The root of the problem

Sullivan, Megan; Gallagher, George; Noonan, Vikki

doi:10.1016/j.adaj.2016.02.018

Cited by 23 publications

(11 citation statements)

References 8 publications

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“…In our study, the incidence of periapical granulomas was 80.19%, which is in accordance with most of the previous studies. Moreover, the incidence of radicular cysts in the current study was 19.81%, which is in line with the findings of Saraf et al and Sullivan et al [ 18 , 21 ] . In agreement with the low incidence of abscesses reported in the literature, there were no abscesses detected in our study.…”

Section: Discussionsupporting

confidence: 93%

Increased interleukin 1α and interleukin 1β expression is involved in the progression of periapical lesions in primary teeth

et al. 2018

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BackgroundInterleukin 1 (IL-1) is involved in bone resorption. However, the role of IL-1 in periapical lesions characterized by periapical bone destruction in primary teeth has not yet been fully elucidated. This study aimed to detect the distribution and expression of IL-1 in periapical lesions in primary teeth and assess the relationship between the cytokines and the degree of inflammatory cell infiltration.MethodsA total of 106 chronic periapical lesions in primary teeth were harvested. Haematoxylin and eosin (H&E) staining was used to determine the histological type and the inflammatory cell infiltration grade (mild, moderate, and severe), and immunohistochemistry and enzyme-linked immunosorbent assay (ELISA) were used to detect the distribution and expression of IL-1α and IL-1β.ResultsOf the 106 chronic periapical lesion samples, there were 85 cases of periapical granuloma, accounting for 80.19% of the total samples, and 21 cases of radicular cysts, accounting for 19.81%; no cases of abscess were detected. Immunohistochemistry results showed that both IL-1α and IL-1β were expressed in periapical granulomas and cysts. ELISA results showed that IL-1α and IL-1β levels were higher in the periapical granuloma group than in the radicular cyst and normal control groups (P < 0.05). In the periapical granuloma group, IL-1α and IL-1β were detected at higher levels in the severe inflammatory cell infiltration subgroup than in the mild-inflammatory cell infiltration subgroup (P < 0.05), and IL-1β expression was also higher in the moderate inflammatory cell infiltration subgroup than in the mild inflammatory cell infiltration subgroup (P < 0.01). A significant positive correlation was observed between the protein expression levels of IL-1α and IL-1β and the inflammation grade in periapical granulomas from primary teeth (P < 0.05).ConclusionExpression levels of the cytokines IL-1α and IL-1β in periapical granulomas from primary teeth increased with increasing inflammatory severity and appeared to be a contributing factor to the progression of periapical lesions.

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Section: Discussionsupporting

confidence: 93%

Increased interleukin 1α and interleukin 1β expression is involved in the progression of periapical lesions in primary teeth

et al. 2018

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“…In addition, care should be taken when focusing on remained function or high numbers of tooth retention only, since apical pathoses may result from both inflammatory and non-inflammatory origin [48] without any subjective symptoms for the patient, not always being resolved by conventional root canal treatment, and often calling for histopathologic clarification. Moreover, pulpal inflammation and persistence of chronic apical periodontitis are associated with a highly complex bacterial community [49], and have recently been reported to be independently associated with development of coronary heart disease [50, 51], thus potentially increasing the patient’s total vascular risk [52–54]; this undoubtedly would call for clinical vigilance.…”

Section: Discussionmentioning

confidence: 99%

Radiologic assessment of quality of root canal fillings and periapical status in an Austrian subpopulation – An observational study

2017

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Background/ObjectiveProgress in endodontic techniques and methodological advances have altered root canal therapy over the last decades. These techniques and methods need periodical documentation. This observational study determined the current prevalence of endodontic treatments, and investigated the relationship of various factors with the periapical status in a Lower Austrian subpopulation.MethodologyOne thousand orthopantomograms of first-time university adult patients radiographed at an outpatient clinic were evaluated. For each tooth, the presence of periradicular pathosis and/or endodontic treatment was recorded, as was the quality of (post-)endodontic treatment (homogeneity and length of root canal fillings; preparation failures; posts/screws; apicoectomies; coronal restorations). Two evaluators, blinded to each other, scored all teeth. In cases of disagreement, they joined for a consensus score.ResultsIn all, 22,586 teeth were counted. Of these, 2,907 teeth (12.9%) had periapical pathosis, while 2,504 teeth had undergone root canal treatment. Of the endodontically treated teeth, 52% showed no radiographic signs of apical periodontitis, while 44.9% had overt apical lesions, and 3,1% revealed widened periodontal ligament space. The majority of the root canal fillings was inhomogeneous (70.4%); 75.4% were rated too short, and 3.8% too long. The presence of apical pathosis was significantly correlated (odds ratio (OR) 2.556 [confidence interval (CI) 2.076–3.146]; P<0.0001) with poor root canal fillings (length and homogeneity). Posts or screws positively affected periapical status (OR 1.853 [CI 1.219–2.819]; P = 0.004), but endodontically treated posterior teeth were infrequently restored (posts, 7.5%; screws, 2.7%). Best results were found for teeth with both appropriate endodontic treatment and adequate coronal restoration.ConclusionA high prevalence of periradicular radiolucencies was observed with root canal filled teeth, along with high numbers of unmet treatment needs. Periapical health was associated with adequate root canal obturation and high-grade postendodontic restorations, and quality regarding these latter aspects is considered mandatory to promote periapical health.

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“…Our findings match the literature data, which have pointed out high prevalence of these oral pathological entities, even when soft tissue lesions are also evaluated ( 16 , 18 ). Both periapical granulomas and periapical cysts are caused by pulpal injury due to caries or trauma ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

Retrospective analysis of jaw biopsies in young adults. A study of 1599 cases in Southern Brazil

Silva

Alves²,

Corrêa³

et al. 2017

Med Oral

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BackgroundTo evaluate the prevalence and the characteristics of jaw lesions diagnosed in young adults aged 20 to 30 years in a southern Brazil reference center, over a period of 25 years. And to analyze the concordance between clinical and histological diagnosis.Material and MethodsIn this cross-sectional retrospective study, the biopsies files from this center were retrieved and data regarding sex, age, bone localization, clinical and histological diagnosis were collected. The histological diagnosis were grouped into the categories Cystic lesions of odontogenic origin, Periapical inflammation, Odontogenic tumors, Bone diseases, Health tissue and Nonspecific diagnostic. Absolute and relative frequencies were estimated with descriptive analysis. The agreement between clinical and histological diagnosis was measured through Kappa statistic.ResultsA total of 18,181 histopathological analysis were performed during the period of the study, registering 1,599 jaw lesions in young adults. The average age of individuals was 24,59 years (SD 3,1). Nine hundred ninety-one (62%) lesions were found in females and 608 (38%) in males. More than half of pathologies were cystic lesions of odontogenic origin (822/51.4%), followed by periapical inflammation (282/17.6%). Regarding the site of lesions, more than half occurred in posterior mandible (877/54.8%), followed by posterior maxilla (339/21.2%). The most frequent entities were periapical cyst, chronic periapical granuloma, dental follicle and paradental cyst, corresponding to a total of 1,202 (75.2%) evaluated cases. In relation to the analysis of concordance between clinical and histological diagnosis the general Kappa index was 0.5, which is considered moderate. Finally, the findings confirm data from literature about the most frequent jaw pathologies in young adults and serve as aid for preventive measures of some entities. Additionally, they can improve the formulation of differential diagnosis and the patient management. Key words: Jaw, biopsy, retrospective studies, young adult, Brazil.

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The root of the problem

Cited by 23 publications

References 8 publications

Increased interleukin 1α and interleukin 1β expression is involved in the progression of periapical lesions in primary teeth

Increased interleukin 1α and interleukin 1β expression is involved in the progression of periapical lesions in primary teeth

Radiologic assessment of quality of root canal fillings and periapical status in an Austrian subpopulation – An observational study

Retrospective analysis of jaw biopsies in young adults. A study of 1599 cases in Southern Brazil

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