Response to the Letter to the Editor regarding “The global prevalence of apical periodontitis: A systematic review and meta‐analysis”

Tibúrcio-Machado, Camilla dos Santos; Zanatta, Fabrício Batistin; Gomes, Maximiliano Schünke; Bier, Carlos Alexandre Souza

doi:10.1111/iej.13591

Cited by 1 publication

(1 citation statement)

References 5 publications

(8 reference statements)

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“…AP manifests itself in different ways, ranging from completely asymptomatic and detected as a periapical radiolucency on a radiograph, to being symptomatic presenting with pain and abscess (Nair, 2004, 2006). The global prevalence of AP and root canal treatments in adults is high (one periapical lesion per patient and two root canal treatments per patient) (Dos Santos Tiburcio‐Machado et al, 2021). Moreover, by contributing to a chronic systemic inflammation AP might have a negative impact on a patient's overall health (Georgiou et al, 2019; Khalighinejad et al, 2016; Niazi & Bakhsh, 2022).…”

Section: Introductionmentioning

confidence: 99%

Successful endodontic treatment reduces serum levels of cardiovascular disease risk biomarkers—high‐sensitivity C‐reactive protein, asymmetric dimethylarginine, and matrix metalloprotease‐2

Al‐Abdulla,

Bakhsh,

Mannocci

et al. 2023

Int Endodontic J

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AimTo investigate serum biomarkers of inflammation 2 years following non‐surgical root canal re‐treatment (Re‐RCT) and peri‐apical surgery (PS). The results were correlated with signs and symptoms, treatment outcome, metabolic syndrome factors, infection with severe acute respiratory syndrome coronavirus 2 SARS‐CoV‐2 (COVID‐19) infection and COVID‐19 vaccination.MethodologySubjects from our previous study were recalled for 2 years post‐treatment follow‐up. Changes to the patient's history (medical, dental, social) were noted. Periapical health of the treated teeth was examined both clinically and radiographically. Blood pressure, fasting HbA1C and low‐density lipoprotein (LDL), high‐density lipoprotein (HDL), triglycerides and total cholesterol (TC) levels were measured. Serum inflammatory marker levels were assayed using a Bio‐Rad Bio‐Plex 200 analyser and values at different time points within the same group were compared using a Wilcoxon signed‐rank test and differences between groups with a Mann–Whitney test. Linear associations were tested using Pearson's correlations.ResultsThe recall percentage at 2 years was 56.9% (n = 37), with a 100% radiographic success rate using periapical radiographs. In total, 21 cases (56.8%) were completely healed, and 16 cases (43.2%) were healing. Higher matrix metalloprotease 2 (MMP2) levels were present in the healing group compared to the healed group. Serum levels of high‐sensitivity C‐reactive protein (hs‐CRP), asymmetric dimethylarginine (ADMA) and MMP‐2 were significantly reduced (p ≤ .001) whereas other biomarkers showed significant increases at 2 year compared to pre‐operative levels, while FGF‐23 and ICAM‐1 were not significantly increased. HbA1C (p = .015), TC (p = .003), LDL (p = .003) and HDL (p = .003) reduced significantly at 2 years post‐treatment compared to their preoperative levels. COVID infection showed a significant association with MMP‐9 (p = .048).Conclusionshs‐CRP, ADMA and MMP‐2 can be regarded as prognostic biomarkers of successful Re‐RCT and PS as they reduced at 2 year recall in cases which showed evidence of clinical and radiographic success. The successful treatment of chronic apical periodontitis is correlated with improvements in metabolic syndrome indicators, better glycemic control, and reduction at 2 year of some systemic inflammatory markers which are related to risks of cardiovascular disease events.

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