Biomaterials in periapical regeneration after microsurgical endodontics: A narrative review.

BACKGROUND: The objective of this narrative review was to analyze the available scientific evidence regarding the application of biomaterials in endodontic microsurgery and its influence in post-surgical tissue repair. MATERIAL AND METHODS: The review question was Do biomaterials used in endodontic microsurgery influence post-surgical tissue repair and regeneration? Systematic MEDLINE/PubMed review was used to evaluate and present the results. RESULTS: The search yielded 131 references, 82 of which were selected for full text review after reading the abstracts. After a manual search in the references of the articles selected, 52 references were eliminated. Finally, 30 articles were selected. CONCLUSIONS: Bone grafts, membranes and bioceramics, especially MTA, are biomaterials with the ability to stimulate periapical tissue regeneration. This is one of many reason why bioceramics are the best choice as retrograde sealing materials. However, microsurgically treated periapical lesions can heal completely without the need to use bone grafts or membranes. Those techniques are indicated in endodontic microsurgery when additional stimulation of tissue regeneration is required, or when bone collapse needs to be prevented. Key words:Bioactive endodontic cements, endodontic surgery, periapical repair.

Influence of Coronal Preflaring on the Accuracy of Electronic Working Length Determination: Systematic Review and Meta-Analysis.

AIM: To conduct a systematic review and meta-analysis according to the following PICO question: in extracted human permanent teeth, does preflaring, compared with unflared canals, influence the accuracy of WL determination with EAL? MATERIAL AND METHODS: A systematic review was conducted according to the PRISMA checklist, using the following databases: PubMed, Science Direct, Scopus, and Web of Science. Studies related to WL determination using EAL both in preflared and unflared root canals of extracted human teeth were included. The outcome of interest was the accuracy of the electronic WL determination. A quality assessment of the included studies was performed, determining the risk of bias. The meta-analyses were calculated with the 5.4 RevMan software using the inverse variance method with random effects. PROSPERO registration: CRD42021243412. RESULTS: Ten experimental studies fulfilled the inclusion criteria, and most of them found that preflaring increases the accuracy of the EALs in WL determination. The calculated OR was 1.98 (95% CI = 1.65-2.37; p < 0.00001; I2 = 10%), indicating that the determination of WL by EALs is almost twice as accurate in preflared canals. The accuracy of Root ZX in WL determination increases more than three times (OR = 3.25; p < 0.00001). Preflaring with Protaper files significantly increases the accuracy of EALs (OR = 1.76; p < 0.00001). The total risk of bias of the included studies was low. No obvious publication bias was observed. CONCLUSIONS: The results indicate a significant increase in the accuracy of WL determination with EAL after preflaring, doubling the percentage of exact measurements. Preflaring should be recommended as an important step during mechanical enlargement of the root canal, not only because it improves the access of the files to the canal, but also because it allows one to obtain more accurate electronic determinations of WL.

Smoking and Radiolucent Periapical Lesions in Root Filled Teeth: Systematic Review and Meta-Analysis.

AIM: This systematic review and meta-analysis aimed to investigate the association between smoking habits and the prevalence of radiolucent periapical lesions (RPLs) in root-filled teeth (RFT). METHODS: The Population, Intervention, Comparison, and Outcome (PICO) question was: in adult patients who have RFT, does the absence or presence of a smoking habit affect the prevalence of RPLs associated with RFT? Systematic MEDLINE/PubMed, Wiley Online Database, Web of Science, Scopus, and PRISMA protocol were used to evaluate and present the results. Studies comparing smokers with control non-smoker subjects, including RFT, and providing data on the prevalence of RFT with RPLs, were included. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used for certainty in the evidence. The risk of bias was assessed according to Cochrane Collaboration common scheme for bias and ROBINS-I tool. Cumulative meta-analysis was performed with a random effects model. PROSPERO registration code: CRD42020165279. RESULTS: Four studies reported data on inclusion criteria, representing data from 9257 root-filled teeth-4465 from non-smokers and 4792 from smoker patients. The meta-analysis provided an odds ratio indicating a significant association between smoking and higher prevalence of root filled teeth with radiolucent periapical lesions (OR = 1.16; 95% CI = 1.07-1.26; p = 0.0004). The certainty of the literature assessment was moderate per GRADE. The ROBINS-I tool classified three studies as low risk of bias, and the fourth as moderate risk of bias. CONCLUSIONS: Moderate, quality scientific evidence indicates a weak but significant relationship between smoking and the prevalence of RPLs in RFT. Smoking can be considered a negative prognostic factor for the outcome of root canal treatment. Endodontic providers should be aware of the relationship between smoking and persistent apical periodontitis, assessed as RPLs, in RFT.

Cigarette Smoking and Root Filled Teeth Extraction: Systematic Review and Meta-Analysis.

AIM: The aim of this systematic review and meta-analysis was to investigate the possible association between smoking habits and the occurrence of root-filled teeth (RFT) extraction. MATERIAL AND METHODS: The Population, Intervention, Comparison, and Outcome (PICO) question was in adult patients who had RFT, does the absence or presence of smoking habits affect the prevalence of extracted RFT? Systematic MEDLINE/PubMed, Wiley Online Database, Web of Science, and PRISMA protocol was used to evaluate and present the results. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system was used for certainty in the evidence. The risk of bias was assessed according to Cochrane Collaboration common scheme for bias and ROBINS-I tool. Cumulative meta-analysis was performed with a random effects model. PROSPERO registration code: CRD42020165279. RESULTS: After search strategy, 571 articles were recovered, seven were selected for full-text analysis, and two reported data on inclusion criteria, including 516 RFT, 351 in non-smokers, and 165 in smoker subjects. The meta-analysis provided an odds ratio indicating significant association between smoking and the prevalence of extracted RFT (OR = 3.43, 95% CI = 1.17-10.05, p = 0.02, I² = 64%). The certainty of the literature assessment was low per GRADE. Both studies were considered as moderate risk of bias. CONCLUSIONS: Tobacco smoking should be considered a negative prognostic factor for the outcome of root canal treatment, although the quality of the evidence is low. RFT of smoking patients are three times more likely to be extracted. Continuing to smoke after endodontic treatment may increase the risk of treatment failure. However, the overall strength of evidence is low. This must be considered a limitation of the present study and the conclusion should be valued with caution.

Tratamiento de la periodontitis apical persistente: cirugía periapical versus retratamiento endodóncico no quirúrgico / Treatment of persistent apical periodontitis: periapical surgery versus nonsurgical retreatment

Se denomina Periodontitis Apical Crónica Persistente (PACP) al proceso inflamatorio periapical que se desarrolla o persiste tras el tratamiento de conductos. Las opciones terapéuticas en el tratamiento de la PACP, cuando el diente puede conservarse, son el retratamiento de conductos por vía ortógrada o la cirugía periapical, e incluso puede ser necesaria una combinación de ambos tratamientos. El objetivo de este trabajo ha sido buscar respuesta a la siguiente pregunta: ¿En un paciente con un diente al que se le ha realizado tratamiento endodóncico que ha fracasado y sufre periodontitis apical crónica persistente (PACP), se obtiene mayor tasa de curación del proceso inflamatorio periapical mediante el retratamiento por vía ortógrada o con la cirugía periapical? La búsqueda realizada proporcionó 7 artículos: 3 ensayos clínicos aleatorios, 3 revisiones sistemáticas y 1 revisión no sistemática. La evidencia científica disponible sugiere que no existen diferencias significativas en las tasas de éxito a largo plazo del retratamiento endodóncico por vía ortógrada y la cirugía periapical, en casos de periodontitis apical crónica persistente tras el tratamiento endodóncico. El retratamiento endodóncico por vía ortógrada obtiene mejores resultados a largo plazo, mientras que la cirugía periapical tiene una tasa de curación más rápida. El retratamiento ortógrado conlleva un mejor postoperatorio para el paciente, mientras que la cirugía periapical implica una mayor necesidad de trata-miento analgésico y antiinflamatorio en los primeros 7 días

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Correction: Criteria and treatment decisions in the management of deep caries lesions: Is there endodontic overtreatment?

[This corrects the article on p. 751 in vol. 10, PMID: 30305872.].

Criteria and treatment decisions in the management of deep caries lesions: Is there endodontic overtreatment?

BACKGROUND: The aim of this study was to investigate the diagnostic criteria and treatment decisions in the management of deep caries lesions (DCLs). The null hypothesis tested was that DCLs are managed according to the current scientific evidence. MATERIAL AND METHODS: A total of 288 dentists were contacted directly or by mail, and 125 (43%) were included in the study. Dentists were requested to answer a questionnaire about the routine approach to the diagnosis and treatment of DCLs. Logistic regression analyses were carried out to calculate odds ratios (OR). RESULTS: Pulp sensitivity tests were used by 65% of dentists when assessing pulpal health in cases of DCLs, particularly those who had followed courses in cariology (OR = 3.8; p = 0.005). Dentine hardness was the most frequent criterion used during DCLs excavation (98%). Two thirds of the respondents (65%) removed carious tissue until they felt hard dentine, and feeling hard dentine correlated with caries removal even at the risk of pulpal exposure (OR = 15.8; p = 0.0000). Acute transient pain or sensitivity to cold or heat (reversible pulpitis) were considered by 58% of respondents as a reason to provide endodontic therapy. CONCLUSIONS: The null hypothesis tested is rejected. The evidence-based more conservative approach on the management of DCLs is not being translated to clinical dentistry. Root canal treatment is being indicated in cases of DCLs in which the diagnosis is reversible pulpitis. Likewise, it can be concluded that non-conservative management of DCLs, with endodontic overtreatment, could be occurring. Key words:Deep caries lesions, dental pulp capping, dental pulp health, dentists, endodontic therapy, pulpal diagnosis, reversible pulpitis, treatment decisions.

Dentist´s knowledge, attitudes and determining factors of the conservative approach in teeth with reversible pulpitis and deep caries lesions.

BACKGROUND: The aim of this study was to investigate dentists` knowledge, attitudes and factors regarding the conservative approach in the management of deep caries lesions (DCLs) in teeth with reversible pulpitis. MATERIAL AND METHODS: 187 dentists were contacted directly or by mail, and 125 (67%) were finally included in the study. Dentists were requested to answer an open/discursive questionnaire about the routine approach to the diagnosis and treatment of DCLs, including knowledge-related attitudinal items. RESULTS: Total caries excavation was the preferred treatment option for more than 80% of dentists in case of DCL with reversible pulpitis. Only a small percentage (8%) chose partial caries removal, leaving some carious dentin close to the pulp to avoid pulp exposure. More than a half (51%) of respondents considered that cariogenic microorganisms must be removed or caries would progress. Dentists teaching at the University strongly disagreed with this statement (OR = 4.6; 95% C.I. = 1.3 - 15.8; p = 0.017). Good clinical result was the most chosen reason (83%) to choose a specific treatment. Patient's oral health (84%) and patient's age (70%) were the two patient-related factors most taken into account for the choice of treatment. CONCLUSIONS: Total caries excavation is still the most frequently chosen treatment in teeth with DCL and reversible pulpitis. The joint assessment of the answers given by respondents allows to conclude that the new knowledge and concepts about caries lesions and the more conservative approach to DCLs have not still been incorporated by dentists into their usual clinical practice. Key words:Caries, deep caries lesions, dental pulp capping, dental pulp health, dentists, endodontic therapy, reversible pulpitis, treatment decisions.

Oxidative stress, mitochondrial dysfunction and, inflammation common events in skin of patients with Fibromyalgia.

Fibromyalgia is a chronic pain syndrome with unknown etiology. Recent studies have shown some evidence demonstrating that oxidative stress, mitochondrial dysfunction and inflammation may have a role in the pathophysiology of fibromyalgia. Despite several skin-related symptoms accompanied by small fiber neuropathy have been studied in FM, these mitochondrial changes have not been yet studied in this tissue. Skin biopsies from patients showed a significant mitochondrial dysfunction with reduced mitochondrial chain activities and bioenergetics levels and increased levels of oxidative stress. These data were related to increased levels of inflammation and correlated with pain, the principal symptom of FM. All these parameters have shown a role in peripheral nerve damage which has been observed in FM as a possible responsible to allodynia. Our findings may support the role of oxidative stress, mitochondrial dysfunction and inflammation as interdependent events in the pathophysiology of FM with a special role in the peripheral alterations.

Glycated hemoglobin levels and prevalence of apical periodontitis in type 2 diabetic patients.

INTRODUCTION: The purpose of this investigation was to study the possible association between the prevalence of apical periodontitis (AP) and the glycemic control of type 2 diabetic patients. METHODS: In a cross-sectional study, the radiographic records of 83 type 2 diabetic patients were examined. Glycemic control was assessed by the mean glycated hemoglobin (HbA1c level). AP was diagnosed as radiolucent periapical lesions (RPLs) using the periapical index score. The Student t test, chi-square test, and logistic regression analysis were used in the statistical analysis. RESULTS: Based on the HbA1c levels, 2 groups of diabetic patients were established: the HbA1c good control group (GCG, n = 24, HbA1c <6.5%) and the HbA1c poor control group (PCG, n = 59, HbA1c ≥6.5%). In the total sample, RPLs in 1 or more teeth were found in 62.7%, and no significant differences between GCG and PCG groups were observed (P = .13). At least 1 root-filled tooth was found in 32.5% of diabetic patients; this percentage was comparable in both HbA1c groups (P = .68). The prevalence of RPLs in RFT (29.6%) was similar in the GCG compared with the PCG (P = .94). Multivariate logistic regression analysis showed that worse periapical status correlated significantly with HbA1c levels ≥6.5% in type 2 diabetic patients (odd ratio = 3.8; 95% confidence interval, 1.1-13.0; P = .03). CONCLUSIONS: HbA1c levels of diabetic patients are associated with periapical status. Data reported in the present study, together with the results of previous studies, further support a relationship between glycemic control and periapical inflammation in diabetic patients.

Respuesta inmune innata pulpar frente a la caries: mecanismos efectores / Pulp innate immune response to caries: effector mechanisms

La respuesta inmune innata de la pulpa frente a las bacterias de la caries se inicia cuando las células efectoras (monocito-macrófagos, células dendríticas inmaduras, células NK, células T y, en la pulpa, también los odontoblastos) reconocen, a través de los receptores toll-like (TLRs), los patrones moleculares inespecíficos presentes en las bacterias (ácido lipoteicoico, LPS, ARN bacteriano). Pero otros mecanismos efectores juegan también un papel fundamental en la respuesta inmune innata pulpar: a) la permeabilidad dentinaria y la presión del fluido dentinario; b) los odontoblastos, habiéndose demostrado que expresan genes de quimioquinas (CXCL2, CXCL8), de receptores de quimioquinas (CXCR2, CCRL1) y los receptores TLR2 y TLR4; c) los neuropéptidos pulpares (CGRP, SP, NKA, NPY, VIP) y la inflamación neurogénica; d) las células efectoras de la inmunidad inespecífica, incluyendo los monocito-macrófagos, las células dendríticas inmaduras (CDs), las células NK (asesinas naturales, natural killer) y las células T; e) las citoquinas innatas (TNF-α, IL-1α, IL-1β, INF-γ); f) las quimioquinas o factores quimiotácticos (CXCL12, CXCL13), y g) los factores humorales. Si esta respuesta innata consigue eliminar precozmente la mayoría de los antígenos que llegan a la pulpa, la inflamación puede ser reversible. Por el contrario, si la infección persiste termina activándose la respuesta inmune adaptativa específica, que incrementa la inflamación y aumenta el edema y la presión intrapulpar, lo que en una cavidad inextensible como lo es la cavidad pulpar, acaba por producir un daño irreversible a la pulpa (pulpitis irreversible, necrosis pulpar)

The pulp innate immune response to caries initiates when its effector cells (monocyte-macrophages, immature dendritic cells, NK cells, T cells and, in the pulp, also the odontoblasts) recognize, by the Toll-like receptors (TLRs) that expressed in their membranes, certain non-specific molecular patterns present in bacteria (lipoteichoic acid, LPS, bacterial RNA). But the effector mechanisms of the pulp innate immune response also include: a) dentin permeability and dentin fluid pressure; b) odontoblasts, who express chemokine genes (CXCL2, CXCL8), chemokine receptors genes (CXCR2, CCRL1), and TLR2 and TLR4 receptors. c) pulp neuropeptides (CGRP, SP, NKA, NPY, VIP); d) the effector cells of innate immunity, including monocyte-macrophages, immature dendritic cells (CDs), NK (natural killer) cells and T cells; e) innate cytokines (TNF-α, IL-1α, IL-1β, INF-γ); f) chemokines (CXCL12, CXCL13); and g) humoral factors. If this innate response eliminate early most of the antigens reaching the pulp, the inflammation may be reversible. On the contrary, if infection persists the specific adaptive immune response is estimulated, increasing inflammation, edema and intrapulp pressure, conducting to irreversible damage of the pulp (irreversible pulpitis, pulp necrosis)

Clinical symptoms in fibromyalgia are associated to overweight and lipid profile.

In order to analyze the association between body mass index (BMI), lipid profile and clinical symptoms in patients with fibromyalgia, we assessed BMI levels, lipid profile and its association with clinical symptoms in 183 patients with fibromyalgia. The patients were evaluated using tender points, FIQ and Visual Analogue Scales of pain (VAS). Serum lipid profile analysis (total cholesterol, triglyceride, HDL, LDL and VLDL), and biochemical parameters were measured in the biochemistry laboratory. The BMI distribution of the nonobese, overweight and obese patients' groups were relatively even with 37.7, 35.5 and 26.8%, respectively, with a mean BMI of 27.3 ± 4.9. The number of tender points showed significantly positive correlation with higher BMI (P < 0.05). A total of 57.9% of patients showed increased levels of total cholesterol, 63.4 % increased levels of LDL cholesterol and 19.9% high levels of triglycerides. BMI, total cholesterol and triglycerides showed high association with some clinical parameters. Overweight and lipid profile could be associated with fibromyalgia symptoms. A treatment program with weight loss strategies, and control in diet and increased physical activity is advised to patients.

Influence of root canal instrumentation and obturation techniques on intra-operative pain during endodontic therapy

Objective: To analyse the influence of root canal instrumentation and obturation techniques on intra-operative pain experienced by patients during endodontic therapy. Method and Materials: A descriptive cross-sectional study was carried out in Ponferrada and Sevilla, Spain, including 80 patients (46 men and 34 women), with ages ranged from 10 to 74 years, randomly recruited. Patient gender and age, affected tooth, pulpal diagnosis, periapical status, previous NSAID or antibiotic (AB) treatment, and root canal instrumentation and obturation techniques were recorded. After root canal treatment (RCT), patients completed a 10-cm visual analogue scale (VAS) that ranked the level of pain. Results were analysed statistically using the Chi-square and ANOVA tests and logistic regression analysis. Results: The mean pain level during root canal treatment was 2.9 ± 3.0 (median = 2) in a VAS between 0 and 10. Forty percent of patients experienced no pain. Gender, age, arch, previous NSAIDs or AB treatment and anaesthetic type did not influence significantly the pain level (p > 0.05). Pain during root canal treatment was significantly greater in molar teeth (OR = 10.1; 95% C.I. = 1.6 - 63.5; p = 0.013). Root canal instrumentation and obturation techniques did not affect significantly patient’s pain during root canal treatment (p > 0.05). Conclusion: Patients feel more pain when RCT is carried out on molar teeth. The root canal instrumentation and obturation techniques do not affect significantly the patients’ pain during RCT (AU)

Influence of root canal instrumentation and obturation techniques on intra-operative pain during endodontic therapy.

OBJECTIVE: To analyse the influence of root canal instrumentation and obturation techniques on intra-operative pain experienced by patients during endodontic therapy. METHOD AND MATERIALS: A descriptive cross-sectional study was carried out in Ponferrada and Sevilla, Spain, including 80 patients (46 men and 34 women), with ages ranged from 10 to 74 years, randomly recruited. Patient gender and age, affected tooth, pulpal diagnosis, periapical status, previous NSAID or antibiotic (AB) treatment, and root canal instrumentation and obturation techniques were recorded. After root canal treatment (RCT), patients completed a 10-cm visual analogue scale (VAS) that ranked the level of pain. Results were analysed statistically using the Chi-square and ANOVA tests and logistic regression analysis. RESULTS: The mean pain level during root canal treatment was 2.9±3.0 (median=2) in a VAS between 0 and 10. Forty percent of patients experienced no pain. Gender, age, arch, previous NSAIDs or AB treatment and anaesthetic type did not influence significantly the pain level (p>0.05). Pain during root canal treatment was significantly greater in molar teeth (OR=10.1; 95% C.I.=1.6-63.5; p=0.013). Root canal instrumentation and obturation techniques did not affect significantly patients' pain during root canal treatment (p>0.05). CONCLUSION: Patients feel more pain when RCT is carried out on molar teeth. The root canal instrumentation and obturation techniques do not affect significantly the patients' pain during RCT.

Diabetes mellitus, periapical inflammation and endodontic treatment outcome

The possible connection between chronic oral inflammatory processes, such as apical periodontitis and periodontal disease (PD), and systemic health is one of the most interesting aspects faced by the medical and dental scientific community. Chronic apical periodontitis shares important characteristics with PD: 1) both are chronic infections of the oral cavity, 2) the Gram-negative anaerobic microbiota found in both diseases is comparable, and3) in both infectious processes increased local levels of inflammatory mediators may have an impact on systemic levels. One of the systemic disorders linked to PD is diabetes mellitus (DM); is therefore plausible to assume that chronic apical periodontitis and endodontic treatment are also associated with DM. The status of knowledge regarding the relationship between DM and endodontics is reviewed. Upon review, we conclude that there are data in the literature that associate DM with a higher prevalence of periapical lesions, greater size of the osteolityc lesions, greater likelihood of asymptomatic infections and worse prognosis for root filled teeth. The results of some studies suggest that periapical disease may contribute to diabetic metabolic dyscontrol (AU)

Coenzyme Q10 in salivary cells correlate with blood cells in Fibromyalgia: improvement in clinical and biochemical parameter after oral treatment.

OBJECTIVE: We have determined Coenzyme Q(10) (CoQ(10)) levels in salivary cells (SCs) and mononuclear blood cells (BMCs) from Fibromyalgia (FM), and we study the influence of oral CoQ(10) supplementation on cells levels and clinical symptoms. METHODS: CoQ(10) was determined by high-performance liquid chromatography (HPLC). Ten patients were supplemented daily with 300 mg of CoQ(10) during 3 months. RESULTS: CoQ(10) were reduced in both cell models. Oral supplementation showed an improvement in clinical symptoms and restored levels. CONCLUSIONS: Patients with FM showed an important dysfunction in CoQ(10) levels and might benefit from oral supplementation.

Utility of Periodontal exploration in patients with Fibromyalgia.

OBJECTIVE: [corrected] Fibromyalgia (FM) is a chronic pain syndrome with unknown etiology, which affects predominantly women. Mitochondrial alteration could have a role in the pathophysilogical mechanisms of inflammatory conditions as FM and periodontitis. The aim of the present study was assay the relationship between both diseases and mitochondrial dysfunction. PATIENT AND METHODS: We study the presence of periodontitis in twelve patients diagnosed of FM and mitochondrial dysfunction described. The diagnosis of FM was established according to ACR criteria and clinical symptoms were evaluated using the Fibromyalgia Impact Questionnaire (FIQ) and Beck Depression Inventory (BDI). RESULTS: Only one patients of twelve included and agreed to participate in the study were diagnosed with periodontitis. CONCLUSIONS: Pending studies with larger numbers of patients, we can conclude that mitochondrial dysfunction in FM is a itself event not related with periodontitis. Periodontitis could be considered a exclusion criterion in all studies about mitochondrial dysfunction in patients. Key words:Peridontitis, fibromyalgia, mitocondrial dysfunction, oxidative stress.

External apical root resorption in maxillary root-filled incisors after orthodontic treatment: a split-mouth design study.

INTRODUCTION: The purpose of this study was to compare, in a split mouth design, the external apical root resorption (EARR) associated with orthodontic treatment in root-filled maxillary incisors and their contralateral teeth with vital pulps. METHODOLOGY: The study sample consisted of 38 patients (14 males and 24 females), who had one root-filled incisor before completion of multiband/bracket orthodontic therapy for at least 1 year. For each patient, digital panoramic radiographs taken before and after orthodontic treatment were used to determine the root resortion and the proportion of external root resorption (PRR), defined as the ratio between the root resorption in the endodontically treated incisor and that in its contralateral incisor with a vital pulp. The student's t-test, chi-square test and logistic regression analysis were used to determine statistical significance. RESULTS: There was no statistically significant difference (p > 0.05) between EARR in vital teeth (1.1 ± 1.0 mm) and endodontically treated incisors (1.1 ± 0.8 mm). Twenty-six patients (68.4%) showed greater resorption of the endodontically treated incisor than its homolog vital tooth (p > 0.05). The mean and standard deviation of PPR were 1.0 ± 0.2. Multivariate logistic regression suggested that PRR does not correlate with any of the variables analyzed. CONCLUSIONS: There was no significant difference in the amount or severity of external root resorption during orthodontic movement between root-filled incisors and their contralateral teeth with vital pulps.

Hypertension and dental periapical condition.

INTRODUCTION: The purpose of this study was to investigate the prevalence of apical periodontitis and endodontic treatment in hypertensive patients and control subjects without hypertension. METHODS: In a cross-sectional study, the records of 40 hypertensive patients and 51 control subjects were examined. Periapical status of all teeth was assessed by using the periapical index score. RESULTS: Apical periodontitis in 1 or more teeth was found in 75% of hypertensive patients and in 61% of control subjects (P = .15; odds ratio, 1.94; 95% confidence interval, 0.78-4.81). One or more root-filled teeth were found in 45% and 39% of hypertensive and control subjects, respectively (P > .0.5). Among hypertensive patients 5.2% of the teeth had apical periodontitis, whereas in the control subjects 4.2% of teeth were affected (P > .05). The percentages of root-filled teeth in the study and control groups were 3.1% and 1.8%, respectively (P > .05). Among hypertensive patients 65% of root-filled teeth had apical periodontitis, whereas in the control subjects 43% of the root-filled teeth were associated with apical periodontitis (P > .05). CONCLUSIONS: The prevalence of apical periodontitis and endodontic treatment was not significantly different in hypertensive patients compared with control subjects without hypertension.