Comparative analysis of prevalence of apical periodontitis in smokers and non-smokers using cone-beam computed tomography

Abstract

ObjectiveThe aim of this study was to compare the prevalence and size of periapical lesions among smokers and non-smokers using cone-beam computed tomography (CBCT).Materials and methodsRetrievable CBCT datasets for 46 male patients ≥18 years during a consecutive period from 2008 to 2016 were examined. The medical, smoking history and other clinical findings (signs of previous dental trauma; Decayed Missing Filled Teeth (DMFT) scores; the percentage of root filled teeth; and oral hygiene status) were obtained. Periapical status of all included teeth was assessed by CBCT images. Statistical analysis was conducted using t-test, Pearson correlation and multiple regression.ResultsThe prevalence of apical periodontitis was 13.93% in smokers and 14.26% in non-smokers with no significant difference (p = 0.936). The mean of the average size of lesions between the two groups were almost comparable, 3.50 mm in smokers and 2.89 mm in non-smokers (p = 0.567). Pearson correlation and multiple regression analysis showed that the percentage of lesion present and the average lesion size were not correlated to any independent variable.ConclusionsWhile smoking is considered a risk factor for marginal periodontitis, there was no difference between smokers and non-smokers in terms of apical periodontitis.

<p>The Effect of Smoking Habit on Apical Status of Adequate Endodontically Treated Teeth with and Without Periodontal Involvement</p>

“…A key feature in this research is counting samples as per tooth not per patient, our opinion matches (Balto et al 2019) as this would give a truer picture of the disease distribution and severity, if we put in mind that a patient with three or more affected teeth is not equal to a person with only one tooth affected with the condition in question which is AP. 37 The endodontic treatment itself is multifactorial too because it passes through instrumentation, irrigation, and lastly obturation, unfortunately, we cannot trace the first two procedures because its operator-dependent and undocumentable, so we depended on the quality of obturation obtained from OPG's and later from PA X-ray to judge the quality of RCT.…”

“…However, there are no data on this topic in the Iraqi population. regarding smoking negative role in AP, [33][34][35] alongside with other authors; knowing that smoking alters the microvasculature and the function of immune system, the cadmium that is found in cigarettes also consumes the Super Oxide dismutase protective enzyme which is an anti-oxidant-in blood and saliva, by replacing the Manganese, copper, and Zinc leaving SOD in an inactive state opening the door to the free radicals generated from smoking to destroy periodontal tissue 33 and this was obvious in the significant relationship between groups (G-c, Ge 6,36,37 suggesting that the development of AP in RCT teeth is multifactorial.…”

Cigarette Smoking and Root Filled Teeth Extraction: Systematic Review and Meta-Analysis

“…It has been shown that cigarette smoking has local and direct pro-inflammatory effect on inflamed periapical tissues, with increased levels of products of lipid peroxidation, such as 8-iso-PGF (2a), and products of the LOX-pathway [ 62 ]. Lastly, cigarette smoking, stimulating osteoclastic cells and reducing angiogenesis, impairs bone healing and tissues reparative response [ 63 , 64 ].…”

Methodologic concerns regarding the evidence of a higher prevalence of apical periodontitis and endodontic treatment need in tobacco smokers

“…We thank Dr Balto and Dr Al-Ekrish for their interest and constructive comments on the study in which we systematically reviewed the association between tobacco smoking and the prevalence of apical periodontitis and root canal treatment. In advance, we congratulate them for their study analysing the prevalence of apical periodontitis in smokers and nonsmokers using CBCT (Balto et al 2019).…”