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Updated: Mar 25, 2026

Inducing Apical Periodontitis in Mice
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Interrelationship Between Periapical Lesion and Systemic Metabolic Disorders.

Hajime Sasaki1, Kimito Hirai, Christine M Martins

  • 1Department of Immunology & Infectious Diseases, The Forsyth Institute, 245 First Street, Cambridge, MA 02494, U.S.A. hsasaki@forsyth.org.

Current Pharmaceutical Design
|February 17, 2016
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Summary

Periapical lesions and metabolic disorders share a common immune pathway. Metabolic inflammation can worsen periapical disease outcomes and hinder healing after endodontic treatment.

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Area of Science:

  • Oral immunology
  • Systemic inflammation
  • Osteoimmunology

Background:

  • Periapical periodontitis, a chronic inflammatory dental disease, stems from endodontic infection and host immune response.
  • Metabolic disorders, linked to lifestyle, induce low-grade systemic inflammation that may modulate immune responses.
  • The host immune system is a shared fundamental mechanism underlying both periapical periodontitis and metabolic disorders.

Purpose of the Study:

  • To review the interrelationship between periapical lesions and metabolic disorders.
  • To explore the common immunological and cytokine-based pathological background.
  • To discuss the impact of metabolic disorders on periapical disease and treatment outcomes.

Main Methods:

  • Comprehensive literature review of over 200 articles.
  • Focus on metabolic disorders including type 2 diabetes mellitus, hypertension, and non-alcoholic fatty liver diseases (NAFLD).
  • Analysis of immunological, osteoimmunological, and cytokine biology aspects.

Main Results:

  • Metabolic disorders elevate systemic inflammation, potentially impacting periapical lesion outcomes and endodontic wound healing.
  • Periapical lesions may negatively affect insulin sensitivity and exacerbate non-alcoholic steatohepatitis.
  • Immune regulatory cytokines from various cells, including immune and adipose tissues, are crucial in this interplay.

Conclusions:

  • The immune system is a critical link between periapical periodontitis and metabolic disorders.
  • Metabolic inflammation can adversely affect dental periapical health and treatment success.
  • Further clinical research is needed to fully elucidate these complex interactions.