About the project
Each year, over one hundred patients are hospitalized in Skåne with more severe forms of systemic spread of an infection that originated in a tooth or in the jaws. It is estimated that approximately half of these have an endodontic cause, originating in a tooth either with an untreated primary infection or for which endodontic treatment has been initiated but not completed. In addition, an unknown proportion of patients hospitalized due to severe systemic infection is associated with a tooth that is previously root-filled but has persisting apical inflammation and remaining root canal infection. In the report Methods of Diagnosis and Treatment in Endodontics (2010), the SBU identified exacerbation of apical periodontitis in root-filled teeth as a potential threat to patient health and well-being. Apical periodontitis is often silent, but the inflammatory process sometimes turns acute with the development of local abscesses that have the potential for life-threatening spreading to other parts of the body. A shift in the balance between infection virulence and host defence is assumed to be the explanation for this sudden event, but factors associated with higher risk are not well understood. The risk of adverse events related to endodontic infections, ranging from only mild pain and moderate functional impairment to severe systemic infection spread with hospitalization and need for intensive care, is largely unknown and predictors of such events have not been identified. Patient-related and clinical parameters may hold the key to the prevention of severe infection spread. If predictors can be identified, it may be possible to protect patient groups with increased risk.
The purpose of this study is to prospectively examine
- the prevalence of severe infection spread associated with root-filled teeth with persisting apical periodontitis and
- clinical and patient-related predictors of such events.
In addition, we will examine the prevalence of severe infections spread associated with teeth with untreated endodontic infections and teeth currently undergoing endodontic treatment.