title: Does apical periodontitis have systemic consequences? The need for well-planned and carefully conducted clinical studies.
abstract: Apical periodontitis, infection of the root canal system, may have systemic consequences. This proposal has been brought forward many times in dentistry literature but the general consensus is that there is no scientific basis for an association between endodontic infections and general health. This opinion paper argues that, in order to obtain such a scientific basis, or to rule out the issue all together, we need carefully designed longitudinal challenge model (that is, intervention) studies in which we follow specific biomarkers of inflammation. These biomarkers can be those that are currently being substantiated in chronic inflammation and low-grade inflammation studies in medicine and nutritional science, where the presence of these inflammatory disorders is linked to systemic outcomes. A list of suggested biomarkers has been included.
authors.affiliation: 1] Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Free University Amsterdam, Amsterdam, The Netherlands [2] Department of Cariology, Endodontology and Paedodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Free University Amsterdam, Amsterdam, The Netherlands.
authors.forename: S V
authors.initials: SV
authors.lastname: van der Waal
authors.affiliation: Infection and Immunity Research Group, Glasgow Dental School, School of Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, UK.
authors.forename: D F
authors.initials: DF
authors.lastname: Lappin
authors.affiliation: Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Free University Amsterdam, Amsterdam, The Netherlands.
authors.forename: W
authors.initials: W
authors.lastname: Crielaard
mesh_terms: D015415:Biomarkers; D002986:Clinical Trials as Topic; D006301:Health Services Needs and Demand; D006801:Humans; D007249:Inflammation / Q000150:complications / Q000209:etiology; D010485:Periapical Periodontitis / Q000150:complications*
chemical_list: D015415:Biomarkers