Endodontik Tıp: Sistemik Hastalıkların Pulpal ve Periapikal Dokular ile İlişkisi

Abstract

Endodontik enfeksiyonlar ile sistemik hastalıklar arasındaki çift yönlü ilişkiyi ele alan “Endodontik Tıp”, her geçen gün daha fazla önem kazanmaktadır. Sistemik hastalıklar endodontik enfeksiyonların patogenezini etkileyebilirken, endodontik enfeksiyonun da sistemik değişikliklere neden olabileceğini gösteren çok sayıda kanıt vardır. Diyabet, kardiyovasküler hastalıklar, renal ve romatoit hastalıklar ve hipoöstrojenemi gibi sistemik hastalıkların pulpa ve periodonsiyumda yarattıkları değişiklikler incelenmektedir. Bu değişiklikler, periapikal bölgede daha şiddetli bir kemik rezorpsiyonu ve enflamasyonun yanı sıra sistemik hastalığın ilerlemesi şeklinde de olabilir. 1800’lerden 1950’lere kadar oral enfeksiyonun sistemik hastalıkla direkt ilişkisini savunan fokal enfeksiyon teorisi nedeniyle diş ve tonsilla gibi organların uzaklaştırılması öneriliyordu. Bu durumun daha sonra kesin bir dil ile reddedilmesine karşın, yeni çalışmalar ışığında sistemik ve pulpal ilişkinin keskin sınırlarla ayrılamayacağı anlaşılmaktadır. Bu derlemenin amacı, sistemik hastalıklar ile endodontik enfeksiyon arasındaki çift taraflı ilişkiyi ortaya koyan literatürü analiz etmek ve bu bağlantıların sistemik sağlık durumu ile endodontik tedavi sonuçlarına nasıl etki edebileceğini belirlemektir.

Keywords

• endodontik tıp
• sistemik hastalıklar
• apikal periodontitis
• endodontik tedavi

Endodontic Medicine: The Relation of Systemic Diseases with Pulpal and Periapical Tissues

Abstract

"Endodontic Medicine", which deals with the bidirectional relationship between endodontic infections and systemic diseases, gains more and more importance day by day. While systemic diseases can affect the pathogenesis of endodontic infections, there is abundant evidence that endodontic infection can also cause systemic changes. The changes in the pulp and periodontium caused by systemic diseases such as diabetes, cardiovascular diseases, renal and rheumatoid diseases, and hypoestrogenemia have been investigated. These changes may be in the form of a more severe bone resorption and inflammation in the periapical region, as well as progression of the systemic disease. From the 1800s until the 1950s, the removal of organs such as teeth and tonsils was recommended according to the focal infection theory, which advocated the existence of a direct relationship between oral infection and systemic disease. Although this situation was later denied with a definite language, in the light of the new studies, it is understood that the relationship between systemic and pulpal health cannot be separated by a sharp boundary. The purpose of this review was to analyze the literature that reveals the bidirectional associaton between systemic diseases and endodontic infection and to determine how these connections may affect systemic health status and endodontic treatment outcomes.

Keywords

• endodontic medicine
• systemic diseases
• apical periodontitis
• root canal treatment

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