General and Digestive Surgery Unit, Hospital Universitario Son Espases, School of Medicine, Balearic Islands Health Research Institute, University of Balearic Islands, Palma de Mallorca, Spain.
Department of Odontostomatology, Faculty of Medicine and Health Sciences [Dentistry], Dentistry Hospital Universidad de Barcelona, Barcelona, Spain.
Int Endod J. 2022 Jul;55(7):748-757. doi: 10.1111/iej.13747. Epub 2022 Apr 26.
Crohn's disease (CD) and ulcerative colitis (UC) are two chronic recurrent inflammatory processes of the gastrointestinal tract, grouped under the name inflammatory bowel disease (IBD), causing clinical episodes of intestinal inflammation. The aim of this study was to investigate the possible association between IBD and the prevalence of apical periodontitis (AP) and root canal treatment.
A case-control study design matched to age and sex was used. The study group (SG) included 28 patients with IBD (13 with CD, 15 with UC). Another 28 healthy subjects, without IBD and age- and sex-matched, were included in the control group (CG). Radiographic records were analysed and AP was diagnosed as radiolucent periapical lesions (RPLs), using the periapical index score. Student's t-test, χ test and multivariate logistic regression were used in the statistical analysis.
In the CG, only 17 subjects (61%) had at least one tooth with AP, whilst in the SG group they were 23 patients (82%; OR = 2.98; 95% CI = 0.87-10.87; p = .08). The number of subjects with one or more root filled teeth (RFT) in the CG was 14 (50%), whilst in the SG they were 22 (79%; OR = 3.67; 95% CI = 1.14-11.79; p = .026). At least one RFT with AP was evident in three subjects (10.7%) in the CG, whilst in the SG 15 patients (53.6%) showed RFT with AP (OR = 9.60; 95% CI = 2.35-39.35; p = .001). In the multivariate logistic regression analysis, only endodontic status was found to be associated with IBD (OR = 1.86; 95% CI = 1.24-2.80; p = .003).
IBD, UC and Crohn's disease are associated with higher prevalence of RFT and higher percentage of RFT with periapical lesions. Dentists should consider these findings when caring for IBD patients by monitoring the evolution of periapical lesions of endodontically treated teeth.
克罗恩病（CD）和溃疡性结肠炎（UC）是两种胃肠道的慢性复发性炎症过程，统称炎症性肠病（IBD），导致肠道炎症的临床发作。本研究旨在探讨 IBD 与根尖周炎（AP）患病率和根管治疗之间的可能关联。
采用病例对照研究设计，与年龄和性别相匹配。研究组（SG）包括 28 例 IBD 患者（13 例 CD，15 例 UC）。另将 28 名年龄和性别匹配、无 IBD 的健康受试者纳入对照组（CG）。分析放射记录，使用根尖指数评分诊断 AP 为根尖透亮区病变（RPL）。统计学分析采用 Student's t 检验、卡方检验和多变量逻辑回归。
在 CG 中，只有 17 名受试者（61%）有至少一颗 AP 牙，而 SG 组有 23 名患者（82%；OR=2.98；95%CI=0.87-10.87；p=0.08）。CG 中有 14 名受试者（50%）有一颗或多颗根管充填牙（RFT），而 SG 中有 22 名受试者（79%；OR=3.67；95%CI=1.14-11.79；p=0.026）。CG 中有 3 名受试者（10.7%）至少有一颗 RFT 伴 AP，而 SG 中有 15 名患者（53.6%）有 RFT 伴 AP（OR=9.60；95%CI=2.35-39.35；p=0.001）。多变量逻辑回归分析显示，只有牙髓治疗状态与 IBD 相关（OR=1.86；95%CI=1.24-2.80；p=0.003）。
IBD、UC 和克罗恩病与 RFT 患病率较高和根管治疗后 RFT 伴根尖病变的比例较高有关。牙医在照顾 IBD 患者时应考虑这些发现，通过监测牙髓治疗牙的根尖病变演变来进行。
