMID: 22185451 DOI: 10.2217/fca.11.75] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
To portray the chronic inflammation in atherosclerosis, leukocytic cell types involved in the immune response to invading pathogens are often the focus. However, atherogenesis is a complex pathological deterioration of the arterial walls, where vascular cell types are participants with regards to deterioration and disease. Since other recent reviews have detailed the role of both the innate and adaptive immune response in atherosclerosis, herein we will summarize the latest developments regarding the association of bacteria with vascular cell types: infections as a risk factor for atherosclerosis; bacterial invasion of vascular cell types; the atherogenic sequelae of bacterial presence such as endothelial activation and blood clotting; and the identification of the species that are able to colonize this niche. The evidence of a polybacterial infectious component of the atheromatous lesions opens the doors for exploration of the new field of vascular infectology and for the study of atherosclerosis microbiome.
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Affiliation(s)
- Emil Kozarov
- Section of Oral & Diagnostic Sciences, Columbia University Medical Center, 630 West 168 Street, P&S Box 20, New York, NY 10032, USA.
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Segura-Egea JJ, Castellanos-Cosano L, Machuca G, López-López J, Martín-González J, Velasco-Ortega E, Sánchez-Domínguez B, López-Frías FJ. Diabetes mellitus, periapical inflammation and endodontic treatment outcome. Med Oral Patol Oral Cir Bucal 2012; 17:e356-61. [PMID: 22143698 PMCID: PMC3448330 DOI: 10.4317/medoral.17452] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2010] [Accepted: 02/26/2011] [Indexed: 12/25/2022] Open
Abstract
The possible connection between chronic oral inflammatory processes, such as apical periodontitis and periodontal disease (PD), and systemic health is one of the most interesting aspects faced by the medical and dental scientific community. Chronic apical periodontitis shares important characteristics with PD: 1) both are chronic infections of the oral cavity, 2) the Gram-negative anaerobic microbiota found in both diseases is comparable, and 3) in both infectious processes increased local levels of inflammatory mediators may have an impact on systemic levels. One of the systemic disorders linked to PD is diabetes mellitus (DM); is therefore plausible to assume that chronic apical periodontitis and endodontic treatment are also associated with DM. The status of knowledge regarding the relationship between DM and endodontics is reviewed. Upon review, we conclude that there are data in the literature that associate DM with a higher prevalence of periapical lesions, greater size of the osteolityc lesions, greater likelihood of asymptomatic infections and worse prognosis for root filled teeth. The results of some studies suggest that periapical disease may contribute to diabetic metabolic dyscontrol. Key words: Apical periodontitis, diabetes mellitus, endodontics, root canal treatment.
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Affiliation(s)
- J-J Segura-Egea
- Dpto. Estomatología, Universidad de Sevilla, C/ Avicena s/n, 41009 Sevilla, Spain.
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47
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Association of Endodontic Infection with Detection of an Initial Lesion to the Cardiovascular System. J Endod 2011; 37:1624-9. [DOI: 10.1016/j.joen.2011.09.006] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 09/04/2011] [Accepted: 09/19/2011] [Indexed: 12/19/2022]
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48
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Segura-Egea JJ, Castellanos-Cosano L, Velasco-Ortega E, Ríos-Santos JV, Llamas-Carreras JM, Machuca G, López-Frías FJ. Relationship between Smoking and Endodontic Variables in Hypertensive Patients. J Endod 2011; 37:764-7. [DOI: 10.1016/j.joen.2011.03.004] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2011] [Revised: 03/17/2011] [Accepted: 03/17/2011] [Indexed: 11/26/2022]
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López-López J, Jané-Salas E, Estrugo-Devesa A, Velasco-Ortega E, Martín-González J, Segura-Egea JJ. Periapical and endodontic status of type 2 diabetic patients in Catalonia, Spain: a cross-sectional study. J Endod 2011; 37:598-601. [PMID: 21496655 DOI: 10.1016/j.joen.2011.01.002] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 01/13/2011] [Accepted: 01/15/2011] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The aim of this study was to investigate radiographically the prevalence of apical periodontitis (AP) and endodontic treatment in a sample of adult type II diabetic patients and control subjects. METHODS In a cross-sectional study, the radiographic records of 50 adult patients reporting a history of well-controlled type 2 diabetes mellitus (DM) (study group) and 50 age- and sex-matched subjects who reported no history of DM (control group) were examined. Periapical status of all teeth was assessed using the periapical index score. RESULTS The average number of teeth per patient in the diabetic and control groups was 21.9 and 24.6 teeth, respectively (P = .012). AP in one or more teeth was found in 37 diabetic patients (74%) and in 21 control subjects (42%) (odds ratio = 3.9, P = .002). One or more root-filled teeth were found in 35 (70%) and 25 (50%) of diabetic and control subjects, respectively (odds ratio = 2.3, P = .043). Among diabetic patients with root-filled teeth, 16 (46%) had AP affecting at least one treated tooth. Among controls with root-filled teeth, 6 (24%) had AP affecting at least one treated tooth (P > .05). Adjusting for teeth number, multivariate logistic regression analysis showed that periapical status (odds ratio = 3.3, P = .0071) and the number of root-filled teeth (odds ratio = 1.7; P = .0035) were significantly associated with diabetic status. CONCLUSIONS The results showed that in adult patients, type 2 DM is significantly associated with an increased prevalence of AP and endodontic treatment.
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Affiliation(s)
- José López-López
- Department of Stomatology, University of Barcelona, Catalonia, Spain
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