Journal of endodontics · 2026
Radiographic Assessment of Apical Periodontitis and Periodontal Bone Loss in Oral Squamous Cell Carcinoma: A Cross-Sectional Study.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Li Rachelle, Sabbagh Melika Pahlevan, Mahjoubi Tina, Singhal Sonica, Azarpazhooh Amir, Kishen Anil, Magalhaes Marco
Аннотация
INTRODUCTION: Chronic oral inflammation has been implicated in oral squamous cell carcinoma (OSCC), but the role of apical periodontitis (AP) remains unclear. This study compared radiographic AP and periodontal radiographic bone loss (RBL), used as a surrogate for periodontal disease, between patients with OSCC and controls with benign oral lesions.
METHODS: This retrospective cross-sectional study included 113 patients with biopsy-confirmed OSCC and 130 controls with benign oral lesions. Two calibrated examiners assessed panoramic radiographs for decayed, missing, and filled teeth, AP, AP lesion size, endodontically treated teeth, and RBL. Multivariable logistic regression evaluated AP after adjustment for age, sex, cancer risk factors, periodontal RBL, and decayed, missing, and filled teeth. Secondary analyses evaluated the AP × RBL interaction and differences by OSCC stage. Exploratory analyses assessed OSCC and AP distributions across neighborhood-level marginalization strata.
RESULTS: After adjustment, AP was not statistically significantly associated with OSCC (adjusted odds ratio, 1.35; 95% confidence interval [CI], 0.74‑2.46; P = .324). After accounting for AP, severe RBL (>33%) was more prevalent in OSCC than in controls (38.9% vs 20.8%, P = .004) and was associated with OSCC (odds ratio, 2.99; 95% CI, 1.38‑6.51; P = .006). No statistically significant AP × RBL interaction was detected. Among patients with OSCC, neither AP nor RBL was significantly associated with the stage.
CONCLUSIONS: Severe periodontal RBL was associated with OSCC after accounting for AP. AP was not statistically significantly associated with OSCC status or stage; however, CIs do not exclude smaller AP-related associations. These findings highlight the importance of periodontal and endodontic assessments as components of preoncologic dental care.
METHODS: This retrospective cross-sectional study included 113 patients with biopsy-confirmed OSCC and 130 controls with benign oral lesions. Two calibrated examiners assessed panoramic radiographs for decayed, missing, and filled teeth, AP, AP lesion size, endodontically treated teeth, and RBL. Multivariable logistic regression evaluated AP after adjustment for age, sex, cancer risk factors, periodontal RBL, and decayed, missing, and filled teeth. Secondary analyses evaluated the AP × RBL interaction and differences by OSCC stage. Exploratory analyses assessed OSCC and AP distributions across neighborhood-level marginalization strata.
RESULTS: After adjustment, AP was not statistically significantly associated with OSCC (adjusted odds ratio, 1.35; 95% confidence interval [CI], 0.74‑2.46; P = .324). After accounting for AP, severe RBL (>33%) was more prevalent in OSCC than in controls (38.9% vs 20.8%, P = .004) and was associated with OSCC (odds ratio, 2.99; 95% CI, 1.38‑6.51; P = .006). No statistically significant AP × RBL interaction was detected. Among patients with OSCC, neither AP nor RBL was significantly associated with the stage.
CONCLUSIONS: Severe periodontal RBL was associated with OSCC after accounting for AP. AP was not statistically significantly associated with OSCC status or stage; however, CIs do not exclude smaller AP-related associations. These findings highlight the importance of periodontal and endodontic assessments as components of preoncologic dental care.