{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T17:30:40Z","timestamp":1780075840967,"version":"3.54.0"},"reference-count":79,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T00:00:00Z","timestamp":1665619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>This study aimed to determine the prevalence and quality of endodontic treatment, by radiographically assessing the periapical periodontitis and endodontic treatment status in patients with cardiovascular disease (CVD) and cardiovascular risk (CVR) factors. Patients who visited the Out Patient Department of Institute of Dental Sciences and Department of Cardiology, Institute of Medical Sciences and SUM Hospital, Siksha \u2018O\u2019 Anusandhan University, Bhubaneswar, from August 2021 to February 2022, for a check-up or dental problem were considered as participants in this study. After obtaining informed consent, the participants were enrolled on the Oral Infections and Vascular Disease Epidemiology Study (INVEST) IDS, BHUBANESWAR. After testing negative for COVID-19, patients\u2019 demographic details, such as age and gender were recorded, followed by a panoramic radiographic examination (OPG). A total sample of 408 patients were divided into three groups: Group 1\/control (without any cardiovascular manifestation) consisting of 102 samples, group 2 of 222 CVR patients, and group 3 of 84 CVD cases. The CVR and CVD groups had a preponderance of elderly age groups between 60 to 70 years, with a significantly higher proportion of males. Co-morbidities such as diabetes mellitus, hypertension, and dyslipidemia were significantly associated with the CVR and CVD groups. From OPG interpretation, it was observed that the periapical radiolucency was greater in the CVR and CVD groups than in the control group (p = 0.009). The prevalence of endodontically treated teeth was higher in CVR and CVD than in the control group (p = 0.028). A high prevalence of dental caries, about 70%, was reported in all three groups (p = 0.356). The presence of dental restoration among all the groups was low (p = 0.079). The proportion of periodontal bone loss in the control group was significantly lower than CVR and CVD (p = 0.000). There was a strong association between periapical radiolucency, endodontically treated teeth, and periodontal bone loss in CVR and CVD patients. Notably, the associations reported herein do not reflect a cause-effect relationship; however, individuals with endodontic pathologies may accumulate additional risk factors predisposing them to hypertension or other CVDs. The results emphasize that eliminating local infections may decrease the systemic infection burden.<\/jats:p>","DOI":"10.3390\/jcm11206046","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T22:21:11Z","timestamp":1665699671000},"page":"6046","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Prevalence and Quality of Endodontic Treatment in Patients with Cardiovascular Disease and Associated Risk Factors"],"prefix":"10.3390","volume":"11","author":[{"given":"Gathani","family":"Dash","sequence":"first","affiliation":[{"name":"Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha \u2018O\u2019 Anusandhan, Bhubaneswar 751003, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8680-2172","authenticated-orcid":false,"given":"Lora","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha \u2018O\u2019 Anusandhan, Bhubaneswar 751003, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naomi Ranjan","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha \u2018O\u2019 Anusandhan, Bhubaneswar 751003, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rini","family":"Behera","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha \u2018O\u2019 Anusandhan, Bhubaneswar 751003, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1994-543X","authenticated-orcid":false,"given":"Satya Ranjan","family":"Misra","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine and Radiology, Institute of Dental Sciences, Siksha \u2018O\u2019 Anusandhan, Bhubaneswar 751003, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Periodontics, Institute of Dental Sciences, Siksha \u2018O\u2019 Anusandhan, Bhubaneswar 751003, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krzysztof","family":"Sokolowski","sequence":"additional","affiliation":[{"name":"Department of Conservative Dentistry, Medical University of Lodz, 251 Pomorska St, 92-213 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunal","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Oral Medicine and Radiology, S.C.B. Dental College and Hospital, Cuttack 753001, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suresh Kumar","family":"Behera","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Institute of Medical Sciences and SUM Hospital, Siksha \u2018O\u2019 Anusandhan, Bhubaneswar 751003, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Cardiology, SUM Ultimate Medicare, Siksha \u2018O\u2019 Anusandhan, Bhubaneswar 751003, Odisha, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2348-8515","authenticated-orcid":false,"given":"Barbara","family":"Lapinska","sequence":"additional","affiliation":[{"name":"Department of General Dentistry, Medical University of Lodz, 251 Pomorska St, 92-213 Lodz, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1007\/s12663-013-0533-4","article-title":"Demographic Study of Prevalence of Systemic Diseases in Oral Maxillofacial Surgery Patients of Central India","volume":"13","author":"Kolte","year":"2014","journal-title":"J. Maxillofac. Oral. Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.cden.2014.07.005","article-title":"Systemic Diseases and Oral Health","volume":"58","author":"Tavares","year":"2014","journal-title":"Dent. Clin. N. Am."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1034\/j.1600-051x.2002.290312.x","article-title":"Oral Health and Cardiovascular Disease in Sweden","volume":"29","author":"Buhlin","year":"2002","journal-title":"J. Clin. Periodontol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/j.ihj.2015.11.034","article-title":"Dental Considerations in Cardiovascular Patients: A Practical Perspective","volume":"68","author":"Chaudhry","year":"2016","journal-title":"Indian Heart J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1177\/00220345960750090301","article-title":"Poor Oral Health and Coronary Heart Disease","volume":"75","author":"Joshipura","year":"1996","journal-title":"J. Dent. Res."},{"key":"ref_6","first-page":"1123","article-title":"Periodontal Disease and Cardiovascular Disease","volume":"67","author":"Beck","year":"1996","journal-title":"J. Periodontol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"5879","DOI":"10.1007\/s00784-021-03893-w","article-title":"Oral Health-Related Quality of Life in Patients with Heart Failure and Left Ventricular Assist Devices-Results of a Cross-Sectional Study","volume":"25","author":"Schmalz","year":"2021","journal-title":"Clin. Oral Investig."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1902\/jop.2012.120051","article-title":"Peripheral Arterial Disease Associated with Caries and Periodontal Disease","volume":"84","author":"Little","year":"2013","journal-title":"J. Periodontol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1177\/204748739900600102","article-title":"Periodontal Disease and Risk of Fatal Coronary Heart and Cerebrovascular Diseases","volume":"6","author":"Morrison","year":"1999","journal-title":"J. Cardiovasc. Risk"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1111\/jcpe.13189","article-title":"Periodontitis and Cardiovascular Diseases: Consensus Report","volume":"47","author":"Sanz","year":"2020","journal-title":"J. Clin. Periodontol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2079","DOI":"10.1007\/s11606-008-0787-6","article-title":"Periodontal Disease and Coronary Heart Disease Incidence: A Systematic Review and Meta-Analysis","volume":"23","author":"Humphrey","year":"2008","journal-title":"J. Gen. Intern. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1111\/iej.12710","article-title":"Association between Apical Periodontitis and Cardiovascular Diseases: A Systematic Review of the Literature","volume":"50","author":"Febbraio","year":"2017","journal-title":"Int. Endod. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1016\/j.joen.2013.06.014","article-title":"Can Apical Periodontitis Modify Systemic Levels of Inflammatory Markers? A Systematic Review and Meta-Analysis","volume":"39","author":"Gomes","year":"2013","journal-title":"J. Endod."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1016\/j.joen.2016.11.008","article-title":"Association between Systemic Diseases and Endodontic Outcome: A Systematic Review","volume":"43","author":"Aminoshariae","year":"2017","journal-title":"J. Endod."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1427","DOI":"10.1016\/j.joen.2016.07.007","article-title":"Association between Systemic Diseases and Apical Periodontitis","volume":"42","author":"Khalighinejad","year":"2016","journal-title":"J. Endod."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1279","DOI":"10.1016\/j.joen.2019.07.017","article-title":"Apical Periodontitis Is Associated with Elevated Concentrations of Inflammatory Mediators in Peripheral Blood: A Systematic Review and Meta-Analysis","volume":"45","author":"Georgiou","year":"2019","journal-title":"J. Endod."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3813","DOI":"10.1007\/s00784-020-03596-8","article-title":"The Impact of Cardiovascular Disease and Endodontic Outcome: A Systematic Review of Longitudinal Studies","volume":"24","author":"Aminoshariae","year":"2020","journal-title":"Clin. Oral Investig."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1374","DOI":"10.1111\/iej.13364","article-title":"Association between Cardiovascular Diseases and Apical Periodontitis: An Umbrella Review","volume":"53","author":"Jakovljevic","year":"2020","journal-title":"Int. Endod. J."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Koletsi, D., Iliadi, A., Tzanetakis, G.N., Vavuranakis, M., and Eliades, T. (2021). Cardiovascular Disease and Chronic Endodontic Infection. Is There an Association? A Systematic Review and Meta-Analysis. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18179111"},{"key":"ref_20","first-page":"e19864","article-title":"Chronic Endodontic Infections and Cardiovascular Diseases: Does the Evidence Support an Independent Association","volume":"13","author":"Aloutaibi","year":"2021","journal-title":"Cureus"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1007\/s10266-021-00636-x","article-title":"Evolution of Endodontic Medicine: A Critical Narrative Review of the Interrelationship between Endodontics and Systemic Pathological Conditions","volume":"109","author":"Cintra","year":"2021","journal-title":"Odontology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"175","DOI":"10.3758\/BF03193146","article-title":"G*Power 3: A Flexible Statistical Power Analysis Program for the Social, Behavioral, and Biomedical Sciences","volume":"39","author":"Faul","year":"2007","journal-title":"Behav. Res. Methods"},{"key":"ref_23","unstructured":"(2022, April 19). Ascvd Risk Factor Estimate\u2014Yahoo India Search Results. Available online: https:\/\/tools.acc.org."},{"key":"ref_24","unstructured":"Decker, B.C. (2008). Ingle\u2019s Endodontics 6, McGraw-Hill Education. [6th ed.]."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1111\/j.1600-9657.1986.tb00119.x","article-title":"The Periapical Index: A Scoring System for Radiographic Assessment of Apical Periodontitis","volume":"2","author":"Kerekes","year":"1986","journal-title":"Dent. Traumatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1016\/j.joen.2005.12.016","article-title":"Prevalence and Quality of Endodontic Treatment in the Northern Manhattan Elderly","volume":"33","author":"Chen","year":"2007","journal-title":"J. Endod."},{"key":"ref_27","first-page":"73","article-title":"Rotational Panoramic Radiography in Epidemiological Studies of Dental Health. Comparison between Panoramic Radiographs and Intraoral Full Mouth Surveys","volume":"10","author":"Ahlqwist","year":"1986","journal-title":"Swed. Dent. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1600-9657.1991.tb00174.x","article-title":"Prevalence of Apical Periodontitis and Results of Endodontic Treatment in Middle-Aged Adults in Norway","volume":"7","author":"Eriksen","year":"1991","journal-title":"Endod. Dent. Traumatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.4103\/njcp.njcp_129_19","article-title":"Radiographic Assessment of the Relationship between Root Canal Treatment Quality, Coronal Restoration Quality, and Periapical Status","volume":"22","author":"Alkis","year":"2019","journal-title":"Niger. J. Clin. Pract."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5624\/isd.2011.41.1.1","article-title":"Assessment of Panoramic Radiography as a National Oral Examination Tool: Review of the Literature","volume":"41","author":"Choi","year":"2011","journal-title":"Imaging Sci. Dent."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/j.1600-9657.1986.tb00155.x","article-title":"Interobserver Variation in Radiographic Examination of Endodontic Variables","volume":"2","author":"Eckerbom","year":"1986","journal-title":"Endod. Dent. Traumatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1259\/dmfr.1980.0006","article-title":"Intra-Observer Variability in the Assessment of Panoramic Radiographs of Children Aged 9\u201310 Years","volume":"9","author":"Locht","year":"1980","journal-title":"Dentomaxillofac. Radiol."},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Sanchez, P., Everett, B., Salamonson, Y., Redfern, J., Ajwani, S., Bhole, S., Bishop, J., Lintern, K., Nolan, S., and Rajaratnam, R. (2019). The Oral Health Status, Behaviours and Knowledge of Patients with Cardiovascular Disease in Sydney Australia: A Cross-Sectional Survey. BMC Oral Health, 19.","DOI":"10.1186\/s12903-018-0697-x"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1007\/s12471-010-0841-y","article-title":"Gender Differences in Coronary Heart Disease","volume":"18","author":"Maas","year":"2010","journal-title":"Neth. Heart J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1080\/07448480009596270","article-title":"Why Do Men Get More Heart Disease than Women? An International Perspective","volume":"48","author":"Weidner","year":"2000","journal-title":"J. Am. Coll. Health"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Han, S.-J., Son, Y.-J., and Kim, B.-H. (2021). Association between Diabetes Mellitus and Oral Health Status in Patients with Cardiovascular Diseases: A Nationwide Population-Based Study. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18094889"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1536\/ihj.17-480","article-title":"Increased Oral Porphyromonas Gingivalis Prevalence in Cardiovascular Patients with Uncontrolled Diabetes Mellitus","volume":"59","author":"Aoyama","year":"2018","journal-title":"Int. Heart J."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Mei, F., Xie, M., Huang, X., Long, Y., Lu, X., Wang, X., and Chen, L. (2020). Porphyromonas gingivalis and Its Systemic Impact: Current Status. Pathogens, 9.","DOI":"10.3390\/pathogens9110944"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1800","DOI":"10.1016\/j.joen.2010.08.004","article-title":"Hypertension and Dental Periapical Condition","volume":"36","year":"2010","journal-title":"J. Endod."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1016\/j.joen.2021.04.006","article-title":"Prevalence of Periapical Abscesses in Patients with Hypertension: A Cross-Sectional Study of a Large Hospital Population","volume":"47","author":"Katz","year":"2021","journal-title":"J. Endod."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1097\/HJH.0000000000003022","article-title":"Association between Oral Health and Cardiovascular Outcomes in Patients with Hypertension: A Nationwide Cohort Study","volume":"40","author":"Kim","year":"2022","journal-title":"J. Hypertens."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"215","DOI":"10.4103\/0973-029X.99069","article-title":"Oral Manifestations in Hypertensive Patients: A Clinical Study","volume":"16","author":"Kumar","year":"2012","journal-title":"J. Oral Maxillofac. Pathol."},{"key":"ref_43","first-page":"e6577","article-title":"The Association Between Hyperlipidemia and Periodontal Infection","volume":"16","author":"Zakavi","year":"2014","journal-title":"Iran. Red Crescent Med. J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s12944-020-01204-y","article-title":"Dyslipidemia and Cardiovascular Disease Risk among the MASHAD Study Population","volume":"19","author":"Hedayatnia","year":"2020","journal-title":"Lipids Health Dis."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Lee, S.K., and Hwang, S.Y. (2021). Oral Health in Adults with Coronary Artery Disease and Its Risk Factors: A Comparative Study Using the Korea National Health and Nutrition Examination Survey Data. BMC Cardiovasc. Disord., 21.","DOI":"10.1186\/s12872-021-01878-x"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1093\/qjmed\/hcp065","article-title":"Dyslipidemia and Cardiovascular Risk: The Importance of Early Prevention","volume":"102","author":"Miller","year":"2009","journal-title":"QJM"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e000358","DOI":"10.1136\/openhrt-2015-000358","article-title":"Cardiovascular Disease Risk Factors in Relation to Smoking Behaviour and History: A Population-Based Cohort Study","volume":"3","author":"Keto","year":"2016","journal-title":"Open Heart"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.joen.2005.10.039","article-title":"Pulpal Inflammation and Incidence of Coronary Heart Disease","volume":"32","author":"Joshipura","year":"2006","journal-title":"J. Endod."},{"key":"ref_49","unstructured":"Colgate (2022, April 05). Effects Of Smoking on Teeth. Available online: https:\/\/www.colgate.com\/en-us\/oral-health\/threats-to-dental-health\/effects-of-smoking-on-teeth."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2435","DOI":"10.1038\/ismej.2016.37","article-title":"Cigarette Smoking and the Oral Microbiome in a Large Study of American Adults","volume":"10","author":"Wu","year":"2016","journal-title":"ISME J."},{"key":"ref_51","unstructured":"(2022, April 17). EBSCOhost 24523838. Smoking and Oral Health Status. Available online: https:\/\/web.p.ebscohost.com\/abstract?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=07098936&AN=24523838&h=sO2OdCJ3DINl10QKv6lEnMycRuBQCEW95M%2bHT0EQN%2bPcaSC%2bZBdHCc%2bM9lCZnXtEsuLosqFzMdMABwFfXOEsmA%3d%3d&crl=c&resultNs=AdminWebAuth&resultLocal=ErrCrlNotAuth&crlhashurl=login.aspx%3fdirect%3dtrue%26profile%3dehost%26scope%3dsite%26authtype%3dcrawler%26jrnl%3d07098936%26AN%3d24523838."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/j.1752-7325.1995.tb02355.x","article-title":"Smoking and Oral Health: A Population Survey in Finland","volume":"55","author":"Telivuo","year":"1995","journal-title":"J. Public Health Dent."},{"key":"ref_53","unstructured":"CDC (2022, April 17). Tobacco Free Smoking, Gum Disease, and Tooth Loss, Available online: https:\/\/www.cdc.gov\/tobacco\/campaign\/tips\/diseases\/periodontal-gum-disease.html."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"148","DOI":"10.15644\/asc52\/2\/8","article-title":"Impact of Smoking on Oral Health: Knowledge and Attitudes of Croatian Dentists and Dental Students","volume":"52","author":"Komar","year":"2018","journal-title":"Acta Stomatol. Croat."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.sdentj.2018.09.006","article-title":"Comparative Analysis of Prevalence of Apical Periodontitis in Smokers and Non-Smokers Using Cone-Beam Computed Tomography","volume":"31","author":"Balto","year":"2019","journal-title":"Saudi Dent. J."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1016\/j.tripleo.2006.01.001","article-title":"Limited Cone-Beam CT and Intraoral Radiography for the Diagnosis of Periapical Pathology","volume":"103","author":"Huumonen","year":"2007","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.molimm.2009.01.011","article-title":"Proinflammatory and Immunoregulatory Mechanisms in Periapical Lesions","volume":"47","author":"Gazivoda","year":"2009","journal-title":"Mol. Immunol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1016\/j.joen.2012.02.021","article-title":"Correlation between Clinical\/Radiographic Features and Inflammatory Cytokine Networks Produced by Macrophages Stimulated with Endodontic Content","volume":"38","author":"Martinho","year":"2012","journal-title":"J. Endod."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Virtanen, E., Nurmi, T., S\u00f6der, P.-\u00d6., Airila-M\u00e5nsson, S., S\u00f6der, B., and Meurman, J.H. (2017). Apical Periodontitis Associates with Cardiovascular Diseases: A Cross-Sectional Study from Sweden. BMC Oral Health, 17.","DOI":"10.1186\/s12903-017-0401-6"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1991","DOI":"10.1016\/j.joen.2015.08.031","article-title":"Unfinished Root Canal Treatments and the Risk of Cardiovascular Disease","volume":"41","author":"Lin","year":"2015","journal-title":"J. Endod."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/0300-5712(95)00042-9","article-title":"Clinical Significance of Dental Root Canal Microflora","volume":"24","author":"Gomes","year":"1996","journal-title":"J. Dent."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1111\/j.1399-302X.1988.tb00091.x","article-title":"Acute Phase Proteins in Patients with Chronic Periapical Granuloma before and after Surgical Treatment","volume":"3","author":"Kiss","year":"1988","journal-title":"Oral Microbiol. Immunol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1111\/j.1600-9657.1999.tb00744.x","article-title":"Detection of Interleukin-6 in Human Dental Pulp and Periapical Lesions","volume":"15","author":"Barkhordar","year":"1999","journal-title":"Endod. Dent. Traumatol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1016\/j.joen.2011.09.006","article-title":"Association of Endodontic Infection with Detection of an Initial Lesion to the Cardiovascular System","volume":"37","author":"Cotti","year":"2011","journal-title":"J. Endod."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1038\/s41415-021-3718-0","article-title":"The Impact of the COVID-19 Pandemic on Oral Health Inequalities and Access to Oral Healthcare in England","volume":"232","author":"Stennett","year":"2022","journal-title":"Br. Dent. J."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"946","DOI":"10.6061\/clinics\/2013(07)10","article-title":"The Occurrence of Dental Caries Is Associated with Atherosclerosis","volume":"68","author":"Glodny","year":"2013","journal-title":"Clinics"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1016\/j.jjcc.2015.06.012","article-title":"Association between Dental Caries and Out-of-Hospital Cardiac Arrests of Cardiac Origin in Japan","volume":"67","author":"Suematsu","year":"2016","journal-title":"J. Cardiol."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"430","DOI":"10.1111\/j.1532-5415.2005.53160.x","article-title":"Dental Caries, Periodontal Disease, and Cardiac Arrhythmias in Community-Dwelling Older Persons Aged 80 and Older: Is There a Link?","volume":"53","author":"Avlund","year":"2005","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/1758-5996-2-22","article-title":"Association of Cardiometabolic Risk Factors and Dental Caries in a Population-Based Sample of Youths","volume":"2","author":"Kelishadi","year":"2010","journal-title":"Diabetol. Metab. Syndr."},{"key":"ref_70","doi-asserted-by":"crossref","unstructured":"Sabharwal, A., Stellrecht, E., and Scannapieco, F.A. (2021). Associations between Dental Caries and Systemic Diseases: A Scoping Review. BMC Oral Health, 21.","DOI":"10.1186\/s12903-021-01803-w"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1111\/j.1600-051X.1993.tb00354.x","article-title":"Periodontal Healing in Teeth with Periapical Lesions. A Clinical Retrospective Study","volume":"20","author":"Ehnevid","year":"1993","journal-title":"J. Clin. Periodontol."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1111\/j.1600-051X.1995.tb00254.x","article-title":"The Influence of Endodontic Infection on Progression of Marginal Bone Loss in Periodontitis","volume":"22","author":"Jansson","year":"1995","journal-title":"J. Clin. Periodontol."},{"key":"ref_73","doi-asserted-by":"crossref","unstructured":"Helmi, M., Goodson, J.M., Hasturk, H., and Natto, Z.S. (2020). Annual Alveolar Bone Loss in Subjects with Cardiovascular Disease Adjusting for Associated Systemic Diseases and Risk Factors: A Retrospective Study. BMC Oral Health, 20.","DOI":"10.1186\/s12903-020-1015-y"},{"key":"ref_74","first-page":"199","article-title":"Periodontal Conditions in Patients with Coronary Heart Disease: A Case-Control Study","volume":"35","author":"Ravald","year":"2012","journal-title":"J. Clin. Periodontol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1515\/pteridines-2018-0013","article-title":"Periodontal, Metabolic, and Cardiovascular Disease: Exploring the Role of Inflammation and Mental Health","volume":"29","author":"Makkar","year":"2018","journal-title":"Pteridines"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1177\/0022034514552491","article-title":"Global Burden of Severe Periodontitis in 1990\u20132010: A Systematic Review and Meta-Regression","volume":"93","author":"Kassebaum","year":"2014","journal-title":"J. Dent. Res."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"S8","DOI":"10.1902\/jop.2013.1340010","article-title":"Periodontal Systemic Associations: Review of the Evidence","volume":"84","author":"Linden","year":"2013","journal-title":"J. Periodontol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"3","DOI":"10.4103\/2231-0754.176244","article-title":"Diabetes and Periodontitis: A Medical Perspective","volume":"8","author":"Sharma","year":"2016","journal-title":"J. Int. Clin. Dent. Res. Organ."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1111\/jcpe.12575","article-title":"Neutrophil Superoxide Release and Plasma C-Reactive Protein Levels Pre- and Post-Periodontal Therapy","volume":"43","author":"Ling","year":"2016","journal-title":"J. Clin. Periodontol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/20\/6046\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:53:27Z","timestamp":1760144007000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/20\/6046"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,13]]},"references-count":79,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["jcm11206046"],"URL":"https:\/\/doi.org\/10.3390\/jcm11206046","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,13]]}}}