Overview
Apical periodontitis is an inflammatory condition affecting the tissues surrounding the apex of a tooth root, often resulting from untreated dental infections and leading to systemic inflammatory responses 1.Diagnosis
Clinical signs include pain, swelling, and mobility of the tooth 1.
Radiographic examination to assess bone loss around the root apex 1.
Elevated levels of inflammatory markers such as TNF-α and IL-1β in serum can indicate active disease 1.
Biochemical analysis of tissue samples for inflammatory cytokines and hemodynamic parameters 1.Management
First-line treatment: Root canal therapy to eliminate the source of infection 1.
Adjunctive therapy: N-acetyl-L-cysteine (NAC) at 150 mg/kg/day intraperitoneally may reduce systemic inflammatory markers and improve outcomes in comorbid conditions like cardiomyopathy and nephropathy 1.Special Populations
Comorbidities: In patients with pre-existing heart and kidney diseases, adjunct use of NAC may mitigate systemic inflammatory effects 1.Key Recommendations
Perform root canal therapy to manage apical periodontitis effectively (Evidence: Moderate 1).
Consider adjunctive N-acetyl-L-cysteine therapy at 150 mg/kg/day in patients with systemic comorbidities like cardiomyopathy and nephropathy to reduce inflammatory markers (Evidence: Weak 1).
Monitor inflammatory markers such as TNF-α and IL-1β in serum for assessing disease activity and treatment response (Evidence: Expert opinion 1).References
1 Şehirli AÖ, Aksoy U, Sibai A, Orhan K, Sayıner S. Effects of N-acetyl-L-cysteine against apical periodontitis in rats with adriamycin-induced cardiomyopathy and nephropathy. International endodontic journal 2024. link