Malmö University Publications
Change search
Link to record
Permanent link

Direct link
Alternative names
Publications (10 of 36) Show all publications
Sebring, D., Buhlin, K., Lund, H., Norhammar, A., Rydén, L. & Kvist, T. (2024). Endodontic Inflammatory Disease and Future Cardiovascular Events and Mortality: A Report from the PAROKRANK Study. Journal of Endodontics, 50(8), 1073-1081.e3, Article ID S0099-2399(24)00283-8.
Open this publication in new window or tab >>Endodontic Inflammatory Disease and Future Cardiovascular Events and Mortality: A Report from the PAROKRANK Study
Show others...
2024 (English)In: Journal of Endodontics, ISSN 0099-2399, E-ISSN 1878-3554, Vol. 50, no 8, p. 1073-1081.e3, article id S0099-2399(24)00283-8Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Apical periodontitis, cardiovascular disease, endodontic variables, mortality, myocardial infarction, systemic health
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-71536 (URN)10.1016/j.joen.2024.05.003 (DOI)001303553600001 ()38763484 (PubMedID)2-s2.0-85195636711 (Scopus ID)
Available from: 2024-10-09 Created: 2024-10-09 Last updated: 2024-10-09Bibliographically approved
Dawson, V. S., Fransson, H., Isberg, P.-E. & Wigsten, E. (2024). Further Interventions After Root Canal Treatment Are Most Common in Molars and Teeth Restored with Direct Restorations: A 10–11-Year Follow-Up of the Adult Swedish Population. Journal of Endodontics, 50(6), 766-773
Open this publication in new window or tab >>Further Interventions After Root Canal Treatment Are Most Common in Molars and Teeth Restored with Direct Restorations: A 10–11-Year Follow-Up of the Adult Swedish Population
Show others...
2024 (English)In: Journal of Endodontics, ISSN 0099-2399, E-ISSN 1878-3554, Vol. 50, no 6, p. 766-773Article in journal (Refereed) Published
Abstract [en]

Introduction: The aims were to investigate 1) the frequency of nonsurgical retreatment, root-end surgery, extraction, and further restorative treatment during a follow-up of 10 to 11 years after root filling and compare the frequencies according to tooth group and type of coronal restoration, and 2) the timing of nonsurgical retreatment, root-end surgery, and extraction.

Methods: Data were collected from the Swedish Social Insurance Agency's register. A search for treatment codes identified teeth root filled in 2009 and the type of coronal restoration (direct, indirect, unspecified) registered within 6 months of root filling. The root-filled teeth were followed 10-11 years, and further interventions were recorded. Descriptive statistics and Chi-square tests were used for statistical analysis.

Results: In 2009, root fillings were registered for 215,611 individuals/teeth. Nonsurgical retreatment, root-end surgery, and extraction were undertaken in 3.5%, 1.4%, and 20% teeth, respectively. The frequency of further interventions varied with respect to tooth group and type of coronal restoration, but only slightly for endodontic retreatments. Further interventions, except for root-end surgery, were registered more often for molars and directly restored teeth (P < 0.001). The majority of endodontic retreatments were undertaken within 4 years, while extractions were evenly distributed over 10-11 years.

Conclusions: The frequency numbers of nonsurgical retreatment and root-end surgery were low, despite one in five root-filled teeth registered as extracted. Further interventions were most common in molars and directly restored teeth. Endodontic retreatments were performed more often during the first 4 years.

Place, publisher, year, edition, pages
Elsevier, 2024
Keywords
Apicoectomy, endodontics, epidemiology, permanent dental restoration, tooth extraction, treatment outcome
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-66370 (URN)10.1016/j.joen.2024.03.005 (DOI)001243470300001 ()38492798 (PubMedID)2-s2.0-85190151069 (Scopus ID)
Available from: 2024-03-19 Created: 2024-03-19 Last updated: 2024-10-09Bibliographically approved
Wigsten, E., Fransson, H., Isberg, P. & Dawson, V. S. (2024). General dental practitioners' fees for root canal treatment, coronal restoration and follow‐on treatment in the adult population in Sweden: A 10‐year follow‐up of data from the Swedish Dental Register. Clinical and Experimental Dental Research, 10(1), Article ID e826.
Open this publication in new window or tab >>General dental practitioners' fees for root canal treatment, coronal restoration and follow‐on treatment in the adult population in Sweden: A 10‐year follow‐up of data from the Swedish Dental Register
Show others...
2024 (English)In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 10, no 1, article id e826Article in journal (Refereed) Published
Abstract [en]

Objectives: To analyze the accumulated fees connected with root filling, permanent coronal restoration and follow-on treatment charged by Swedish dentists over a 10-11-year follow-up period. Furthermore, analyzing these fees with reference to the type of restoration, tooth group, and the root-filled teeth which survived compared to those requiring extraction.

Material and methods: In 2009, the data register of the Swedish Social Insurance Agency recorded a total of 215,611 teeth as root-filled. The accumulated fees for each tooth encompassed the following interventions: initial root filling, coronal restorations, and follow-up treatments during the designated period. The outcomes were analyzed using descriptive and analytic statistics, including t tests and one-way analysis of variance. The fees are presented in Euros (€1 = SEK 8.94).

Results: The total accumulated fees for root fillings amounted to 72 million Euros: the mean fee per root filled tooth was €333.6. The total mean fee over a 10-11-year period, comprising root canal treatment, coronal restorations, and any follow-up treatments, was €923.4. Root-filled teeth with indirect restorations presented a higher mean fee (€1 279.3) compared to those with direct restorations (€829.4) or those without specified restorations (€832.7; p < .001). Moreover, molars presented a significantly higher mean fee (€966.4) compared to premolars (€882.8) and anterior teeth (€891.3; p < .001). Lastly, the mean fee for extracted teeth was €1225.3, which was higher compared to those who survived the follow-up period (€848.0; p < .001).

Conclusions: Fees charged by general dental practitioners for root-filled teeth accumulate over time, probably due to the need for further treatment of the tooth. The total mean fee was significantly higher for molars and root-filled teeth with indirect restorations. However, an analysis of the total costs would require prospective clinical cost-effectiveness studies.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-64310 (URN)10.1002/cre2.826 (DOI)001116694100001 ()38062924 (PubMedID)2-s2.0-85178955898 (Scopus ID)
Available from: 2023-12-12 Created: 2023-12-12 Last updated: 2024-10-09Bibliographically approved
Olsson, S. R., Jonsson Sjögren, J., Pigg, M., Fransson, H., Eliasson, A. & Kvist, T. (2024). Interventions in root‐filled teeth identified in general dental practice: A 6‐year longitudinal observational study. International Endodontic Journal, 57(9), 1212-1227
Open this publication in new window or tab >>Interventions in root‐filled teeth identified in general dental practice: A 6‐year longitudinal observational study
Show others...
2024 (English)In: International Endodontic Journal, ISSN 0143-2885, E-ISSN 1365-2591, Vol. 57, no 9, p. 1212-1227Article in journal (Refereed) Published
Abstract [en]

Aim: To investigate what happens to cross-sectionally identified root-filled teeth over a 6-year period, regardless of the time that elapsed since primary root canal treatment, in a cohort of adult patients regularly attending a Public Dental Service. A secondary aim was to investigate how the cumulative events affecting root-filled teeth over the same time were associated with variables obtained from a baseline examination.

Methodology: Adult patients with ≥1 previously root-filled tooth and regularly attending the Public Dental Service in Örebro County were enrolled for study participation in 2015. General dental practitioners examined all identified root-filled teeth in this cohort at baseline using a standardized protocol and were also responsible for further decision-making and treatments. After six years, information on events of the root-filled teeth was collected from dental records. The highest rating (most invasive treatment) on a 5-point ordinal scale was used in the analyses. Regression analyses with stepwise selection were performed for associations between patient- and tooth-related factors and events.

Results: A total of 445 patients with 1007 root-filled teeth were followed the entire observation time. Twenty (2.0%) of the root-filled teeth had endodontic retreatment and 150 (14.9%) were extracted over six years. Among teeth with periapical radiolucency or pain, the majority did not undergo retreatment or extraction; however, the multivariate analysis demonstrated that retreatment or extraction was associated with baseline recordings of teeth with periapical radiolucency (p < .0001), tenderness to percussion (p < .0001), and poor coronal restoration (p < .0001).

Conclusions: This study corroborates the notion that in general dentistry, root-filled teeth with radiological signs of apical disease often remain untreated over time. Furthermore, it also reveals that root-filled teeth presenting with mild pain do not necessarily receive any intervention. However, teeth with baseline signs of apical periodontitis, pain, or inadequate coronal restoration were more likely to have received intervention during the six-year period.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
endodontically treated teeth, endodontics, periapical diseases, public health, retreatment, root canal therapy
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-67250 (URN)10.1111/iej.14079 (DOI)001216357900001 ()39302850 (PubMedID)2-s2.0-85192544982 (Scopus ID)
Available from: 2024-05-16 Created: 2024-05-16 Last updated: 2024-10-09Bibliographically approved
Lindström, M. G., Fransson, H., Dawson, V., Kvist, T. & Wolf, E. (2024). Why do dentists refrain from intervention in cases of persistent asymptomatic apical periodontitis in root canal filled teeth? An interview study among general dental practitioners. International Endodontic Journal
Open this publication in new window or tab >>Why do dentists refrain from intervention in cases of persistent asymptomatic apical periodontitis in root canal filled teeth? An interview study among general dental practitioners
Show others...
2024 (English)In: International Endodontic Journal, ISSN 0143-2885, E-ISSN 1365-2591Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim: To explore the context in which general dental practitioners (GDPs) decide to refrain from further treatment, that is, ortho- or retrograde retreatment or extraction of a root canal filled tooth with persistent asymptomatic apical periodontitis (PAAP).

Methodology: Fifteen GDPs were strategically selected for in-depth interviews. The informants were encouraged to describe in their own words and in as much detail as possible, the three most recent patient cases of PAAP of a root canal filled tooth, in which they decided to refrain from further treatment. The interviews were recorded digitally and transcribed verbatim. The collected material was analysed according to Qualitative Content Analysis with an inductive approach.

Results: A pattern of varying degrees of uncertainty associated with the decision process was identified. The motives to refrain intervention had great diversity. The result from analysis of the qualitative data was formulated in an overall theme 'Between doubt and certainty in a complex clinical context' covering the latent content. The first main category covering the manifest content was 'The continuum of confidence' with three subcategories 'Experienced uncertainty', 'Reluctant approval' and 'At ease with refraining' illustrating the feelings and attitudes experienced by the informants. The second category was 'In support of acceptance' with three subcategories 'Patient's autonomy, risks and cost-benefits', 'Emotional aspects' and 'Relieving measures' representing the reasons for refraining from intervention.

Conclusions: The decision to refrain from further treatment, that is, ortho- or retrograde retreatment or extraction of a root canal filled tooth with PAAP was made with some measure of confidence, combined with compensatory strategies to support the decision, taking into account not only values beneficial to the patient and awareness of limited external resources, but also factors related to the informants' personal preferences, convenience, concerns, ambition and emotions.

Place, publisher, year, edition, pages
John Wiley & Sons, 2024
Keywords
[clinical] decision‐making, endodontics, periapical periodontitis, qualitative research, retreatment, tooth extraction
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-71804 (URN)10.1111/iej.14158 (DOI)001338456900001 ()39440881 (PubMedID)2-s2.0-85207229771 (Scopus ID)
Available from: 2024-10-28 Created: 2024-10-28 Last updated: 2024-11-08Bibliographically approved
Wigsten, E., Kvist, T., Husberg, M. & Davidson, T. (2023). Cost‐effectiveness of root canal treatment compared with tooth extraction in a Swedish Public Dental Service: A prospective controlled cohort study. Clinical and Experimental Dental Research, 9(4), 661-669
Open this publication in new window or tab >>Cost‐effectiveness of root canal treatment compared with tooth extraction in a Swedish Public Dental Service: A prospective controlled cohort study
Show others...
2023 (English)In: Clinical and Experimental Dental Research, E-ISSN 2057-4347, Vol. 9, no 4, p. 661-669Article in journal (Refereed) Published
Abstract [en]

Objectives: To evaluate the cost-effectiveness of root canal treatment (RCT) compared with a tooth extraction in a general dental practice setting, with reference to cost per quality-adjusted life-year (QALY) gained over 1 year.

Material and methods: This is a prospective controlled cohort study based on patients either starting RCT or undergoing extraction at one of six Public Dental Service clinics in the county of Västra Götaland, Sweden. From a total of 65 patients, 2 comparable groups were formed: 37 started RCT and 28 underwent extraction. A societal perspective was used for the cost calculations. QALYs were estimated, based on the EQ-5D-5L given to the patients at their first treatment appointment and then after 1, 6, and 12 months.

Results: The total mean cost of RCT ($689.1) was higher than for extraction ($280.1). For those patients whose extracted tooth was replaced, the costs were even higher ($1245.5). There were no significant intergroup differences in QALYs, but a significant improvement in health state values in the tooth-preserving group.

Conclusions: In the short term, extraction was cost-effective compared with preserving a tooth with RCT. However, the potential need for future replacement of the extracted tooth, by an implant, fixed prosthesis, or removable partial dentures, may change the calculation in favor of RCT.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
EQ-5D-5L, cost-effectiveness analysis, patient-reported outcome measures, quality-adjusted life years
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-71529 (URN)10.1002/cre2.759 (DOI)001020021500001 ()37386766 (PubMedID)2-s2.0-85163684466 (Scopus ID)
Available from: 2024-10-09 Created: 2024-10-09 Last updated: 2024-10-09Bibliographically approved
Wigsten, E., Fransson, H., Isberg, P.-E., EndoReCo, E. R. & Dawson, V. (2023). Fees for root canal treatment and further dental care in the adult population in sweden: a 10-year follow-up of data from the Swedish dental register. In: ESE Wladimir Adlivankine Research Prize, Education Prize and Original Research Abstracts: . Paper presented at 21st Biennial Congress of the European Society of Endodontology, Helsingfors, Finland 2023. , Article ID R107.
Open this publication in new window or tab >>Fees for root canal treatment and further dental care in the adult population in sweden: a 10-year follow-up of data from the Swedish dental register
Show others...
2023 (English)In: ESE Wladimir Adlivankine Research Prize, Education Prize and Original Research Abstracts, 2023, article id R107Conference paper, Poster (with or without abstract) (Other academic)
Abstract [en]

Aim: To investigate the fees for root filling and further dental care charged by Swedish dentists during a follow-up period of 10 to 11 years. Comparisons are made between type of restoration registered within 6 months of the root filling, the tooth group, and the root filled teeth that survived versus those that were extracted.Methods: A total of 215 611 teeth were registered as root filled in the Swedish Social Insurance Agency’s data register in 2009. For each identified tooth, the fees for the following interventions were tracked: initial root filling, coronal restorations, and further dental interventions registered during the follow-up period. The outcomes were analysed with descriptive and analytic statistics, using one-way ANOVA and t-tests. The fees are presented in Euro (€1 = SEK 8.94; 01/01/2012).Results: The total fee for the root fillings was 72 million euros, and the mean fee was €333.6 per root filling. The total mean fee for the preservation of a root filled tooth over 10 to 11 years was €923.4, which included root canal treatment, coronal restorations, and further interventions. The mean fee for indirectly restored root filled teeth was higher (€1 279.3) than for those directly restored (€829.4) and for teeth without specified restorations (€832.7; P < 0.001). Molars had a significantly higher mean fee (€966.4) compared to premolars (€882.8) and anterior teeth (€891.3; P < 0.001). The mean fee for teeth that were extracted was higher (€1 225.3) than for those that survived the follow-up (€848.0; P < 0.001). Conclusions: Fees for root filled teeth have accumulated over time probably due to further dental care needed. The total mean fee was significantly higher for indirectly restored root filled teeth than for directly restored. However, prospective clinical cost-effectiveness studies are needed to analyse the total costs.

National Category
Dentistry
Research subject
Health and society
Identifiers
urn:nbn:se:mau:diva-62631 (URN)
Conference
21st Biennial Congress of the European Society of Endodontology, Helsingfors, Finland 2023
Available from: 2023-09-18 Created: 2023-09-18 Last updated: 2024-09-15Bibliographically approved
Dawson, V., Fransson, H., Isberg, P.-E., EndoReCo, E. R. & Wigsten, E. (2023). Further interventions after root canal treatment in relation to type of coronal restoration and tooth group: a 10-year follow-up of a Swedish dental register. In: ESE Wladimir Adlivankine Research Prize, Education Prize and Original Research Abstracts: . Paper presented at 21st Biennial Congress of the European Society of Endodontology, Helsingfors, Finland 2023. , Article ID R043.
Open this publication in new window or tab >>Further interventions after root canal treatment in relation to type of coronal restoration and tooth group: a 10-year follow-up of a Swedish dental register
Show others...
2023 (English)In: ESE Wladimir Adlivankine Research Prize, Education Prize and Original Research Abstracts, 2023, article id R043Conference paper, Oral presentation with published abstract (Other academic)
Abstract [en]

Aim: To investigate the frequency of further interventions after root filling during a follow-up of 10 to 11 years, and to compare the outcomes with respect to type of coronal restoration and tooth group.Methods: Data from the Swedish Social Insurance Agency´s register of dental treatments were obtained to identify the teeth registered as root filled in Sweden 2009. Type of coronal restoration within 6 months after root filling, as well as the frequency of further interventions (nonsurgical retreatment, periradicular surgery, extraction, further direct and indirect restoration) were tracked in the data register until December 31, 2019. Descriptive statistics and Chi-square tests were used for statistical analysis.Results: Of the 215 611 teeth root filled in 2009, nonsurgical retreatment, periradicular surgery, and extraction were registered for 3.5%, 1.4% and 20%, respectively. The highest frequency of nonsurgical retreatment was registered for molars (4.2%), and periradicular surgery was most frequent in maxillary canines and incisors (2.3%). The highest frequency of extractions was registered for mandibular molars (25.1%). Directly restored teeth had higher frequency of nonsurgical retreatment (3.9%) and extraction (20.8%), compared to indirectly restored teeth (1.7% and 13.6%, respectively; P < 0.001). Of teeth restored with direct restoration within 6 months after root filling, 41.5% were registered with at least one further direct restoration and 14.7% with an indirect restoration. In the group of indirectly restored teeth, 9.3% and 7.1% underwent further restorative treatment with direct and indirect restoration, respectively. The differences registered between directly and indirectly restored root filled teeth were statistically significant (P < 0.001).Conclusions: The frequencies of nonsurgical retreatment and periradicular surgery were low 10 to 11 years after root filling, despite one in five root filled teeth being registered as extracted. Further interventions were significantly more common for directly restored teeth than for those indirectly restored.

National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-62629 (URN)
Conference
21st Biennial Congress of the European Society of Endodontology, Helsingfors, Finland 2023
Available from: 2023-09-18 Created: 2023-09-18 Last updated: 2024-09-15Bibliographically approved
Mota de Almeida, F. J., Dawson, V., Kvist, T., Frisk, F., Bjørndal, L., Isberg, P. & Fransson, H. (2023). Periradicular surgery: A longitudinal registry study of 10‐year outcomes and factors predictive of post‐surgical extraction. International Endodontic Journal, 56(10), 1212-1221
Open this publication in new window or tab >>Periradicular surgery: A longitudinal registry study of 10‐year outcomes and factors predictive of post‐surgical extraction
Show others...
2023 (English)In: International Endodontic Journal, ISSN 0143-2885, E-ISSN 1365-2591, Vol. 56, no 10, p. 1212-1221Article in journal (Refereed) Published
Abstract [en]

Aim: This historical prospective cohort study of the adult population of Sweden is based on data from a national registry: the primary aim was to evaluate the long-term survival of teeth after periradicular surgery. A secondary aim was to identify factors predictive of extraction within 10 years of registration of periradicular surgery.

Methodology: The cohort consisted of all individuals who had undergone periradicular surgery to treat apical periodontitis, as reported to the Swedish Social Insurance Agency (SSIA) during 2009. The cohort was followed until December 31, 2020. Subsequent registrations of extractions were collected for Kaplan-Meier survival analyses and survival tables. The patients' sex, age, dental service provider and tooth group were also retrieved from SSIA. Only one tooth per individual was included in the analyses. Multivariable regression analysis was used and P < 0.05 was considered statistically significant. The reporting guidelines STROBE and PROBE were followed.

Results: After data cleaning, and exclusion of 157 teeth, 5 622 teeth/individuals remained for analysis. The mean age of the individuals at the time of the periradicular surgery was 60.5 years (range 20-97, standard deviation 13.31); 55% were women. At the end of the follow-up, that is, up to 12 years, a total of 34.1% of the teeth had been reported as extracted. The multivariate logistic regression analysis, based on follow-up data at 10 years after registration of the periradicular surgery, included 5 548 teeth, of which 1 461 (26.3%) had been extracted. Significant associations between the independent variables tooth group and dental care setting (both P < 0.001) and the dependent variable extraction were found. The highest odds ratio (OR) for extraction applied to tooth group: compared to maxillary incisors and canines, mandibular molars were at greatest risk of extraction (OR 2.429, confidence interval 1.975-2.987, P < 0.001).

Conclusions: After periradicular surgery in predominantly elderly people in Sweden, approximately three quarters of the teeth are retained over a 10-year period. The type of tooth is associated with extraction: mandibular molars are at greater risk of extraction than maxillary incisors and canines.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
apicoectomy, endodontics, epidemiology, public health, survival analysis, treatment outcome
National Category
Dentistry
Research subject
Health and society
Identifiers
urn:nbn:se:mau:diva-61733 (URN)10.1111/iej.13952 (DOI)001029340300001 ()37403305 (PubMedID)2-s2.0-85165583770 (Scopus ID)
Available from: 2023-07-23 Created: 2023-07-23 Last updated: 2024-10-09Bibliographically approved
Sebring, D., Kvist, T., Lund, H., Jonasson, P., Lira‐Junior, R., Norhammar, A., . . . Buhlin, K. (2023). Primary apical periodontitis correlates to elevated levels of interleukin‐8 in a Swedish population: A report from the PAROKRANK study. International Endodontic Journal, 57(1), 12-22
Open this publication in new window or tab >>Primary apical periodontitis correlates to elevated levels of interleukin‐8 in a Swedish population: A report from the PAROKRANK study
Show others...
2023 (English)In: International Endodontic Journal, ISSN 0143-2885, E-ISSN 1365-2591, Vol. 57, no 1, p. 12-22Article in journal (Refereed) Published
Abstract [en]

Aim: To explore associations between root filled teeth, primary and secondary apical periodontitis, and levels of inflammatory markers in blood from patients with a first myocardial infarction and matched controls.

Methodology: Between May 2010 and February 2014, 805 patients with a first myocardial infarction and 805 controls, matched for sex, age, and postal code area, were recruited to the multicentre case-control study PAROKRANK (periodontitis and its relation to coronary artery disease). All participants underwent a physical and oral examination, as well as blood sampling. Using panoramic radiography, root filled teeth, primary apical periodontitis, and secondary apical periodontitis were assessed by three independent observers. Blood samples were analysed with enzyme-linked immunosorbent assay method for the following inflammatory markers: interleukin-1β (IL-1β), IL-2, IL-6, IL-8, IL-12p70, tumour necrosis factor-α, and high-sensitivity C-reactive protein (hsCRP). Additionally, white blood cell count and plasma-fibrinogen were analysed. Associations between endodontic variables and the levels of inflammatory markers were statistically analysed with Mann-Whitney U-test and Spearman correlation, adjusted for confounding effects of baseline factors (sex, age, myocardial infarction, current smoking, diabetes, family history of cardiovascular disease, education, marital status, and periodontal disease).

Results: Mean age of the cohort was 62 years, and 81% were males. Root fillings were present in 8.4% of the 39 978 examined teeth and were associated with higher levels of hsCRP, fibrinogen, and leukocyte count, but lower levels of IL-2 and IL-12p70. After adjusting for confounders, root filled teeth remained associated with higher levels of fibrinogen, but lower levels of IL-1β, IL-2, IL-6, and IL-12p70. Primary apical periodontitis was found in 1.2% of non-root filled teeth and associated with higher levels of IL-8 (correlation 0.06, p = .025). Secondary apical periodontitis was found in 29.6% of root filled teeth but did not relate to the levels of any of the inflammatory markers.

Conclusions: This study supports the notion that inflammation at the periapex is more than a local process and that systemic influences cannot be disregarded. Whether the observed alterations in plasma levels of inflammatory markers have any dismal effects on systemic health is presently unknown but, considering the present results, in demand of further investigation.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
apical periodontitis, cardiovascular, endodontics, inflammation, myocardial infarction, systemic health
National Category
Dentistry
Identifiers
urn:nbn:se:mau:diva-71519 (URN)10.1111/iej.13987 (DOI)001083175300001 ()38290211 (PubMedID)2-s2.0-85173995034 (Scopus ID)
Funder
University of GothenburgRegion Västra Götaland
Available from: 2024-10-08 Created: 2024-10-08 Last updated: 2024-10-09Bibliographically approved
Projects
Prediction of endodontic infection spread (PRENDIS)
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0003-4332-7962

Search in DiVA

Show all publications