{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T10:22:09Z","timestamp":1784370129762,"version":"3.55.0"},"reference-count":51,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:00:00Z","timestamp":1704844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Endodontic J"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>To evaluate the association between apical periodontitis (AP) and atherosclerotic cardiovascular disease (ASCDV).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methodology<\/jats:title><jats:p>A total of 65 periodontally and systemically healthy patients (age\u2009\u2265\u200940\u2009years) were included in the study. Periapical status was assessed through dental examination and periapical radiographs; 33 subjects had AP (AP+), while 32 acted as control (AP\u2212). Moreover, data regarding their periapical index (PAI) score and the Decayed, Missing, and Filled Teeth (DMFT) index were recorded. All subjects underwent echo\u2010colour Doppler assessment of carotid intima\u2010media thickness (CIMT), carotid plaques, degree of stenosis using the North American Symptomatic Carotid Surgery Trial (NASCET) method, maximum diameter of the abdominal aorta (maximum AA) and common iliac arteries (CIA) diameters. Furthermore, peripheral blood flow was also measured using the ankle\u2010brachial index (ABI). Simple and multiple regression analyses were performed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among AP+ patients, 57.58% disclosed at least one sign of subclinical carotid atherosclerosis. Multiple regression analysis identified AP as a significant risk indicator for carotid plaques [OR\u2009=\u20094.87 (1.27, 18.98; <jats:italic>p<\/jats:italic>\u2009=\u2009.021)] and marked carotid intima\u2010media thickenings (OR\u2009=\u200914.58 [1.22, 176.15], <jats:italic>p<\/jats:italic>\u2009=\u2009.035). A significant association was established between AP and other cardiovascular (CV) variables (CIMT, NASCET, and maximum AA). On the contrary, a higher PAI score does not correlate to increased odds of carotid alterations, and the presence of AP did not prove any significant change in CIA and ABI. No significant correlation was established between DMFT and other variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Results from the current study highlight that the presence of AP may be regarded as a risk indicator for ASCVD, with AP being associated with 5\u2010fold increased odds of having carotid plaques and 15\u2010fold increased odds of having marked carotid intima\u2010media thickenings. Further studies should be conducted in order to verify whether AP treatment could be beneficial for ASCVD signs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/iej.14018","type":"journal-article","created":{"date-parts":[[2024,1,11]],"date-time":"2024-01-11T06:54:21Z","timestamp":1704956061000},"page":"281-296","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Association between apical periodontitis and secondary outcomes of atherosclerotic cardiovascular disease: A case\u2013control study"],"prefix":"10.1111","volume":"57","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5968-6471","authenticated-orcid":false,"given":"Giulia","family":"Malvicini","sequence":"first","affiliation":[{"name":"Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1088-2046","authenticated-orcid":false,"given":"Crystal","family":"Marruganti","sequence":"additional","affiliation":[{"name":"Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1967-4481","authenticated-orcid":false,"given":"Mustafa","family":"Abu Leil","sequence":"additional","affiliation":[{"name":"Unit of Vascular Surgery, Department of Medicine, Surgery and Neurosciences University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Martignoni","sequence":"additional","affiliation":[{"name":"Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6619-0159","authenticated-orcid":false,"given":"Edoardo","family":"Pasqui","sequence":"additional","affiliation":[{"name":"Unit of Vascular Surgery, Department of Medicine, Surgery and Neurosciences University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2451-8501","authenticated-orcid":false,"given":"Gianmarco","family":"de Donato","sequence":"additional","affiliation":[{"name":"Unit of Vascular Surgery, Department of Medicine, Surgery and Neurosciences University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6723-2784","authenticated-orcid":false,"given":"Simone","family":"Grandini","sequence":"additional","affiliation":[{"name":"Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2736-8046","authenticated-orcid":false,"given":"Carlo","family":"Gaeta","sequence":"additional","affiliation":[{"name":"Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies University of Siena  Siena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,1,10]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.4103\/jispcd.JISPCD_316_18"},{"key":"e_1_2_15_3_1","unstructured":"American Association of Endodontists. 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