{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T11:40:06Z","timestamp":1777030806746,"version":"3.51.4"},"reference-count":62,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":112,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Scientific World Journal"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Apical periodontitis (AP) is an inflammatory response to microbial infection of the root canal system. The microorganisms that cause AP can modulate the host\u2019s immune response by secreting inflammatory biomarkers, which might be associated with cardiovascular diseases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the existing evidence on the relationship between endodontic treatment of teeth with AP and changes in the levels of inflammatory biomarkers associated with cardiovascular risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This systematic review was registered in PROSPERO (CRD42024574082) and followed the PRISMA guidelines (2020) and Cochrane Handbook (2023). Searches were performed in April 2025 in Medline\/PubMed, Embase, Web of Science, Scopus, Cochrane, LILACS, and gray literature, with no publication year restrictions. The PICO strategy was followed: (1) population: healthy adult patients with AP; (2) intervention: evaluation of the levels of inflammatory biomarkers of cardiovascular disease risk (IL\u20106, hs\u2010CRP, IL\u20101\u03b2, TNF\u2010\u03b1, and others) before and after endodontic procedures; (3) comparison: the same patients before any endodontic intervention; and (4) outcomes: reduction in the levels of cardiovascular disease risk biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty clinical studies were included in the qualitative analysis, and 18 reported a reduction in inflammatory biomarkers after endodontic treatment. A meta\u2010analysis evaluated hs\u2010CRP at 1 and 6\u2009months post\u2010treatment, as well as IL\u20106 and TNF\u2010\u03b1 at 6\u2009months and 1\u2009year post\u2010treatment and IL\u20101\u03b2 at 6\u2009months. There was a significant reduction in hs\u2010CRP 6\u2009months post\u2010treatment. No significant changes were found in the other biomarkers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion and Recommendations<\/jats:title>\n                    <jats:p>A significant reduction in hs\u2010CRP was observed 6\u2009months after endodontic treatment. However, there was no association between endodontic treatment of teeth with AP and the reduction in the other biomarkers evaluated in this systematic review and meta\u2010analysis. Furthermore, the certainty of evidence was classified as low according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, mainly because of the heterogeneity across primary studies and the lack of adequate control for potential confounding factors such as marginal periodontitis and smoking, which are linked to increased systemic inflammatory burden. Well\u2010designed clinical trials using rigorous control of these factors, standardized methodologies, and longer follow\u2010up periods are needed to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/tswj\/5896031","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T10:53:27Z","timestamp":1777028007000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Endodontic Treatment of Teeth With Apical Periodontitis on Levels of Inflammatory Biomarkers Associated With Cardiovascular Risk: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5474-6815","authenticated-orcid":false,"given":"Carolina Viana Vasco","family":"Lyra","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2882-5103","authenticated-orcid":false,"given":"J\u00e9ssica Meirinhos","family":"Miranda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1101-3491","authenticated-orcid":false,"given":"Renata de Albuquerque Cavalcanti","family":"Almeida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8991-2721","authenticated-orcid":false,"given":"Marina da Cunha","family":"Isaltino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3692-6699","authenticated-orcid":false,"given":"Ana Virginia Silva","family":"Vilela","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9174-2541","authenticated-orcid":false,"given":"Marleny Elizabeth M\u00e1rquez de Mart\u00ednez","family":"Gerbi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7897-2489","authenticated-orcid":false,"given":"Diana Santana de","family":"Albuquerque","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6937-1537","authenticated-orcid":false,"given":"Nat\u00e1lia Gomes de","family":"Oliveira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/0030-4220"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/iej.13677"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/adj.12684"},{"key":"e_1_2_11_4_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1366954"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/iej.13467"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2020.07.007"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/iej.14029"},{"key":"e_1_2_11_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/jech"},{"key":"e_1_2_11_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/iej.13979"},{"key":"e_1_2_11_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.116.023528"},{"key":"e_1_2_11_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2011.09.006"},{"key":"e_1_2_11_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joen.2019.01.018"},{"key":"e_1_2_11_13_2","doi-asserted-by":"publisher","DOI":"10.32067\/gie.2019.33.01.07"},{"key":"e_1_2_11_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/iej.13786"},{"key":"e_1_2_11_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10103-024-04117-"},{"key":"e_1_2_11_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_11_17_2","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions Version 6.4","author":"Higgins J. 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