A systematic review was conducted to assess the association between apical periodontitis (AP) and cardiovascular disease (CVD). Studies published from the earliest date available until September 2015 were retrieved from the Medline, PubMed and Embase databases. The included studies reported the results from observational studies and assessed the link between AP and CVD as confirmed by one of the following criteria: diagnosed coronary artery disease, angina pectoris, acute myocardial infarction, stroke or mortality caused by cardiac pathology. The study characteristics were abstracted by independent researchers following the PRISMA standard protocol. NOS criteria were used to rate the quality of the studies, and the GRADE was used for level of evidence evaluation. Nineteen epidemiological studies fulfilled the predetermined inclusion criteria: 10 case-control studies, five cross-sectional studies and four cohort studies. There was considerable heterogeneity amongst the included studies in terms of their study design, population, outcomes of interest and AP evaluation methods. Considering the limited availability and the heterogeneity amongst the studies, meta-analysis was not attempted. Thirteen of the 19 included studies found a significant positive association between apical periodontitis and cardiovascular disease, although in two of them, the significance was present only in univariate analysis. Five studies failed to reveal positive significance, and one study reported a negative association. In conclusion, although most of the published studies found a positive association between apical periodontitis and cardiovascular disease, the quality of the existing evidence is moderate-low and a causal relationship cannot be established.

AimTo evaluate, retrospectively, the quality of previously published case reports in Endodontics according to the PRICE 2020 guidelines.MethodologyAn electronic literature search was conducted in PubMed database on 12 March 2020, to identify case reports published during the last five years in the International Endodontic Journal and the Journal of Endodontics. For each of the included case reports, information regarding fulfilment of each of the items of the PRICE 2020 guidelines was extracted as ‘0’ (not present in the manuscript), ‘1’ (present in the manuscript) and ‘NA’ (not applicable) and translated into a score (percentage of items fulfilled). Additionally, the percentage of papers fulfilling each item was calculated.ResultsOverall, 70 endodontic case reports were identified. The scores of the papers ranged between 56.41% and 79.55%, with a mean score of 70.26 ± 4.36% (SD). The percentage of papers fulfilling each item of the applicable PRICE 2020 items ranged widely, between 0% and 100%. The median of the percentage of all the items (n = 47) was 97.01% and mean 73.33 ± 36.28% (SD). The lowest scores were recorded for specific items in the following domains: ‘Case Report Information’‐Items 6c, 6g–i, ‘Patient Perspective’‐Item 8a and ‘Quality of Images’‐Items 12c–d.ConclusionsSeveral areas with low reporting rates were identified in case reports published over the last 5 years in Endodontics. Authors should be encouraged to follow the PRICE 2020 guidelines in order to increase the quality and improve reproducibility of their case reports.

AimFirst, to determine the feasibility of using the low‐density lipoprotein receptor knockout (LDLR KO) mouse model to study apical periodontitis (AP). Secondly, to investigate the causal relationship between AP and atherosclerosis. It was hypothesized that it would be feasible to induce AP and atherosclerosis in LDLR KO mice and find a difference in atherosclerosis between AP and Sham groups.MethodologyUsing a published methodology, AP was induced in LDLR KO mice by exposing the dental pulp of the four first molars (Tx). Shams received only anaesthesia. Mice were fed a high fat, Western‐type diet (WTD), to induce atherosclerosis. At 16 weeks, mice were euthanized and aortas collected to measure atherosclerosis lesion burden (oil red O staining). Periapical lesions were validated using micro‐CT and histology. Systemic inflammation was measured using a cytokine array.ResultsBoth groups developed a similar degree of atherosclerosis (mean lesion area 7.46 ± 0.44% in the Tx group compared with 7.65 ± 0.46%, in the Sham group, P = 0.77), and a similar degree of inflammation. Periapical lesions (PALs) in all four molars were only identified in a small subset of Tx mice.ConclusionsA novel mouse model, which combines AP and CVD, was created. This model allows investigation of the relationship between the two diseases, whilst avoiding other potential common confounders. Although no difference in the degree of atherosclerosis was found between the groups, more studies in which the number of periapical lesions, changes in systemic inflammation and the degree of atherosclerosis are correlated are necessary to ultimately determine the impact of AP on CVD.

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Objective: To quantify tooth volume differences from extracted teeth when using three different three-dimensional (3D) computed tomography (CT)-based imaging modalities. Design: Ex vivo study. Setting: Laboratory and clinics of the University of Alberta. Methods: Cone-beam CT (CBCT) of 12 extracted teeth were scanned using 0.25- and 0.30-mm voxel size from CBCT and a 0.06-mm voxel size from micro-CT (reference standard). 3D reconstructions for each tooth from each imaging modality were made through the software ITK-SNAP®. The mean volume differences between each pair of scanning modalities were calculated and then compared and analysed through a repeated measures ANOVA. Results: The average overestimations of the teeth volume were 15.2% for the high-resolution CBCT and 28.1% for the low-resolution CBCT compared to micro-CT measurements. The differences in absolute volume were 81.6 mm3 and 152.8 mm3, respectively. All differences were statistically significant ( P < 0.05). Conclusions: Orthodontists and researchers who assess root resorption through CBCT imaging should be aware that the depicted volumes may likely be overestimating tooth volume and camouflaging real root volumetric treatment changes.