Endodontic Treatment Modifies Circulatory Inflammatory Mediator Levels: a Systematic Review
Bibliographic record
Abstract
Objectives Apical periodontitis (AP) represents persistent inflammation within the periapical tissues mostly caused by a range of microorganisms of endodontic origin. Locally produced mediators and microbial virulence factors may enter the bloodstream and potentially sustain a persistent low-grade systemic inflammation, exerting an impact on the general health of the patient. This investigation aimed to systematically review and critically evaluate the evidence on reducing circulatory inflammatory mediators in patients with AP after successful endodontic nonsurgical and surgical treatment. Methods This systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA) statement, and the protocol of the review was registered a priori with the PROSPERO. A literature search was conducted across the following electronic databases: Web of Science, Scopus, and PubMed from inception to March 2024, with no language restriction. The Gray literature was additionally searched to ensure study inclusivity. Observational studies with prospective or retrospective designs were included. Articles with duplicate or overlapping results, abstract-only papers, case reports, case series, animal studies, and reviews were excluded. All phases were completed by two independent researchers while disagreements were resolved by a third reviewer. The Newcastle–Ottawa Scale (NOS) was used to assess the quality of included studies. Results Sixteen studies were included in the final review following full-text evaluation. As the included studies reported different outcomes, the heterogeneity of data prevented a meta-analysis being undertaken. The included studies were published between 1990 and 2024, with a total of 957 participating individuals with an approximate age range of 18 to 70 years. Although different inflammatory mediators were assessed, most of the studies investigated the change in the serum levels of C-reactive protein before and after endodontic treatment. The overall quality of the evidence for the most included studies was ‘Fair’, while five studies were categorized as ‘Good’. Conclusions Based on ‘Fair’ and ‘Good’ quality of evidence it has been shown that successful endodontic treatment reduces the level of circulatory inflammatory mediators in patients with AP.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.003 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".