Blood Metallomic and Histologic Organs Analysis in Induced Periapical Lesion Model: In Vivo Animal Study

Ten essential metallic elements play key roles in metabolic and biological processes, and their levels may vary in pathologic conditions. Apical periodontitis is a common endodontic disease with systemic repercussions; however, no studies have assessed its influence on systemic metallic element concentrations compared with healthy conditions. This study aimed to investigate such variations in whole blood and evaluate liver and kidney histopathologic alterations.

Thirty-eight animals were allocated into periapical lesion (n = 19) and sham (n = 19) groups. Lesions were induced for 40 days, while the sham group underwent same procedures without induction. Whole blood was collected via intracardiac puncture for biochemical and metallomic analysis by inductively coupled plasma optical emission spectrometry, calibrated for sodium, potassium, magnesium, calcium, iron, manganese, cobalt, copper, zinc, and molybdenum. Liver and kidney samples were processed for histology with different staining protocols. Statistical analyses were performed at a 5% significance level.

Radiographic analysis confirmed lesion formation. Inductively coupled plasma optical emission spectrometry revealed significantly higher calcium concentrations in the lesion group (P < .05). Biochemical tests showed reduced total bilirubin (P < .05) and direct bilirubin (P < .05), along with elevated alanine aminotransferase (P < .05) and creatinine (P < .05). Histology demonstrated mild hepatic inflammation and pronounced renal injury, including tubular necrosis, indicating systemic repercussions.

Periapical lesions systemically alter metallomic and haematologic homeostasis, with calcium dysregulation in whole blood and histopathologic organ damage confirming their systemic inflammatory impact. Within animal model limitations, findings indicate potential association between apical periodontitis and systemic alterations.