Association between Endodontic Infection, Its Treatment and Systemic Health: A Narrative Review
The ‘Focal Infection Era in Dentistry’ in the late 19th and early 20th century resulted in widespread implementation of tooth extraction and limited the progress of endodontics. The theory proposed that bacteria and toxins entrapped in dentinal tubules could disseminate systemically to remote body p...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-07-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/7/931 |
| _version_ | 1797433331268190208 |
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| author | Sadia Ambreen Niazi Abdulaziz Bakhsh |
| author_facet | Sadia Ambreen Niazi Abdulaziz Bakhsh |
| author_sort | Sadia Ambreen Niazi |
| collection | DOAJ |
| description | The ‘Focal Infection Era in Dentistry’ in the late 19th and early 20th century resulted in widespread implementation of tooth extraction and limited the progress of endodontics. The theory proposed that bacteria and toxins entrapped in dentinal tubules could disseminate systemically to remote body parts, resulting in many types of degenerative systemic diseases. This theory was eventually refuted due to anecdotal evidence. However, lately there has been increased interest in investigating whether endodontic disease could have an impact on general health. There are reviews that have previously been carried out on this subject, but as new data have emerged since then, this review aims to appraise the available literature investigating the dynamic associations between apical periodontitis, endodontic treatment, and systemic health. The available evidence regarding focal infection theory, bacteraemia and inflammatory markers was appraised. The review also collated the available research arguing the associations of apical periodontitis with cardiovascular diseases, diabetes mellitus, adverse pregnancy outcome and autoimmune disorders, along with the effect of statins and immunomodulators on apical periodontitis prevalence and endodontic treatment prognosis. There is emerging evidence that bacteraemia and low-grade systemic inflammation associated with apical periodontitis may negatively impact systemic health, e.g., development of cardiovascular diseases, adverse pregnancy outcomes, and diabetic metabolic dyscontrol. However, there is limited information supporting the effect of diabetes mellitus or autoimmune disorders on the prevalence and prognosis post endodontic treatment. Furthermore, convincing evidence supports that successful root canal treatment has a beneficial impact on systemic health by reducing the inflammatory burden, thereby dismissing the misconceptions of focal infection theory. Although compelling evidence regarding the association between apical periodontitis and systemic health is present, further high-quality research is required to support and establish the benefits of endodontic treatment on systemic health. |
| first_indexed | 2024-03-09T10:15:31Z |
| format | Article |
| id | doaj.art-8845c2756a0949bcb14a65ab0384361d |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T10:15:31Z |
| publishDate | 2022-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-8845c2756a0949bcb14a65ab0384361d2023-12-01T22:25:27ZengMDPI AGMedicina1010-660X1648-91442022-07-0158793110.3390/medicina58070931Association between Endodontic Infection, Its Treatment and Systemic Health: A Narrative ReviewSadia Ambreen Niazi0Abdulaziz Bakhsh1Department of Endodontics, Centre of Oral Clinical & Translational Sciences, Faculty of Dentistry, Oral & Craniofacial Sciences, Guy’s Dental Hospital, King’s College London, London SE1 9RT, UKDepartment of Restorative Dentistry, Faculty of Dentistry, Umm Al-Qura University, Makkah 24381, Saudi ArabiaThe ‘Focal Infection Era in Dentistry’ in the late 19th and early 20th century resulted in widespread implementation of tooth extraction and limited the progress of endodontics. The theory proposed that bacteria and toxins entrapped in dentinal tubules could disseminate systemically to remote body parts, resulting in many types of degenerative systemic diseases. This theory was eventually refuted due to anecdotal evidence. However, lately there has been increased interest in investigating whether endodontic disease could have an impact on general health. There are reviews that have previously been carried out on this subject, but as new data have emerged since then, this review aims to appraise the available literature investigating the dynamic associations between apical periodontitis, endodontic treatment, and systemic health. The available evidence regarding focal infection theory, bacteraemia and inflammatory markers was appraised. The review also collated the available research arguing the associations of apical periodontitis with cardiovascular diseases, diabetes mellitus, adverse pregnancy outcome and autoimmune disorders, along with the effect of statins and immunomodulators on apical periodontitis prevalence and endodontic treatment prognosis. There is emerging evidence that bacteraemia and low-grade systemic inflammation associated with apical periodontitis may negatively impact systemic health, e.g., development of cardiovascular diseases, adverse pregnancy outcomes, and diabetic metabolic dyscontrol. However, there is limited information supporting the effect of diabetes mellitus or autoimmune disorders on the prevalence and prognosis post endodontic treatment. Furthermore, convincing evidence supports that successful root canal treatment has a beneficial impact on systemic health by reducing the inflammatory burden, thereby dismissing the misconceptions of focal infection theory. Although compelling evidence regarding the association between apical periodontitis and systemic health is present, further high-quality research is required to support and establish the benefits of endodontic treatment on systemic health.https://www.mdpi.com/1648-9144/58/7/931apical periodontitissystemic healthcardiovascular diseasesdiabetes mellituspregnancyautoimmune disorder |
| spellingShingle | Sadia Ambreen Niazi Abdulaziz Bakhsh Association between Endodontic Infection, Its Treatment and Systemic Health: A Narrative Review Medicina apical periodontitis systemic health cardiovascular diseases diabetes mellitus pregnancy autoimmune disorder |
| title | Association between Endodontic Infection, Its Treatment and Systemic Health: A Narrative Review |
| title_full | Association between Endodontic Infection, Its Treatment and Systemic Health: A Narrative Review |
| title_fullStr | Association between Endodontic Infection, Its Treatment and Systemic Health: A Narrative Review |
| title_full_unstemmed | Association between Endodontic Infection, Its Treatment and Systemic Health: A Narrative Review |
| title_short | Association between Endodontic Infection, Its Treatment and Systemic Health: A Narrative Review |
| title_sort | association between endodontic infection its treatment and systemic health a narrative review |
| topic | apical periodontitis systemic health cardiovascular diseases diabetes mellitus pregnancy autoimmune disorder |
| url | https://www.mdpi.com/1648-9144/58/7/931 |
| work_keys_str_mv | AT sadiaambreenniazi associationbetweenendodonticinfectionitstreatmentandsystemichealthanarrativereview AT abdulazizbakhsh associationbetweenendodonticinfectionitstreatmentandsystemichealthanarrativereview |