Cabanillas-Balsera, D., Areal-Quecuty, V., Cantiga-Silva, C., de Cardoso, C., Cintra, L.T.A., Martín-González, J. et al. (2023) Prevalence of apical periodontitis and non-retention of root-filled teeth in hypertensive patients: Systematic review and meta-analysis. International Endodontic Journal, 00, 1–14. Available from: https://doi.org/10.1111/iej.14007

這篇一直在想要不要放

因為很像R1 做出來的論文

整片大概在介紹高血壓/apical periodontitis/non-retention of root-filled teeth

三者之間有沒有關係

結論大概就是

高血壓跟apical periodontitis 沒有絕對關係，但如果病人已經有一些跟間問題，牙齒就比較容易掉(OR = 1.78 (95% CI = 1.60–1.98; p = .000001))

問題是，這篇的參考論文只有8篇……. 我覺得證據力偏低

但它讓我想到一些點

系統性疾病(DM, HTN)感覺在口外牙周談論的比較多

但根管呢

理論上來說應該會有差，但具體差在哪裏

隨便放幾個google的結果

Diabetes mellitus, periapical inflammation and endodontic treatment outcome

Segura-Egea, J. J., Castellanos-Cosano, L., Machuca, G., López-López, J., Martín-González, J., Velasco-Ortega, E., Sánchez-Domínguez, B., & López-Frías, F. J. (2012). Diabetes mellitus, periapical inflammation and endodontic treatment outcome. Medicina oral, patologia oral y cirugia bucal, 17(2), e356–e361. https://doi.org/10.4317/medoral.17452

 Upon review, we conclude that there are data in the literature that associate DM with a higher prevalence of periapical lesions, greater size of the osteolityc lesions, greater likelihood of asymptomatic infections and worse prognosis for root filled teeth.

這篇224引用，拿一些裡頭的數據好了

動物實驗-

Dentin bridge formation was inhibited in diabetic rats (p = 0.029) along with more inflammation in these pulps (p = 0.005). There was an inverse association between dentin bridge formation and inflammatory cell infiltration (p = 0.001). 

人體實驗

 Results showed that apical periodontitis in at least one tooth was found in 81.3% of diabetic patients and in 58% of control subjects (p = 0.036; OR = 3.2, 95% C.I. = 1.1 – 9.4). Amongst diabetic patients 7% of the teeth had AP, whereas in the control subjects 4% of teeth were affected (p = 0.007; OR = 1.8, 95% C.I. = 1.2 – 2.8)