Evidence map›Paper›PMID 39530542›Full record

ArticleInternational endodontic journal2025

Lifestyle, caries, and apical periodontitis: Results from a university-based cross-sectional study.

Carlo Gaeta, Giulia Malvicini, Dominga Di Lascio, Marco Martignoni, Gabriele Ragucci, Simone Grandini, Crystal Marruganti

Abstract read
In one paragraph

Article in International endodontic journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

  1. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Carlo GaetaUnit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy.ORCID 0000-0002-2736-8046
Giulia MalviciniUnit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy.ORCID 0000-0001-5968-6471
Dominga Di LascioUnit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
Marco MartignoniUnit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy.
Gabriele RagucciPrivate Practice in Milan, Milan, Italy.
Simone GrandiniUnit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy.ORCID 0000-0002-6723-2784
Crystal MarrugantiUnit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy.ORCID 0000-0003-1088-2046

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimLifestyle factors significantly influence the development of inflammatory diseases, and emerging evidence suggests they may also impact oral health. However, no studies have explored their role in apical periodontitis (AP) amongst adults. This study aimed to assess the association between adherence to the Mediterranean diet (MD), physical activity, perceived stress, and sleep quality with the periapical and caries status in a university-based cohort. METHODOLOGY: A total of 149 periodontally healthy patients were included in the study. Clinical assessments and radiographic examinations [Orthopantomography (opt) and periapical radiographs] were conducted to evaluate the periapical status. Data on their periapical index (PAI) score and the decayed, missing and filled teeth (DMFT) index were recorded. Validated questionnaires were used to investigate patient's lifestyles. A final logistic regression model was performed for the multivariable analysis to evaluate the predictive ability of adherence to Mediterranean lifestyle on the presence of AP; other local, systemic and environmental factors were included as independent factors in the model.

resultsSignificant associations were observed between AP and high/low adherence to the MD (p = .00), high/low-moderate physical activity (p = .00), high/low sleep quality (p = .00) and high/low perceived stress (p = .00). The final multivariable regression model showed that low adherence to MD (OR = 3.68; 95% confidence interval [CI]: 1.24-10.83; p = . 01) and reduced sleep quality (OR = 3.04; 95% CI: 1.42-6.50; p = .00) were identified as potential risk factors for AP development. On the other hand, the DMFT index showed no significant association with lifestyle factors (OR = 1.0; CI: 1.01-1.14; p = .02) but was correlated with the development of AP (OR = 1.07; CI: 1.01-1.14; p = .02).

conclusionResults from the present study suggest a potential association between low adherence to MD and reduced sleep quality with the development of AP. Individuals with low adherence to MD and inadequate sleep quality faced respectively 4-fold and 3-fold increased odds of developing periapical lesions. Further research is essential to elucidate the causal mechanisms underlying these associations and to determine whether lifestyle adjustments could improve endodontic success rate.

Indexed as

Dental CariesLife StylePeriapical PeriodontitisAdultCross-Sectional StudiesDiet, MediterraneanDMF IndexExerciseFemaleHumansMaleMiddle AgedSleep QualityStress, PsychologicalSurveys and QuestionnairesUniversitiesapical periodontitiscarieslifestyleMediterranean dietphysical activitystress

Identifiers

PMID39530542
PMCPMC11715138

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.