Gastric adenocarcinoma and periodontal disease: A systematic review and meta-analysis.

BACKGROUND: The oral cavity is a link between of external environment with gastrointestinal tract. Studies are controversial on the presence of Periodontal Disease (PD) and its association with Gastric Adenocarcinoma (GAC). METHODS: The authors performed a systematic review and meta-analysis to verify the association between PD and GAC. Six electronic databases were evaluated between 1961 and 2022. Titles and abstracts were reviewed independently according to the eligibility criteria, assessing full texts of selected studies. The quality of the included research was verified using the Newcastle-Ottawa Scale for case-control and cohort studies. Statistical analyses were performed based on fixed and/or random effects models to calculate the summarized Relative Risk (RR) and its 95 % Confidence Interval (95 % CI). RESULTS: There were 639 studies, of which nine articles were included (3 case-controls and 6 cohorts). Overall, the authors identified 1,253 cases of GAC 2,501 controls in case-control studies, and 1,631 patients with GAC enrolled in cohort studies. Patients presenting PD increased the risk of developing GAC by 17 % (RR=1.17; 95 % CI 1.03‒1.32), which remained regardless of the diagnostic method for PD, i.e., clinical examination (RR = 1.19; 95 % CI 1.14‒1.24) and self-report (RR = 1.34; 95 % CI 1.06‒1.69). Moreover, Asian patients (RR=1.17; 95 % CI 1.00‒1.36) with PD had a higher risk of having GAC than American and European patients (RR = 1.18; 95 % CI 0.84‒1.66). CONCLUSIONS: The presence of PD the risk of GAC suggesting that its infectious-inflammatory process of PD may be related to GAC development. Further investigations on the oral-gastric microbiota and its role in the carcinogenesis of gastric cancer should be carried out, and the screening of patients with potential risk for GAC should be considered in the clinical practice of dentists.

Gastric adenocarcinoma and periodontal disease: A systematic review and meta-analysis

Abstract Background The oral cavity is a link between of external environment with gastrointestinal tract. Studies are controversial on the presence of Periodontal Disease (PD) and its association with Gastric Adenocarcinoma (GAC). Methods The authors performed a systematic review and meta-analysis to verify the association between PD and GAC. Six electronic databases were evaluated between 1961 and 2022. Titles and abstracts were reviewed independently according to the eligibility criteria, assessing full texts of selected studies. The quality of the included research was verified using the Newcastle-Ottawa Scale for case-control and cohort studies. Statistical analyses were performed based on fixed and/or random effects models to calculate the summarized Relative Risk (RR) and its 95 % Confidence Interval (95 % CI). Results There were 639 studies, of which nine articles were included (3 case-controls and 6 cohorts). Overall, the authors identified 1,253 cases of GAC 2,501 controls in case-control studies, and 1,631 patients with GAC enrolled in cohort studies. Patients presenting PD increased the risk of developing GAC by 17 % (RR=1.17; 95 % CI 1.03‒1.32), which remained regardless of the diagnostic method for PD, i.e., clinical examination (RR = 1.19; 95 % CI 1.14‒1.24) and self-report (RR = 1.34; 95 % CI 1.06‒1.69). Moreover, Asian patients (RR=1.17; 95 % CI 1.00‒1.36) with PD had a higher risk of having GAC than American and European patients (RR = 1.18; 95 % CI 0.84‒1.66). Conclusions The presence of PD the risk of GAC suggesting that its infectious-inflammatory process of PD may be related to GAC development. Further investigations on the oral-gastric microbiota and its role in the carcinogenesis of gastric cancer should be carried out, and the screening of patients with potential risk for GAC should be considered in the clinical practice of dentists.

Estudo in vitro da morfologia dos canais radiculares do primeiro pré-molar inferior, utilizando tomografia computadorizada de feixe cônico / In vitro study of mandibular first premolar root canals morphology using cone-beam computed tomography

Introdução: o tratamento endodôntico objetiva limpar e modelar o sistema de canais radiculares. O preparo químico-mecânico e a obturação tridimensional (3D) do sistema de canais radiculares são baseados no conhecimento da anatomia dentária interna. As radiografias convencionais e periapicais digitais apresentam limitações na definição da imagem, devido à anatomia 3D do elemento a ser tratado, que é compactada em uma imagem bidimensional. A tomografia computadorizada de feixe cônico (TCFC) é, atualmente, um interessante instrumento para análises anatômicas, devido à precisão volumétrica e ausência de sobreposição de estruturas. Métodos: foram analisados, in vitro, sessenta e quatro (n = 64) primeiros pré-molares inferiores humanos extraídos por indicação terapêutica. Em seguida, foram feitos protótipos com gengiva artificial de silicone, posicionando-se os elementos de forma semelhante a arcadas, para serem geradas as imagens de TCFC e analisadas por um endodontista experiente. O número de canais por raiz foi quantificado em cada elemento dentário e suas configurações anatômicas foram descritas seguindo a classificação de Vertucci. Resultados: foram encontrados 59% de canais Tipo I (n = 38); 0% do Tipo II (n = 0); 9% do Tipo III (n = 6); 6% do Tipo IV (n = 4); 16% do Tipo V (n = 10); 3% do Tipo VI (n = 2); 5% do Tipo VII (n = 3); 0% do Tipo VIII (n = 0) e 2% do Tipo C-shaped. Conclusão: as imagens de TCFC revelam em 3D a anatomia dentária interna, permitindo o planejamento da terapia endodôntica e um mapeamento detalhado da morfologia interna. O conhecimento dessa microanatomia viabiliza uma maior previsibilidade na realização do tratamento, assim como no seu prognóstico, e possibilita melhorar a descontaminação de áreas anatômicas complexas (AU).

Introduction: Endodontic treatment aims to clean and shape the root canal system. Chemomechanical preparation and tridimensional (3D) filling of the root canal system are based on knowledge of internal dental anatomy. Conventional and periapical digital radiographs present limitations in image definition due to the tridimensional anatomy of the tooth to be treated. The 3D anatomy is compressed in a two-dimensional image. Cone-beam computed tomography (CBCT) is currently an interesting tool for anatomical analysis because of volumetric precision and absence of overlapping structures. Methods: A total of 64 (sixty-four) human mandibular first premolars were extracted for therapeutic recommendation. Then prototypes were manufactured with artificial gingiva made of silicone, positioning the teeth in a format similar to the arches. They were subjected to CBCT examination and analyzed by an experienced endodontist. The number of canals per root was quantified for each tooth, and their anatomical configurations were described following Vertucci's classification. Results: The following were found: Type I (n = 38) 59%; Type II (n = 0); Type III (n = 6) 9%; Type IV (n = 4) 6%; Type V (n = 10) 16%; Type VI (n = 2) 3%; Type VII (n = 3) 5%; Type VIII (n = 0) and C-shaped 2%. Conclusion: CBCT image reveals tridimensional anatomy on the basis of which endodontic therapy is planned. It maps internal morphology in detail. Knowledge of micro-endodontics allows for greater predictability in treatment as well as prognosis, in addition to improving decontamination of complex anatomical areas.