Endodontik Tıp: Apikal Periodontitis Kardiyovasküler Hastalıklara Predispozan Etken Olabilir mi?

Yıl 2023, Cilt: 5 Sayı: 2, 133 - 138, 28.08.2023

Eray Ceylanoğlu Dilek Hançerlioğulları

Öz

Apikal periodontitis (AP), pulpa dokusunda gelişen polimikrobiyal enfeksiyon nedeniyle periradiküler alanda gelişen akut veya kronik inflamatuar lezyon olarak bilinir. Kök kanal tedavisi sırasında enfektif doku, irrigasyon solüsyonları veya dolgu maddelerinin periapikal alana taşırılmasıyla da oluşabilen, görülme sıklığı oldukça yüksek bir patolojidir. Mikrobiyal faktörlerle konakçı immun yanıtı arasındaki etkileşim periradiküler dokuların iltihaplanması ve mineralize dokuların rezorpsiyonuyla sonuçlanır. Apikal periodontitiste görülen inflamasyon sürecinin, sistemik etkileri konusunda araştırmalar yapan endodontik tıp kavramı doğmuştur. Milattan önceki yıllara kadar dayanan endodontik tıp, endodonti bilimini pulpa ve periapikal doku patolojilerinin lokal incelenmesi ve tedavisinin ötesine taşımış; odontojenik enfeksiyonların romatoid artrit, diabet, kalp hastalıkları gibi çeşitli sistemik hastalıklarla ilişkisi incelenmiştir. İnflamatuar mediatör salınımının yoğun olduğu kronik enfeksiyonda bakterilerin metastatik yolla lokalize kalmayabileceği, uzak dokulardaki patolojiyi destekleyebileceği düşünülmektedir. Dünyada mortalite ve morbidite oranı en yüksek hastalıklar arasında üst sıralarda yer alan kardiyovasküler hastalıkların major risk faktörlerinin yanında koagulasyon eğilimini arttıran faktörler ve inflamasyon göstergeleri (fibrinojen, CRP, Cu, Fe, IL-6, TNF-α gibi) eklenmiştir. Tedavi edilmemiş enfekte kök kanalları ve apikal periodontitiste yükseldiği tespit edilen bu değerlerin, genel sağlığı etkileyebileceği düşünülmektedir. Endodontik enfeksiyonun sistemik bir hastalığa sebep olabileceği gibi sistemik hastalığın da endodontik enfeksiyonun patogenezinde rol alabileceği ve ayrıca endodontik tedavi görmüş dişlerin iyileşme sürecini de etkileyebileceği öne sürülmüştür. Bu derlemenin amacı; güncel araştırmalar ışığında kronik inflamasyona neden olan apikal periodontitis ile kardiyovasküler hastalıklar arasındaki ilişkinin araştırılmasıdır.

Anahtar Kelimeler

Endodonti, Periapikal periodontitis, Kardiyovasküler hastalıklar

Destekleyen Kurum

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Proje Numarası

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Teşekkür

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Endodontic Medicine: Can Apical Periodontitis Be a Predisposing Factor to Cardiovascular Diseases?

Öz

Apical periodontitis (AP) is known as an acute or chronic inflammatory lesion developing in the periradicular area due to polymicrobial
infection in the pulp tissue. It is a pathology with a very high incidence, which can also occur when infected pulp tissue, dentin debris,
irrigation solutions or filling materials are carried over to the periapical area during root canal treatment. Endodontic medicine has moved
the science of endodontics beyond the local examination and treatment of pulp and periapical tissue pathologies; the relationship between
odontogenic infections and various systemic diseases such as rheumatoid arthritis, diabetes and heart diseases was investigated. It is
thought that in chronic infection where inflammatory mediator release is intense, bacteria may cause bacteremia via metastatic way and
support the pathology in distant tissues. It is suspected that chronic oral infections may have a predisposing effect on cardiovascular
diseases, which are among the diseases with the highest mortality and morbidity rates in the world. Inflammation indicators found to be
elevated in untreated infected root canals and apical periodontitis are thought to affect general health. It has been suggested that as
endodontic infection may cause a systemic disease, systemic disease may also play a role in the pathogenesis of endodontic infection and
may also affect the healing process of endodontically treated teeth.

Anahtar Kelimeler

Endodontics, Periapical periodontitis, Cardiovascular diseases

Proje Numarası

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Kaynakça

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