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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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Ghanbari Z, Moradi Y, Samiee N, Moradpour F. Dental caries prevalence in relation to the cardiovascular diseases: cross-sectional findings from the Iranian kurdish population. BMC Oral Health 2024; 24:509. [PMID: 38685018 PMCID: PMC11059578 DOI: 10.1186/s12903-024-04280-z] [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: 11/13/2023] [Accepted: 04/19/2024] [Indexed: 05/02/2024] Open
Abstract
OBJECTIVE Oral and dental health (ODH) is a significant public health concern globally, affecting billions of people. This cross-sectional study aimed to examine the prevalence of dental caries using the DMFT index and investigate its relationship with cardiovascular diseases in the Iranian Kurdish population. METHODS A total of 3,996 individuals aged 35-70 years were included from the Dehgolan prospective cohort study (DehPCS). Clinical examinations were performed to assess decayed (DT), missing (MT) and filled (FT) teeth (DMFT index). Data on demographics, socioeconomic status, medical history, oral hygiene practices were also collected. Cardiovascular disease (CVD) history was self-reported via questionnaires assessing heart disease, heart attack and stroke. Logistic regression was used to assess associations between oral health indicators and self-reported CVD, adjusting for potential confounders. RESULTS The mean DMFT score was 18.18 ± 19, indicating a high oral disease burden. Specifically, 60.04% had DT, 37.82% had more than 16 MT, and 38.83% had FT. Only 13.21% reported flossing regularly and 43.17% brushed less than daily, showing suboptimal oral hygiene. The overall CVD prevalence was 9.21%. Individuals with high DMFT (≥ 14) scores had approximately two times higher CVD prevalence than those with low DMFT. DMFT decreased by 10.23% with increase in education level, and by 5.87% as economic status increased In adjusted analyses, high DMFT scores (OR = 1.5, 95%CI: 1.2-1.9) and MT (OR = 1.5, 95%CI: 1.1-2.1) were associated with 50-150% increased odds of CVD, though associations weakened after adjusting for age. Among men, DMFT remained a significant predictor for CVD after age adjustment, with an odds ratio of 2.37 (95% CI: 1.22-4.60). CONCLUSION This population had substantial oral disease and poor oral hygiene. Higher DMFT scores and MT positively correlated with increased CVD prevalence. Promoting preventive oral care and health education could help reduce dental issues and potentially lower CVD risk. Further research is needed to clarify biological mechanisms linking oral and systemic health.
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Affiliation(s)
- Zahra Ghanbari
- Department of oral and maxillofacial medicine, School of Dentistry, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Yousef Moradi
- Department of Epidemiology and Biostatistics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
| | - Negin Samiee
- Department of oral and maxillofacial medicine, School of Dentistry, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Farhad Moradpour
- Social Determinants of Health Research Center, Research Institute for Health Development, University of Medical Sciences, Kurdistan, Sanandaj, Iran.
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Min Q, Chen Y, Geng H, Gao Q, Zhang X, Xu M. Causal relationship between PCOS and related sex hormones with oral inflammatory diseases: a bidirectional Mendelian randomization study. Front Endocrinol (Lausanne) 2024; 14:1282056. [PMID: 38264282 PMCID: PMC10803436 DOI: 10.3389/fendo.2023.1282056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 12/01/2023] [Indexed: 01/25/2024] Open
Abstract
Background Observational studies have identified a strong association between polycystic ovary syndrome (PCOS) and hormone levels related to oral inflammatory diseases. To better understand the relationship between them, we conducted an analysis using a two-sample Mendelian randomization (MR) approach. Methods We gathered summary statistical data from previously published genome-wide association studies (GWAS) on PCOS and three sex hormones (AMH, Estradiol, LH) along with four oral inflammatory diseases (painful gums, loose teeth, mouth ulcers, and toothache). We selected single nucleotide polymorphisms (SNPs) as instrumental variables and employed four types of MR analysis methods to evaluate causal relationships between exposure and outcome. Finally, the robustness of our results was further validated through sensitivity tests and reverse MR. Results We observed that PCOS could increase the risk of mouth ulcers (ORIVW= 1.0013, 95%CI: 1.0001-1.0025, PIVW = 0.0278), painful gums (ORIVW= 1.0015, 95%CI:1.0003-1.0027, PIVW = 0.0163), and loose teeth (ORIVW= 1.0014, 95%CI: 1.0001-1.0027, PIVW = 0.0328). Moreover, LH was also found to increase the risk of mouth ulcers (ORIVW= 1.0031, 95%CI: 0.0001-1.0062, PIVW = 0.0457). MR-Egger regression, weighted mode, and WE indicated similar results. Additionally, we discovered no causal link between PCOS and toothache (PIVW>0.05), LH and painful gums, loose teeth, or toothache (PIVW>0.05), or AMH and Estradiol level with any of the four oral diseases (PIVW>0.05). Conclusion Our research provides new insights and references for exploring the effects of PCOS and related hormones on oral inflammatory lesions. For patients with PCOS, especially those with elevated LH levels, early intervention measures should be taken to prevent the occurrence of oral inflammatory diseases.
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Affiliation(s)
- Qiusi Min
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yi Chen
- Department of Gynecology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Hongling Geng
- Department of Gynecology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
| | - Qian Gao
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xueying Zhang
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Min Xu
- Department of Gynecology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong, China
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Ideo F, Manca MF, Niazi S, Mannocci F, Bardini G, Cotti E. The role of systemic statins in the inception and healing of apical periodontitis: a systematic review. BMC Oral Health 2023; 23:730. [PMID: 37805447 PMCID: PMC10560424 DOI: 10.1186/s12903-023-03472-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/28/2023] [Indexed: 10/09/2023] Open
Abstract
OBJECTIVES Statins are a category of medications widely used to reduce plasma LDL-cholesterol levels, that also possess antibacterial, anti-inflammatory, and immunomodulatory action. The aim of this systematic review was to explore the effects of systemic statins therapy on the development and treatment of apical periodontitis (AP) on humans and animals. MATERIAL AND METHODS Three electronic databases (PubMed, Web of Science, and Scopus) and grey literature were searched from their inception until February, 20 2023 (PROSPERO CRD42021246231). For the quality assessment and risk of bias, different guidelines were used according to the typology of the studies considered (Animal Research Reporting of In Vivo Experiments, Newcastle-Ottawa Quality Assessment Form for Cohort Studies, Systematic Review Centre for Laboratory animal Experimentation Risk of Bias tool and Tool to assess risk of bias in cohort studies of CLARITY Group). RESULTS Seven hundred eleven records were screened, and six articles were included for this qualitative review. The eligible studies showed a moderate overall quality and risk of bias. Human patients in treatment with statins exhibited a higher healing rate of AP following root canal treatment. In experimental animal models, statins had a beneficial effect on the development of AP. CONCLUSIONS Despite the limited number of studies and considering that most of them are on animals, our findings suggest that systemically administered statins make a positive contribution to prevent the development and help healing of AP. CLINICAL RELEVANCE There is an increased evidence that a pharmacologic adjunct to endodontic treatment may be considered to enhance healing of AP. Among other medications, statins seem to have a positive impact on the disease.
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Affiliation(s)
- Francesca Ideo
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - Matteo Francesco Manca
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - Sadia Niazi
- Department of Endodontology, Centre for Oral, Clinical & Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Hospital, London, UK
| | - Francesco Mannocci
- Department of Endodontology, Centre for Oral, Clinical & Translational Sciences, Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, Guy's Hospital, London, UK
| | - Giulia Bardini
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - Elisabetta Cotti
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy.
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Duncan HF, Kirkevang LL, Peters OA, El-Karim I, Krastl G, Del Fabbro M, Chong BS, Galler KM, Segura-Egea JJ, Kebschull M. Treatment of pulpal and apical disease: The European Society of Endodontology (ESE) S3-level clinical practice guideline. Int Endod J 2023; 56 Suppl 3:238-295. [PMID: 37772327 DOI: 10.1111/iej.13974] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND The ESE previously published quality guidelines for endodontic treatment in 2006; however, there have been significant changes since not only in clinical endodontics but also in consensus and guideline development processes. In the development of the inaugural S3-level clinical practice guidelines (CPG), a comprehensive systematic and methodologically robust guideline consultation process was followed in order to produce evidence-based recommendations for the management of patients presenting with pulpal and apical disease. AIM To develop an S3-level CPG for the treatment of pulpal and apical disease, focusing on diagnosis and the implementation of the treatment approaches required to manage patients presenting with pulpitis and apical periodontitis (AP) with the ultimate goal of preventing tooth loss. METHODS This S3-level CPG was developed by the ESE, with the assistance of independent methodological guidance provided by the Association of Scientific Medical Societies in Germany and utilizing the GRADE process. A robust, rigorous and transparent process included the analysis of relevant comparative research in 14 specifically commissioned systematic reviews, prior to evaluation of the quality and strength of evidence, the formulation of specific evidence and expert-based recommendations in a structured consensus process with leading endodontic experts and a broad base of external stakeholders. RESULTS The S3-level CPG for the treatment of pulpal and apical disease describes in a series of clinical recommendations the effectiveness of diagnosing pulpitis and AP, prior to investigating the effectiveness of endodontic treatments in managing those diseases. Therapeutic strategies include the effectiveness of deep caries management in cases with, and without, spontaneous pain and pulp exposure, vital versus nonvital teeth, the effectiveness of root canal instrumentation, irrigation, dressing, root canal filling materials and adjunct intracanal procedures in the management of AP. Prior to treatment planning, the critical importance of history and case evaluation, aseptic techniques, appropriate training and re-evaluations during and after treatment is stressed. CONCLUSION The first S3-level CPG in endodontics informs clinical practice, health systems, policymakers, other stakeholders and patients on the available and most effective treatments to manage patients with pulpitis and AP in order to preserve teeth over a patient's lifetime, according to the best comparative evidence currently available.
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Affiliation(s)
- Henry F Duncan
- Division of Restorative Dentistry & Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | | | - Ove A Peters
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - Ikhlas El-Karim
- School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Gabriel Krastl
- Department of Conservative Dentistry and Periodontology, University Hospital of Würzburg, Würzburg, Germany
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, Università degli Studi di Milano, Milan, Italy
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Bun San Chong
- Faculty of Medicine & Dentistry, Institute of Dentistry, Queen Mary University of London, London, UK
| | - Kerstin M Galler
- Department of Operative Dentistry and Periodontology, Friedrich-Alexander-University Erlangen-Nuernberg, Erlangen, Germany
| | - Juan J Segura-Egea
- Department of Stomatology, Endodontics Section, School of Dentistry, University of Sevilla, Sevilla, Spain
| | - Moritz Kebschull
- School of Dentistry, Institute of Clinical Sciences, College of Medical & Dental Sciences, University of Birmingham, Birmingham, UK
- Birmingham Community Healthcare NHS Trust, Birmingham, UK
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, New York, USA
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Feuerriegel GC, Burian E, Sollmann N, Leonhardt Y, Burian G, Griesbauer M, Bumm C, Makowski MR, Probst M, Probst FA, Karampinos DC, Folwaczny M. Evaluation of 3D MRI for early detection of bone edema associated with apical periodontitis. Clin Oral Investig 2023; 27:5403-5412. [PMID: 37464086 PMCID: PMC10492681 DOI: 10.1007/s00784-023-05159-z] [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: 02/09/2023] [Accepted: 07/11/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVES To detect and evaluate early signs of apical periodontitis using MRI based on a 3D short-tau-inversion-recovery (STIR) sequence compared to conventional panoramic radiography (OPT) and periapical radiographs in patients with apical periodontitis. MATERIALS AND METHODS Patients with clinical evidence of periodontal disease were enrolled prospectively and received OPT as well as MRI of the viscerocranium including a 3D-STIR sequence. The MRI sequences were assessed for the occurrence and extent of bone changes associated with apical periodontitis including bone edema, periradicular cysts, and dental granulomas. OPTs and intraoral periapical radiographs, if available, were assessed for corresponding periapical radiolucencies using the periapical index (PAI). RESULTS In total, 232 teeth of 37 patients (mean age 62±13.9 years, 18 women) were assessed. In 69 cases reactive bone edema was detected on MRI with corresponding radiolucency according to OPT. In 105 cases edema was detected without corresponding radiolucency on OPT. The overall extent of edema measured on MRI was significantly larger compared to the radiolucency on OPT (mean: STIR 2.4±1.4 mm, dental radiograph 1.3±1.2 mm, OPT 0.8±1.1 mm, P=0.01). The overall PAI score was significantly higher on MRI compared to OPT (mean PAI: STIR 1.9±0.7, dental radiograph 1.3±0.5, OPT 1.2±0.7, P=0.02). CONCLUSION Early detection and assessment of bone changes of apical periodontitis using MRI was feasible while the extent of bone edema measured on MRI exceeded the radiolucencies measured on OPT. CLINICAL RELEVANCE In clinical routine, dental MRI might be useful for early detection and assessment of apical periodontitis before irreversible bone loss is detected on conventional panoramic and intraoral periapical radiographs.
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Affiliation(s)
- Georg C. Feuerriegel
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany
| | - Egon Burian
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Yannik Leonhardt
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany
| | - Gintare Burian
- Department of Prosthodontics, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Magdalena Griesbauer
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Caspar Bumm
- Department of Restorative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Marcus R. Makowski
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany
| | - Monika Probst
- Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Florian A. Probst
- Department of Restorative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
| | - Dimitrios C. Karampinos
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Ismaninger Strasse 22, 81675 Munich, Germany
| | - Matthias Folwaczny
- Department of Restorative Dentistry and Periodontology, LMU University Hospital, Ludwig-Maximilians-University, Munich, Germany
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Fransson H, Dawson V. Tooth survival after endodontic treatment. Int Endod J 2023; 56 Suppl 2:140-153. [PMID: 36149887 DOI: 10.1111/iej.13835] [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: 05/19/2022] [Revised: 09/16/2022] [Accepted: 09/18/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND There are several measures that are, or could be, in use in relation to estimating the outcome of endodontic treatments. It is important to reflect on when and why a certain outcome measure is used; when caring for an individual patient it is obvious that the goal always should be a tooth in a healthy state, that is striving to remove any infection and aim for the tooth to have healthy periapical tissues. For patients in general and for society, it is also interesting to know if endodontic treatments will lead to retention of teeth in a functioning state. From epidemiological studies, with high prevalence of root filled teeth with periapical radiolucencies, it is implied that dentists and/or patients accept the retention of a root filled tooth with persistent apical periodontitis. In conjunction with an endodontic treatment the prognosis is considered and since the prognostic factors seem to be somewhat different depending on whether one is considering for example the outcome 'healthy periapical tissues' or 'tooth survival' they are equally important to know. Factors affecting the outcome 'healthy periapical tissues' probably has to do with removal of infection and reconstituting the barrier to prevent leakage whilst 'tooth survival' is more likely associated with factors outside of the classical endodontic field such as restorability and avoidance of further destruction of tooth substance. Objective This narrative review will focus on tooth survival after endodontic treatment and root canal treatment will be the focus. Method The search was performed in PubMed. Results As a crude estimation, there is to be an annual loss of 2% of teeth which have received a root canal treatment. Conclusion Of the pre-, peri- and postoperative factors that have been studied in conjunction with root canal treatments the restoration of the tooth is the factor that has been most extensively studied. Many studies imply that root filled teeth restored with indirect restorations have a better survival than teeth restored with direct restorations, it is not possible to determine whether this indeed is a prognostic factor. Registration None.
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Affiliation(s)
- Helena Fransson
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Victoria Dawson
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Nagendrababu V, Duncan HF, Fouad AF, Kirkevang LL, Parashos P, Pigg M, Vaeth M, Jayaraman J, Suresh N, Jakovljevic A, Dummer PMH. PROBE 2023 guidelines for reporting observational studies in endodontics: Explanation and elaboration. Int Endod J 2023; 56:652-685. [PMID: 36851874 DOI: 10.1111/iej.13909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
Observational studies play a critical role in evaluating the prevalence and incidence of conditions or diseases in populations as well as in defining the benefits and potential hazards of health-related interventions. There are currently no reporting guidelines for observational studies in the field of Endodontics. The Preferred Reporting Items for study Designs in Endodontology (PRIDE) team has developed and published new reporting guidelines for observational-based studies called the 'Preferred Reporting items for OBservational studies in Endodontics (PROBE) 2023' guidelines. The PROBE 2023 guidelines were developed exclusively for the speciality of Endodontics by integrating and adapting the 'STrengthening the Reporting of OBservational studies in Epidemiology (STROBE)' checklist and the 'Clinical and Laboratory Images in Publications (CLIP)' principles. The recommendations of the Guidance for Developers of Health Research Reporting Guidelines were adhered to throughout the process of developing the guidelines. The purpose of this document is to serve as a guide for authors by providing an explanation for each of the items in the PROBE 2023 checklist along with relevant examples from the literature. The document also offers advice to authors on how they can address each item in their manuscript before submission to a journal. The PROBE 2023 checklist is freely accessible and downloadable from the PRIDE website (http://pride-endodonticguidelines.org/probe/).
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Affiliation(s)
| | - Henry F Duncan
- Division of Restorative Dentistry, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland
| | - Ashraf F Fouad
- Department of Endodontics, School of Dentistry, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | | | - Peter Parashos
- Melbourne Dental School, University of Melbourne, Melbourne, Victoria, Australia
| | - Maria Pigg
- Department of Endodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Michael Vaeth
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Jayakumar Jayaraman
- Department of Pediatric Dentistry, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Nandini Suresh
- Faculty of Dentistry, Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College and Hospital, Meenakshi Academy of Higher Education and Research (MAHER), Chennai, India
| | - Aleksandar Jakovljevic
- Department of Pathophysiology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia
| | - Paul M H Dummer
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
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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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Cotti E, Schirru E. Present status and future directions: Imaging techniques for the detection of periapical lesions. Int Endod J 2022; 55 Suppl 4:1085-1099. [PMID: 36059089 DOI: 10.1111/iej.13828] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/25/2022] [Accepted: 08/26/2022] [Indexed: 11/29/2022]
Abstract
Diagnosing and treating apical periodontitis (AP) in an attempt to preserve the natural dentition, and to prevent the direct and indirect systemic effects of this condition, is the major goal in endodontics. Considering that AP is frequently asymptomatic, and is most often associated with a lesion in the periapex of the affected tooth, within the maxillary bones, imaging becomes of paramount importance for the diagnosis of the disease. The aim of this narrative review was to investigate the most relevant classic and current literature to describe which are, to date, the diagnostic imaging systems most reliable and advanced to achieve the early and predictable detection of AP, the best measures of the lesions and the disclosure of the different features of the disease. Dental panoramic tomography (DPT) is a classic exam, considered still useful to provide the basic diagnosis of AP in certain districts of the maxillary bones. Periapical radiographs (PRs) represent a valid routine examination, with few, known limitations. Cone-beam computed tomography (CBCT) is the only system that ensures the early and predictable detection of all periapical lesions in the jaws, with the minor risk of false positives. These techniques can be successfully implemented, with ultrasounds (USI) or magnetic resonance (MRI) imaging, exams that do not use ionising radiations. MRI and USI provide information on specific features of the lesions, like the presence and amount of vascular supply, their content and their relationship with the surrounding soft tissues, leading to differential diagnoses. Further, all the three-dimensional systems (CBCT, USI and MRI) allow the volumetric assessment of AP. Pioneering research on artificial intelligence is slowly progressing in the detection of periapical radiolucencies on DPTs, PRs and CBCTs, however, with promising results. Finally, it is established that all imaging techniques have to be associated with a thorough clinical examination and a good degree of calibration of the operator.
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Affiliation(s)
- Elisabetta Cotti
- Department of Conservative Dentistry and Endodontics, University of Cagliari, Cagliari, Italy
| | - Elia Schirru
- Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
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Szerszeń M, Górski B, Kowalski J. Clinical Condition of the Oral Cavity in the Adult Polish Population below 70 Years of Age after Myocardial Infarction-A Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127265. [PMID: 35742511 PMCID: PMC9224220 DOI: 10.3390/ijerph19127265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/10/2022] [Accepted: 06/13/2022] [Indexed: 01/22/2023]
Abstract
According to recent scientific consensus, there is an increasing amount of evidence on the correlation between oral health and cardiovascular disease morbidity. The aim of the present study was to investigate the number of missing teeth, the presence of residual roots with necrotic pulp and teeth with caries, the type of teeth deficiencies, and periodontal status in patients after myocardial infarction (MI). A total of 151 patients after MI and 160 randomly selected controls without history of MI were enrolled in the study. Epidemiological data were collected, and dental examination was performed. Findings showed significantly more women, subjects with lower level of education, lower income, higher percentage of nicotine addiction, more frequent presence of arterial hypertension, diabetes, and obesity than in the study group. Moreover, oral status of the subjects who suffered from MI was inferior to the control group. An average patient from the study group had 11 missing teeth, when compared to four missing teeth in an average control subject (p < 0.0001). The majority of patients in the control group had occlusal contacts in intercuspal position in premolars and molars (group A), in contrast to the patients after MI, who had at least one missing supporting zone (group B) (p < 0.0001). Severe periodontitis was found in 50.3% of tests and in 30.4% of controls (p < 0.0001). A correlation was found between the edentulousness and the risk of myocardial infarction after adjusting for other known risk factors of cardiovascular diseases (OR = 3.8; 95% CI = 3.01−7.21; p < 0.0001). This case−control study showed that MI patients had more missing teeth, more residual roots with necrotic pulp, much higher incidence of edentulism and occlusal contacts in intercuspal position in fewer than four occlusal supporting zones, as well as worse periodontal status when compared to healthy subjects without a history of MI. Due to the methodology of unmatched controls, the presented results must be interpreted with caution.
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Affiliation(s)
- Marcin Szerszeń
- Department of Prosthodontics, Medical University of Warsaw, 02-097 Warsaw, Poland
- Correspondence:
| | - Bartłomiej Górski
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland; (B.G.); (J.K.)
| | - Jan Kowalski
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Warsaw, 02-097 Warsaw, Poland; (B.G.); (J.K.)
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Parashar SR, Kasabwala K, Ulaganathan S, MCV A, Khandelwal P, Arockiam S, Natanasabapathy V. ASSOCIATION OF PULP CALCIFICATIONS AND CARDIOVASCULAR DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS. J Evid Based Dent Pract 2022; 22:101707. [DOI: 10.1016/j.jebdp.2022.101707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 02/01/2022] [Accepted: 02/11/2022] [Indexed: 10/19/2022]
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Comparative evaluation of serum high sensitivity C-reactive protein and complete hemogram indices in subjects with and without apical periodontitis: A prospective interventional study. J Endod 2022; 48:1020-1028. [DOI: 10.1016/j.joen.2022.05.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 05/05/2022] [Accepted: 05/07/2022] [Indexed: 01/08/2023]
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Segura-Sampedro JJ, Jiménez-Giménez C, Jane Salas E, Cabanillas-Balsera D, Martín-González J, Segura-Egea JJ, López-López J. Periapical and Endodontic Status of Patients with Inflammatory Bowel Disease: Age- and Sex- matched Case-control Study. Int Endod J 2022; 55:748-757. [PMID: 35403728 PMCID: PMC9325481 DOI: 10.1111/iej.13747] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 04/06/2022] [Accepted: 04/07/2022] [Indexed: 11/28/2022]
Abstract
AIM Crohn's disease (CD) and ulcerative colitis (UC) are two chronic recurrent inflammatory processes of the gastrointestinal tract, grouped under the name Inflammatory Bowel Disease (IBD), causing clinical episodes of intestinal inflammation. The aim of this study was to investigate the possible association between IBD and the prevalence of apical periodontitis and root canal treatment. METHODOLOGY A case-control study design matched to age and sex was used. The study group (SG) included 28 patients with IBD (13 with CD, 15 with UC). Another 28 healthy subjects, without IBD and age- and sex- matched, were included in the control group (CG). Radiographic records were analyzed and apical periodontitis (AP) was diagnosed as radiolucent periapical lesions (RPLs), using the periapical index score (PAI). Student's t test, χ2 test and multivariate logistic regression were used in the statistical analysis. RESULTS In the CG, only 17 subjects (61%) had at least one tooth with AP, while in the SG group they were 23 patients (82%) (OR = 2.98; CI 95% = 0.87 - 10.87; p = 0.08). The number of subjects with one or more root filled teeth (RFT) in the CG was 14 (50%), while in the SG they were 22 (79%) (OR = 3.67; 95% CI = 1.14 - 11.79; p = 0.026). At least one RFT with AP was evident in 3 subjects (10.7%) in the control group, while in the study group 15 patients (53.6%) showed RFT with AP (OR = 9.60; 95% CI = 2.35 - 39.35; p = 0.001). In the multivariate logistic regression analysis, only endodontic status was found to be associated with IBD (OR = 1.86; 95% CI = 1.24 - 2.80; p = 0.003). CONCLUSION IBD, ulcerative colitis and Crohn´s disease, is associated with higher prevalence of RFT and higher percentage of RFT with periapical lesions. Dentists should consider these findings when caring for IBD patients by monitoring the evolution of periapical lesions of endodontically treated teeth.
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Affiliation(s)
- Juan J Segura-Sampedro
- General & Digestive Surgery Unit. Hospital Universitario Son Espases, School of Medicine, University of Balearic Islands. Balearic Islands Health Research Institute, Palma de Mallorca, Spain
| | - Carla Jiménez-Giménez
- Department of Odontostomatology, Faculty of Medicine and Health Sciences [Dentistry]. C / feixa LLarga s / n. Hospitalet de LLobregat, Barcelona, 08907, Spain
| | - Enric Jane Salas
- Department of Odontostomatology, Faculty of Medicine and Health Sciences [Dentistry] - Dentistry Hospital Universidad de Barcelona. C / feixa LLarga s / n. Hospitalet de LLobregat, Barcelona, 08907, Spain
| | - Daniel Cabanillas-Balsera
- Department of Stomatology, School of Dentistry, University of Sevilla, C/ Avicena s/n, 41009, Sevilla, Spain
| | - Jenifer Martín-González
- Department of Stomatology, School of Dentistry, University of Sevilla, C/ Avicena s/n, 41009, Sevilla, Spain
| | - Juan J Segura-Egea
- Department of Stomatology, School of Dentistry, University of Sevilla, C/ Avicena s/n, 41009, Sevilla, Spain
| | - José López-López
- Department of Odontostomatology, Faculty of Medicine and Health Sciences [Dentistry] - Dentistry Hospital Universidad de Barcelona. C / feixa LLarga s / n. Hospitalet de LLobregat, Barcelona, 08907, Spain
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