Non-Cochrane · intervention · PM42026989
Impact of Endodontic Treatment of Teeth With Apical Periodontitis on Levels of Inflammatory Biomarkers Associated With Cardiovascular Risk: A Systematic Review and Meta-Analysis.
Lyra Carolina Viana Vasco, Miranda Jéssica Meirinhos, Almeida Renata de Albuquerque Cavalcanti, et al. · TheScientificWorldJournal · 2026 · PubMed · doi:10.1155/tswj/5896031
Findings
Population Healthy adults with apical periodontitis
8 findings
| Endodontic treatment of teeth with apical periodontitis (nonsurgical and surgical procedures) | Same patients before endodontic treatment | hs-CRP level (serum) 1 month | MD 1.28 [-0.06, 2.62] GRADE not reported 2 studies · 81 participants |
| Endodontic treatment of teeth with apical periodontitis (nonsurgical and surgical procedures) | Same patients before endodontic treatment | Reduction in inflammatory biomarkers (blood, saliva and gingival crevicular fluid) 3 days to 2 years | Relative: Not estimable; Absolute: Not estimable Low Downgraded: imprecision, inconsistency 20 studies · 642 participants |
| Endodontic treatment of teeth with apical periodontitis (nonsurgical and surgical procedures) | Same patients before endodontic treatment | IL-1beta level 6 months | MD 1.21 [-0.64, 3.07] GRADE not reported 2 studies · 99 participants |
| Endodontic treatment of teeth with apical periodontitis (nonsurgical and surgical procedures) | Same patients before endodontic treatment | IL-6 level 1 year | MD 2.94 [-1.21, 7.09] GRADE not reported 2 studies · 95 participants |
| Endodontic treatment of teeth with apical periodontitis (nonsurgical and surgical procedures) | Same patients before endodontic treatment | TNF-alpha level 1 year | MD 0.26 [-0.14, 0.67] GRADE not reported 2 studies · 95 participants |
| Endodontic treatment of teeth with apical periodontitis (nonsurgical and surgical procedures) | Same patients before endodontic treatment | TNF-alpha level 6 months | MD 0.08 [-1.41, 1.58] GRADE not reported 2 studies · 99 participants |
| Endodontic treatment of teeth with apical periodontitis (nonsurgical and surgical procedures) | Same patients before endodontic treatment | hs-CRP level (serum) 6 months | MD 1.46 [0.96, 1.97] GRADE not reported 3 studies · 125 participants |
| Endodontic treatment of teeth with apical periodontitis (nonsurgical and surgical procedures) | Same patients before endodontic treatment | IL-6 level 6 months | MD 1.8 [-2.1, 5.71] GRADE not reported 2 studies · 99 participants |
Included primary studies 20
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Bains 2020 Pre- and post-treatment levels of serum high-sensitivity C-reactive protein in patients with lesions of endodontic origin: A clinical… DOI:10.25259/ajohas_1_2020 | 2020 | 1 other review | not stated | not extracted yet |
| Bakhsh 2022 The impact of apical periodontitis, non-surgical root canal retreatment and periapical surgery on serum inflammatory biomarkers. PMID:35707939 | 2022 | 1 other review | not stated | not extracted yet |
| Bergandi 2019 Endothelial Dysfunction Marker Variation in Young Adults with Chronic Apical Periodontitis before and after Endodontic Treatment. PMID:30910354 | 2019 | 1 other review | not stated | not extracted yet |
| Brosco 2009 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Garrido 2024 Reduced C-reactive protein levels after root canal treatment in clinically healthy young apical periodontitis individuals at… PMID:38243897 | 2024 | 1 other review | not stated | not extracted yet |
| Kumar 2022 Comparative Evaluation of Serum High-sensitivity C-Reactive Protein and Complete Hemogram Indices in Subjects with and without Apical… PMID:35577144 | 2022 | 1 other review | not stated | not extracted yet |
| Marton and Kiss 1992 Influence of surgical treatment of periapical lesions on serum and blood levels of inflammatory mediators. PMID:1291518 | 1992 | 1 other review | not stated | not extracted yet |
| Poornima 2021 Impact of root canal treatment on high-sensitivity C-reactive protein levels in systemically healthy adults with apical periodontitis - a… PMID:33185278 | 2021 | 1 other review | not stated | not extracted yet |
| Al-Abdulla 2023 Successful endodontic treatment reduces serum levels of cardiovascular disease risk biomarkers-high-sensitivity C-reactive protein,… PMID:37787168 | 2023 | this review only | not stated | not extracted yet |
| Bains 2020 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Bakhsh 2023 The Impact of Apical Periodontitis and Endodontic Treatment on Salivary Inflammatory Biomarkers: A Longitudinal Study DOI:10.3390/app13063952 | 2023 | this review only | not stated | not extracted yet |
| Dezerega 2012 Pro-oxidant status and matrix metalloproteinases in apical lesions and gingival crevicular fluid as potential biomarkers for asymptomatic… PMID:22436166 | 2012 | this review only | not stated | not extracted yet |
| Gandhe 2024 Effect of apical foraminal enlargement on postoperative pain and inflammatory markers in asymtomatic single-rooted mandibular teeth with… PMID:38989502 | 2024 | this review only | not stated | not extracted yet |
| Giuggia 2019 DOI:10.32067/gie.2019.33.01.07 | NR | this review only | not stated | not extracted yet |
| Hepsenoglu 2024 Is SWEEPS better than PUI in reducing intracanal bacteria and inflammation in cases of apical periodontitis? PMID:39012553 | 2024 | this review only | not stated | not extracted yet |
| Inchingolo 2014 Influence of endodontic treatment on systemic oxidative stress. PMID:24396280 | 2014 | this review only | not stated | not extracted yet |
| Marton 1988 Acute phase proteins in patients with chronic periapical granuloma before and after surgical treatment. PMID:3268759 | 1988 | this review only | not stated | not extracted yet |
| Multari 2024 Endodontic Treatment of Chronic Apical Periodontitis Ameliorates Systemic Inflammation and Restores Impaired Cellular Responses to Insulin… PMID:38821264 | 2024 | this review only | not stated | not extracted yet |
| Palafox-Sanchez 2023 Evaluation of Serum Levels of Cytokines in Acute Apical Abscess: A Longitudinal Observational Study. PMID:37423583 | 2023 | this review only | not stated | not extracted yet |
| Sathyanarayanan 2023 Asymptomatic Apical Periodontitis Lesions and Their Association With Systemic Inflammatory Burden: A Preliminary Prospective Clinical Study. PMID:37920638 | 2023 | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Does endodontic treatment modify serum inflammatory markers of cardiovascular risk in individuals with asymptomatic apical periodontitis?… (2026) | 8 | 0.40 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Healthy adult patients with apical periodontitis | Patients with apical periodontitis (n=642 across 20 studies) |
| Intervention | Evaluation of levels of inflammatory biomarkers of cardiovascular risk (IL-6, hs-CRP, IL-1beta, TNF-alpha, others) before and after nonsurgical and surgical endodontic procedures | Primary root canal treatment, nonsurgical retreatment, periapical surgery, retreatment with surgery |
| Comparison | The same patients before any endodontic intervention | Pre-treatment levels in the same patients |
| Outcomes | Reduction in levels of biomarkers of cardiovascular disease risk | hs-CRP, IL-6, IL-1beta, TNF-alpha (pooled); other biomarkers narrative |
| Study designs | Randomized clinical trials, nonrandomized clinical trials and cohort studies; no publication year restriction | 2 RCTs and 18 observational longitudinal studies (6 in meta-analysis) |
| Timing | Not specified | Follow-up 3 days to 2 years; pooled at 1 month, 6 months and 1 year |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Partial Yes | NRSI: Partial Yes · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: N/A · NRSI: No | NRSI: No · RCT: N/A | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | No | No | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |