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Dental Disease, Inflammation, Cardiovascular Disease, Nutrition and Nutritional Supplements
Published in Stephen T. Sinatra, Mark C. Houston, Nutritional and Integrative Strategies in Cardiovascular Medicine, 2022
Douglas G. Thompson, Gregori M. Kurtzman, Chelsea Q. Watkins
Periapical infections (infections at the root end of the teeth) can be of pulpal (nerve) or periodontal (gum) origin. Bacterial invasion of the pulpal tissue related to caries of the overlying tooth structure is the most common cause of devitalization of the tooth’s pulp. During this devitalization process, the body responds with a foreign body reaction at the root end (apex) of the tooth. This may result in suppuration, pain and/or swelling in addition to bacterial accumulation in the area surrounding the tooth’s apex. Streptococcus viridans, a facultative anaerobe, is typically the putative pathogen in this infection; however,11Staphylococcus aureus has been frequently reported from acute dental abscesses, ranging from 0.7% to 15%.12 It has been reported that 41%–59% of individuals have had at least one endodontic treatment (root canal), and 24%–65% of these endodontically treated teeth remain associated with secondary apical periodontitis (SAP).13 Both primary and secondary periapical periodontitis have a direct effect on inflammation and generalized inflammatory biomarkers. These streptococci have systemic implications in various systemic diseases, such as infective endocarditis, purulent infections, brain hemorrhage, intestinal inflammation and autoimmune diseases, as well as generalized bacteremia.14
Benign Oral and Dental Disease
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Konrad S. Staines, Alexander Crighton
Most oral pain is from common dental and periodontal inflammatory causes such as pulpitis, periapical periodontitis and pericoronitis. Neurological, vascular and referred causes are less common. Non-dental and idiopathic facial pain are common in specialist settings and present to dentists, general practitioners, neurologists and oral surgeons as well as oral medicine and ENT specialists. Often a patient has multiple referrals to a variety of specialist services from different practitioners and these other specialty contacts must be identified in the history so that collaborative working can take place.
Craniofacial Pain
Published in John W. Scadding, Nicholas A. Losseff, Clinical Neurology, 2011
Periapical periodontitis and abscess cause severe pain in the affected tooth and adjacent gingiva, which sometimes radiates widely. Examination of the affected tooth may not reveal any obvious abnormality, but the gingiva are often inflamed and a gum boil may discharge into the mouth.
Is tooth conservation possible in odontogenic sinusitis? Prospective evaluation of affected teeth condition-based protocol
Published in Acta Oto-Laryngologica, 2023
Akiko Ito, Muneo Nakaya, Kazuhiro Tada, Junko Kumada, Wataru Kida, Yasuhiro Inayoshi
Patients visiting the Otolaryngology Department at Tokyo Metropolitan Tama Medical Center between April 2017 and March 2019 with a diagnosis of ODS who failed to respond to previous medical treatment were enrolled. Only patients with ODS stemming from dental caries or periapical periodontitis were included. Examinations for endodontic and periodontic lesions and for any relationship between a lesion and the maxillary sinus were done using computed tomography (CT). All those patients met the following criteria: (1) presence of intranasal endoscopic findings (purulent discharge, polyp in the middle meatus, bulging uncinate process), (2) maxillary sinus shadow shown in CT images, (3) periapical lesion of maxillary tooth in CT images, (4) communication between maxillary sinus and root apex or periapical lesion in CT images. For further dental evaluations, dental scan or orthopantomography were performed in most cases. At the commencement of treatment for untreated root canal, pulp test was performed. Based on CT findings evaluated by dental surgeons, the dental pathologies were grouped by discontinuity with the sinus floor; or by the presence in the affected tooth of periapical pathosis; a radicular cyst; periapical periodontitis with vertical bone resorption; or periapical periodontitis with marginal periodontitis (Figure 2). We defined dental mobility as a condition in which the movement is more than 1 mm in a buccolingual direction and depressible (Miller index 3) [16].
Coexistence of Candida albicans and Enterococcus faecalis increases biofilm virulence and periapical lesions in rats
Published in Biofouling, 2021
Qian Du, Shasha Yuan, Shuangyuan Zhao, Di Fu, Yifei Chen, Yuan Zhou, Yangpei Cao, Yuan Gao, Xin Xu, Xuedong Zhou, Jinzhi He
40 Sprague Dawley rats (male, 8 weeks old, 200 ∼ 250 g) were housed in specific pathogen-free animal facility. The surgical procedures were conducted in accordance with Lu et al. (2015) with minor modifications. Briefly, after general anesthesia, the pulps of the rat upper left first molars were exposed by using a quarter size round bur (Dentsply Maillefer, Ballaigues, Switzerland). The pulp was left exposed to the oral environment for three weeks to develop the periapical periodontitis lesions. The rats were anesthetized again. The distal root canals of the upper left first molars were instrumented with reamers and files (Dentsply Maillefer, Ballaigues, Switzerland), along with copious irrigation of 15% EDTA (Xilong Chemical Co, Ltd, Guangdong, China) and 2.5% NaOCl (Ziyi Reagent Factory, Shanghai, China). After root canal preparation, a cotton pellet soaked with formocresol (Second Medical Zhangjiang Biological Material Co, Ltd, Shanghai, China) was placed into each pulp cavity, then the access cavity was sealed with glass ionomer cement (ShoFu, Kyoto, Japan). Two weeks later, the rats were put under anesthesia again. The sealing material and cotton pellets were removed from pulp cavity. The root canals were irrigated with 1 ml saline and dried with sterile paper points. Rats (n = 10 per group) were randomly selected into 4 groups. The pulp cavity of each rat was infected with (1) C. albicans, (2) E. faecalis, (3) C. albicans + E. faecalis, or (4) PBS as a sham control, 0.1 ml for each group. The concentration of E. faecalis and C. albicans was 1 × 107 CFU ml−1 and 1 × 103 cells ml−1, respectively. The access cavity was then sealed with glass ionomer cement, and another two weeks later, the rats were sacrificed by CO2 inhalation.
The interaction between innate immunity and oral microbiota in oral diseases
Published in Expert Review of Clinical Immunology, 2023
Hongzhi He, Yu Hao, Yu Fan, Bolei Li, Lei Cheng
Lastly, using probiotics or prebiotics is a novel adjunctive therapy that modulates oral microbiota and remodels immunity. The use of probiotics or prebiotics is now becoming an option for treating and preventing oral diseases, but more laboratorial and clinical studies are needed to determine its mechanisms and efficacy in preventing or treating oral diseases. Periodontitis is caused by a dysbiotic microbiota, engineering or reconstituting the composition of microbiota (i.g. the use of probiotics) might be a possible resolution for treating and preventing periodontitis. The effects of probiotics can originate from three main modes of action: competitive exclusion mechanisms, host innate and acquired immune system modulation, and production of antimicrobial particles against pathogens [138]. Clinical studies have investigated the effects of probiotics on periodontitis, showing that probiotics can achieve improvement in periodontal conditions and enhance clinical outcomes [10]. However, few studies have investigated the mechanism of probiotics in treating periodontitis. Since our understanding of the mechanism is still limited, the mechanism of probiotics in treating periodontitis is needed to be further elucidated. The role of probiotics in preventing and treating oral cancer is an emerging field. Prominent roles of probiotics in managing oral cancer include the secretion of antitumoral agents, antimicrobial and anti-biofilm activity against carcinogenic pathogens, and immunomodulatory effects leading to apoptosis [139]. Up to now, several studies have investigated the antitumoral effects and mechanisms of probiotics in vitro [140–142]. The use of probiotics is not an optimizing option, however, for treating pulpitis and apical periodontitis. Because the key to treating pulpitis and periapical periodontitis is to control the infection within the dental pulp and periapical tissue.