Comparative Evaluation of Serum High-sensitivity C-Reactive Protein and Complete Hemogram Indices in Subjects with and without Apical Periodontitis: A Prospective Interventional Study.

INTRODUCTION

This study aimed to compare the levels of high-sensitivity C-reactive protein (hsCRP) and complete hemogram (CH) parameters before and after root canal treatment in patients with apical periodontitis (AP) and healthy controls.

METHODS

Twenty-five patients with asymptomatic AP in a single permanent tooth were recruited along with age- and sex-matched healthy controls. Baseline serum hsCRP and CH parameters were recorded in both groups. Root canal treatment was performed in teeth with AP, and biochemical parameters were re-evaluated at the 6-month follow-up. Mann-Whitney and chi-square tests were used to analyze data quantitatively and qualitatively, respectively. Spearman correlation was applied to explore the relation between hsCRP with AP and periapical healing. Multivariate linear regression tests were used to assess the effect of independent variables such as age, sex, body mass index, and periapical index score on levels of hsCRP.

RESULTS

A baseline comparison between patients with AP (3.37 ± 2.69 mg/L) and controls (1.69 ± 2.2 mg/L) revealed a significant difference in hsCRP levels. However, all CH parameters were within the reference range. A total of 22 patients in the AP group completed follow-up, and based on the periapical index score and clinical presentations, 72.2% of patients were classified as healed. At follow-up, hsCRP significantly reduced to 1.79 ± 1.65 mg/L in the AP group. A significant correlation between AP and hsCRP was observed.

CONCLUSIONS

Patients with AP had a significantly higher inflammatory burden than healthy controls, which significantly reduced after root canal treatment. No significant change was detected in CH indices.