Participation of endotoxin in root canal infections: A systematic review and meta-analysis

Frederico Canato Martinho; Diego Guilherme Dias de Rabello; Luciana Louzada Ferreira; Gustavo Giacomelli Nascimento

doi:10.4103/ejd.ejd_84_17

European Journal of Dentistry, Table of Contents

Eur J Dent 2017; 11(03): 398-406
DOI: 10.4103/ejd.ejd_84_17

Review Article

Thieme Medical and Scientific Publishers Private Ltd. A-12, Second Floor, Sector -2, NOIDA -201301, India

Participation of endotoxin in root canal infections: A systematic review and meta-analysis

Frederico Canato Martinho

¹Department of Restorative Dentistry, São José dos Campos Dental School, State University of São Paulo, São Paulo

,

Diego Guilherme Dias de Rabello

¹Department of Restorative Dentistry, São José dos Campos Dental School, State University of São Paulo, São Paulo

,

Luciana Louzada Ferreira

¹Department of Restorative Dentistry, São José dos Campos Dental School, State University of São Paulo, São Paulo

,

Gustavo Giacomelli Nascimento

²Section of Periodontology, Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark

› Author Affiliations

Abstract

ABSTRACT

This systematic review and meta-analysis aimed to evaluate the relationship between endotoxin levels and presence of clinical signs/symptoms and radiographic features in patients with endodontic infection. Electronic searches were performed on Medline/PubMed, Embase, Cochrane Library, Scielo, Science Direct, Web of Knowledge and Scopus databases for identification of relevant studies published up to December 2016. Grey literature was searched in Google Scholar. The selected literature was reviewed independently by two authors. Clinical studies evaluating the levels of endotoxin and the presence of clinical and radiographic features were included in this review. In order to determine the relationship between endotoxin levels and presence of clinical signs/symptoms and radiographic features meta-analyses were performed. Among the 385 articles identified in the initial search, 30 were included for full-text appraisal and only eight studies met the inclusion criteria for this systematic review. Meta-analysis revealed that individuals having teeth with tenderness to percussion (TTP) (P = 0.04; I² 57%) and previous episode of pain (PEP) (P = 0.001; I² 81%) had higher levels of endotoxin than their counterparts. Size of radiographic lesion >2 mm (P = 0.02; I² 68%) and presence of root canal exudation (EX) (P = 0.0007; I² 0%) were associated with higher levels of endotoxin. This systematic review and meta-analyses provided a strong evidence that endotoxin are related with the presence of clinical signs/symptoms and radiographic features in patients with endodontic infection.

Key words:

Endodontic treatment - endotoxins - meta-analysis - systematic review

Full Text

References

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