Evidence map›Paper›PMID 40011389›Full record

SynthesisOdontology2025

Association between apical periodontitis and brain inflammation: a systematic review from animals and human studies.

Julia da Conceição Francisquini, Luan Felipe Toro, Renato Gomes Azevedo, Gestter Willian Lattari Tessarin

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Odontology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. The Relationship Between Severity of Apical Periodontitis and Next-Generation Systemic Inflammatory Biomarkers.Australian endodontic journal : the journal of the Australian Society of Endodontology Inc · 2026
    Article
  3. Article
  4. Article
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

4 authors.

Julia da Conceição FrancisquiniUniversity Center in the North of São Paulo (UNORTE), School of Dentistry, São José Do Rio Preto, São Paulo, Brazil.
Luan Felipe ToroMarilia Medical School (FAMEMA), Marília, São Paulo, Brazil.
Renato Gomes AzevedoUniversity Center in the North of São Paulo (UNORTE), School of Dentistry, São José Do Rio Preto, São Paulo, Brazil.
Gestter Willian Lattari TessarinUniversity Center in the North of São Paulo (UNORTE), School of Dentistry, São José Do Rio Preto, São Paulo, Brazil. gestter.tessarin@unesp.br.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Apical periodontitis (AP) is an oral inflammatory disease induced by dental pulp infection. It is characterized by inflammation, destruction, and resorption of mineralized tissues located around the dental apex. Although this is a local infection, pathogens and their products in the periapical area, as well as inflammatory cytokines, can reach other regions of the body and trigger a systemic immune/inflammatory response in the host. This condition has been associated with several types of systemic diseases. This systematic review aimed to explore the association between AP and neuroinflammation, providing insights into this relationship and discussing potential pathways used by AP microorganisms to reach the central nervous system. Extensive searches in electronic databases (PubMed, Embase, and Cochrane) and hand searches were conducted from January 2013 until May 2024, using the keywords apical periodontitis, endodontic infection, periapical abscess, periodontitis apical, brain inflammation, brain disorders, and neuroinflammation. Initially, 394 studies were selected. After exclusion and inclusion criteria were applied, 12 studies (7 case reports and 1 case series, 3 experimental studies using animal models, and 1 cohort study) were included in this systematic review. All studies showed the presence of AP in upper and/or lower teeth and brain disorders with neuroinflammation. It is important to mention that some cases reported the death of the patient. This systematic review indicates a significant relationship between AP and neuroinflammation based on animal and human studies. Moreover, this study suggests there may be pathways connecting upper and lower teeth with apical periodontitis to the brain, inducing neuroinflammation. Additionally, the oral cavity can become easily accessible when AP is present, allowing for the invasion of microorganisms that are usually non-invasive. This contributes to the development of systemic disorders and/or strengthens their effect, worsening brain pathologies by causing or enhancing neuroinflammation, potentially leading to death. Based on these inferences, periapex health care is essential to improve the health of the world population.Registration number: Prospero registration nº. CRD42023453543.

Indexed as

Neuroinflammatory DiseasesPeriapical PeriodontitisAnimalsHumansApical periodontitisCentral nervous systemInflammationNeuroinflammationSystematic review

Identifiers

PMID40011389

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.