title: Influence of endodontic treatment on systemic oxidative stress.
abstract: BACKGROUND
  An increased production of oxidizing species related to reactive oral diseases, such as chronic apical periodontitis, could have systemic implications such as an increase in cardiovascular morbidity. Based on this consideration, we conducted a prospective study to assess whether subjects affected by chronic periodontitis presented with higher values of oxidative stress than reference values before endodontic treatment, and whether endodontic treatment can reduce the oxidative imbalance and bring it back to normal in these subjects.
  
  
  METHODS
  The authors recruited 2 groups of patients from private studies and dental clinics: these patients were recruited randomly. The oxidative balance in both patients with chronic apical periodontitis (CAP) and healthy control patients was determined by measuring the oxidant status, using an identification of the reactive oxygen metabolites (d-ROMs) test, while the antioxidant status in these patients was determined using a biological antioxidant potential (BAP) test. Both these tests were carried on plasma samples taken from enrolled patients. Values were measured both before the endodontic treatment of the patients with chronic apical periodontitis, and 30 and 90 days after treatment, and compared to those obtained from healthy control patients.
  
  
  RESULTS
  It was found that, on recruitment, the patients with chronic apical periodontitis exhibited significantly higher levels of oxidative stress than control patients, as determined by the d-ROMs and BAP tests. Furthermore, the d-ROMs test values were shown to decrease and the BAP test values to increase over time in patients with chronic apical periodontitis following endodontic therapy. As the levels of oxidative stress in these patients tended to reduce and return to normal by 90 days following treatment.
  
  
  CONCLUSIONS
  This study has demonstrated a positive association between chronic apical periodontitis and oxidative stress. Subjects affected by chronic apical periodontitis are exposed to a condition of oxidative stress, which is extremely dangerous to general health. Moreover, one can infer from these findings that through proper endodontic therapy, a good oxidative balance can be restored, thereby avoiding the risk of contracting the abovementioned diseases.
authors.affiliation: 1. Department of interdisciplinary Medicine, University of Bari, General Hospital, Bari, Italy;
authors.forename: Francesco
authors.initials: F
authors.lastname: Inchingolo
authors.affiliation: 2. Unit of Maxillofacial Surgery, Calabrodental, Crotone, Italy; ; 4. Tecnologica Research Institute, Biomedical Section, Crotone, Italy;
authors.forename: Massimo
authors.initials: M
authors.lastname: Marrelli
authors.affiliation: 6. Department of Stomatology and Maxillofacial Science - Oral Surgery Unit - University of Rome "Sapienza" Rome, Italy;
authors.forename: Susanna
authors.initials: S
authors.lastname: Annibali
authors.affiliation: 6. Department of Stomatology and Maxillofacial Science - Oral Surgery Unit - University of Rome "Sapienza" Rome, Italy;
authors.forename: Maria Paola
authors.initials: MP
authors.lastname: Cristalli
authors.affiliation: 2. Unit of Maxillofacial Surgery, Calabrodental, Crotone, Italy;
authors.forename: Gianna
authors.initials: G
authors.lastname: Dipalma
authors.affiliation: 7. Medical School, University of Bari, Bari, Italy;
authors.forename: Alessio Danilo
authors.initials: AD
authors.lastname: Inchingolo
authors.affiliation: 7. Medical School, University of Bari, Bari, Italy;
authors.forename: Antonio
authors.initials: A
authors.lastname: Palladino
authors.affiliation: 5. Department of Surgical, Reconstructive, and Diagnostic Sciences, University of Milan, Milan, Italy;
authors.forename: Angelo Michele
authors.initials: AM
authors.lastname: Inchingolo
authors.affiliation: 8. Department of Clinical Sciences and Translational Medicine, University of Rome "Tor Vergata", Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Gargari
authors.affiliation: 2. Unit of Maxillofacial Surgery, Calabrodental, Crotone, Italy; ; 3. Department of Basic Medical Sciences, University of Bari, Bari, Italy; ; 4. Tecnologica Research Institute, Biomedical Section, Crotone, Italy;
authors.forename: Marco
authors.initials: M
authors.lastname: Tatullo
mesh_terms: D000328:Adult; D000368:Aged; D000975:Antioxidants / Q000032:analysis / Q000378:metabolism; D055113:Chronic Periodontitis / Q000378:metabolism* / Q000628:therapy*; D004708:Endodontics / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D010485:Periapical Periodontitis / Q000378:metabolism* / Q000628:therapy*; D011446:Prospective Studies; D017382:Reactive Oxygen Species / Q000097:blood; D016896:Treatment Outcome
chemical_list: D000975:Antioxidants; D017382:Reactive Oxygen Species
keywords: Oxidative stress; chronic apical periodontitis; endodontic treatment.