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Endodontic and Periodontal Medicine: Systemic Implications of Oral Infections
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Endodontic and Periodontal Medicine: Systemic Implications of Oral Infections

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: 20 August 2025 | Viewed by 1587

Special Issue Editors

Prof. Dr. Juan J. Segura-Egea

E-Mail Website
Guest Editor
Department of Stomatology, School of Dentistry, University of Sevilla, Calle Avicena s/n, Sevilla, Spain
Interests: apical periodontitis; endodontic medicine; periodontal disease; periodontal medicine; pulpitis; systemic diseases; root canal treatment
Prof. Dr. Daniel Cabanillas-Balsera

E-Mail Website
Guest Editor
Endodontic Section, Department of Stomatology, School of Dentistry, University of Sevilla, Sevilla, Spain
Interests: apical periodontitis; endodontic medicine; periodontal disease; periodontal medicine; pulpitis; systemic diseases; root canal treatment

Special Issue Information

Dear Colleagues,

The scientific evidence accumulated over the past few decades supports that although oral infections, including periodontal disease and endodontic infection, occur at a specific location in the body, they have an echo at a systemic level. The interrelations between periodontal disease and systemic diseases, such as diabetes and cardiovascular pathologies, have been widely considered. Numerous studies have also been conducted on the association of apical periodontitis or root canal treatment with systemic diseases and habits such as diabetes, arteriosclerosis, hypertension or smoking. A large number of cross-sectional epidemiological studies have found a significant association between the prevalence of oral infections and that of systemic pathology. In fact, it is striking that very few studies comparing control patients with patients with systemic pathology do not find an association. However, the existence of publication bias cannot be ruled out. On the other hand, longitudinal studies are needed to analyze endodontic and periodontal variables in control groups and those with systemic pathology over time.

In this Special Issue, we invite research articles on the prevalence of oral infections in patients with previously uninvestigated systemic pathologies, as well as longitudinal studies and systematic reviews on endodontic medicine and periodontal medicine.

Prof. Dr. Juan J. Segura-Egea
Prof. Dr. Daniel Cabanillas-Balsera
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • apical periodontitis
  • endodontic medicine
  • periodontal disease
  • periodontal medicine
  • pulpitis
  • systemic diseases
  • root canal treatment

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Published Papers (3 papers)

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Research

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18 pages, 2901 KiB  
Article
Knowledge of Antibiotic Management in Surgery, Periodontics and Endodontics Among Patients, Students and Dentistry Professors: A Cross-Sectional Study at the University of Barcelona (Spain)
by Adrián Toribio-Méndez, Paloma Montero-Miralles, Sonia Egido-Moreno, Verónica Schiavo Di Flaviano, Beatriz González-Navarro and José López-López
J. Clin. Med. 2025, 14(7), 2179; https://doi.org/10.3390/jcm14072179 - 22 Mar 2025
Viewed by 361
Abstract
Background/Objectives: The main objective of this study was to analyze the knowledge on the use and management of antibiotics in dentistry within three different groups of interest: patients, fifth-year dental students at the University of Barcelona and professors of the faculty of [...] Read more.
Background/Objectives: The main objective of this study was to analyze the knowledge on the use and management of antibiotics in dentistry within three different groups of interest: patients, fifth-year dental students at the University of Barcelona and professors of the faculty of dentistry of the University of Barcelona. Methods: A cross-sectional pilot study was carried out using questionnaires addressed to the three groups of interest: patients (n = 250), students (n = 79) and professors (n = 50). Sociodemographic questions were asked of all the groups. The professor and student questions were related to antibiotic therapy in relation to dental procedures. The patients were asked questions related to antibiotic management. Results: Regarding the patient group, there were statistically significant differences between the participants of the group; people without higher education were more likely to self-medicate (p = 0.043) or to be unaware of the adverse effects (p = 0.045). Regarding the student and professor groups, there were no significant differences in the prescription of antibiotics. Amoxicillin 750 mg was the most commonly used in patients without an allergy to Penicillin, but there were significant differences in the antibiotic of choice for those patients allergic to Penicillin, the most commonly prescribed being either Clindamycin or Azithromycin (p = 0.002). Conclusions: The study revealed a lack of uniformity in the knowledge and management of antibiotics among both students and professors, which highlights the need to improve university training in pharmacology and for professors to continue education throughout their working lives. It also indicates the need for patient health education regarding antibiotics. Full article
(This article belongs to the Special Issue Endodontic and Periodontal Medicine: Systemic Implications of Oral Infections)
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13 pages, 240 KiB  
Article
Cone-Beam Computed Tomography Assessment of the Prevalence and Association of Pulp Calcification with Dental and Periodontal Pathology: A Descriptive Study
by José Luis Sanz, Lucía Callado, Stefana Mantale, Jenifer Nicolás, James Ghilotti and Carmen Llena
J. Clin. Med. 2025, 14(4), 1373; https://doi.org/10.3390/jcm14041373 - 19 Feb 2025
Viewed by 481
Abstract
Background/Objectives: Pulp stones (PSs) are calcified masses, with rounded or oval shapes, ranging from small particles to masses larger than the chamber and/or canals. There are limited data regarding the prevalence of pulp stones in the Iberian population. Our aim was to [...] Read more.
Background/Objectives: Pulp stones (PSs) are calcified masses, with rounded or oval shapes, ranging from small particles to masses larger than the chamber and/or canals. There are limited data regarding the prevalence of pulp stones in the Iberian population. Our aim was to determine the prevalence of PSs, using CBCT, in an Iberian population, and its association with gender, age, tooth location (arch and hemiarch), dental group, the presence of caries, restorations, alveolar bone loss, and a history of orthodontic treatment. Methods: In total, 300 CBCTs were analyzed, selected from the database of the Dental Clinic of the University of Valencia. A total of 5485 teeth were included. The images were obtained by NewTom equipment and visualized using NNT software 11 by a single calibrated examiner in the axial, sagittal, and coronal planes. The Chi-square test, ANOVA, and t-test were used to analyze the study variables for a significance level of p < 0.05. Results: The prevalence of PSs was 88.3% from the total number of patients assessed and 61.2% from the total number of teeth assessed. No differences were found by gender or age. A significant association was found within tooth groups between arches and hemiarches. The proportion of PSs was 3.7 times higher in teeth with caries, 4.7 times higher in teeth with fillings, and 2.3 times higher in teeth with alveolar bone loss. Conclusions: PSs were more prevalent in molars. The presence of caries, fillings, and bone loss increased the chance of presenting PSs. Maxillary teeth had a higher prevalence of PSs than mandibular teeth. Full article
(This article belongs to the Special Issue Endodontic and Periodontal Medicine: Systemic Implications of Oral Infections)

Review

Jump to: Research

16 pages, 1477 KiB  
Review
Atherosclerosis and Chronic Apical Periodontitis: Systematic Review and Meta-Analysis
by María León-López, Daniel Cabanillas-Balsera, Jenifer Martín-González, Benito Sánchez-Domínguez, Juan J. Saúco-Márquez and Juan J. Segura-Egea
J. Clin. Med. 2025, 14(5), 1504; https://doi.org/10.3390/jcm14051504 - 24 Feb 2025
Viewed by 476
Abstract
Background: Atherosclerosis is a chronic and progressive condition of the arteries, characterized by the thickening and hardening of their walls due to the formation of atherosclerotic plaques. Low-grade inflammation is implicated in the pathogeny of atherosclerosis. Chronic apical periodontitis (CAP), the chronic inflammation [...] Read more.
Background: Atherosclerosis is a chronic and progressive condition of the arteries, characterized by the thickening and hardening of their walls due to the formation of atherosclerotic plaques. Low-grade inflammation is implicated in the pathogeny of atherosclerosis. Chronic apical periodontitis (CAP), the chronic inflammation around the root apex of infected teeth, is associated with a low-grade inflammatory state, and thus a connection between atherosclerosis and CAP has been suggested. The aim of this study was to conduct a systematic review with meta-analysis to answer the following PICO question: In adult patients, does the presence or absence of atherosclerosis affect the prevalence of CAP? Methods: The PRISMA guidelines were followed to carry out this systematic review, which was registered in PROSPERO (651359). A bibliographic search was performed in PubMed-MEDLINE, Embase, and Scielo. The inclusion criteria selected studies presenting data on the prevalence of CAP in patients diagnosed with atherosclerosis and control patients. The statistical analysis was carried out using RevMan software v.5.4. The study characteristics and risk ratios with 95% confidence intervals (CIs) were extracted. Random-effects meta-analyses were performed. Risk of bias was assessed using the Newcastle-Ottawa scale, which was adapted for cross-sectional studies. To estimate variance and heterogeneity between trials, the Higgins I2 test was used. The quality of the evidence was evaluated using GRADE. Results: The search strategy recovered 102 articles, and only five met the inclusion criteria. Meta-analysis showed an overall OR = 2.94 (95% CI = 1.83–4.74; p < 0.01) for the prevalence of CAP among patients with atherosclerosis. The overall risk of bias was moderate. The quality of the evidence showed a low level of certainty. Conclusions: Patients with atherosclerosis are almost three times more likely to have CAP. This finding supports the hypothesis that chronic inflammatory processes in the oral cavity could significantly impact cardiovascular health, emphasizing the importance of an integrated approach to oral and systemic health care. This result should be translated to daily clinical practice, and the healthcare community should be aware of this association and suspect atherosclerotic pathology in patients who show a high prevalence of CAP. Likewise, patients with atherosclerosis should be monitored in the dental clinic for CAP. Full article
(This article belongs to the Special Issue Endodontic and Periodontal Medicine: Systemic Implications of Oral Infections)
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