Interrelationship between periapical lesion and systemic metabolic disorders

Hajime Sasaki, Kimito Hirai, Christine M. Martins, Hisako Furusho, Ricardo Battaglino, Koshi Hashimoto

Research output: Contribution to journalArticlepeer-review

57 Citations (Scopus)


Background: Periapical periodontitis, also known as periapical lesion, is a common dental disease, along with periodontitis (gum disease). Periapical periodontitis is a chronic inflammatory disease, caused by endodontic infection, and its development is regulated by the host immune/inflammatory response. Metabolic disorders, which are largely dependent on life style such as eating habits, have been interpreted as a “metabolically-triggered” low-grade systemic inflammation and may interact with periapical periodontitis by triggering immune modulation. The host immune system is therefore considered the common fundamental mechanism of both disease conditions. Method: We have reviewed >200 articles to discuss the interrelationship between periapical lesions and metabolic disorders including type 2 diabetes mellitus, hypertension, and non-alcoholic fatty liver diseases (NAFLD), and their common pathological background in immunology/osteoimmunology and cytokine biology. Results: An elevated inflammatory state caused by metabolic disorders can impact the clinical outcome of periapical lesions and interfere with wound healing after endodontic treatment. Although additional well-designed clinical studies are needed, periapical lesions appear to affect insulin sensitivity and exacerbate non-alcoholic steatohepatitis. Conclusion: Immune regulatory cytokines produced by various cell types, including immune cells and adipose tissue, play an important role in this interrelationship.

Original languageEnglish
Pages (from-to)2204-2215
Number of pages12
JournalCurrent Pharmaceutical Design
Issue number15
Publication statusPublished - Apr 1 2016
Externally publishedYes


  • Cytokines
  • Hypertension
  • Immunity
  • Inflammation
  • Metabolic disorders
  • Periapical lesion
  • Type 2 diabetes

ASJC Scopus subject areas

  • Pharmacology
  • Drug Discovery


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