On 15 November at 15 Veiko Vengerfeldt will defend his doctoral thesis „Apical periodontitis: prevalence and etiopathogenetic aspects“,
Professor Reet Mändar (dr. med. (meditsiin)), Institute of Biomedicine and Translational Medicine, University of Tartu
Professor Mare Saag (knd (meditsiin)), Institute of Dentistry, University of Tartu
Associate Professor Tiiu Kullisaar (knd (bioloogia)), Institute of Biomedicine and Translational Medicine, University of Tartu
Professor Vytautė Pečiulienė (PhD), Institute of Dentistry, Faculty of Medicine, Vilnius University
Apical periodontitis (AP) is an inflammatory disease around the apex of a tooth root that is caused by infection in root canal system. AP can be considered a sequela of advanced dental caries, and it is radiologically visible as hard tissue destruction around the apex of the tooth root. AP is a widespread condition all around the world and its prevalence is associated with age, gender, level of previous dental diseases and treatment and socioeconomic status of the region. The general aim of the present thesis was to clarify the prevalence, determining factors and etiopathogentic aspects of AP among Estonian population.
To clarify the prevalence of AP we analyzed radiographs of 6552 patient, we described and evaluated all teeth and their status. AP was diagnosed over half of the patients and we found a strong correlation between AP and previous dental diseases as well as the quality of previous dental treatment. The prevalence of AP was considerably lower in patients with high quality dental treatment.
Microbial samples were collected from 12 root canals, DNA was isolated and the bacteria were characterized. The communities were individually different but anaerobic bacteria predominated as the rule. We discovered several hard to cultivate and even some not yet discovered spices from root canals. Therefore, the microbiological analysis of the root canal content in case of endodontic pathologies is meaningless, and the treatment measures must be directed against wide spectrum of aerobic and anaerobic bacteria.
To measure oxidative stress (OxS), the saliva and root canal samples of 86 patients were analyzed. OxS levels were elevated in patients with endodontic pathologies compared to healthy subjects. OxS appeared to be an important pathogenetic mechanism in several endodontic pathologies being significantly associated with essential clinical markers like dental pain and bone destruction area around the apex of the tooth.