Effect of root canal treatment on hs-CRP levels and non-invasive cardiovascular risk marker in systemically healthy individuals with apical periodontitis of anterior teeth – a prospective clinical study

C-reactive protein (CRP), particularly high-sensitivity CRP (hs-CRP), is a biomarker for systemic inflammation and is associated with various chronic inflammatory conditions. Root canal treatment significantly reduces hs-CRP levels and decreases carotid intimamedia thickness (CIMT) in apical periodontitis patients.

AIM OF THE STUDY The aim of present study is to assess the impact of root canal treatment on hs-CRP levels and noninvasive cardiovascular risk marker (CIMT) in systemically healthy adults with apical periodontitis of anterior teeth.

OBJECTIVES OF THE STUDY To measure hs-CRP and CIMT levels before and after root canal treatment. To compare hs-CRP and CIMT levels in treated patients with a control group of untreated individuals.

Group 1 – Experimental group • Prior to the clinical procedure. Baseline hs CRP and CIMT levels will be recorded from the patient. • The tooth will be isolated with rubber dam following Local anesthesia administration with lignocaine with 1:100, 000 epinephrine • Access cavity will be prepared. • Working length will be determined using electronic apex locator and radiographic confirmation will be taken. • Cleaning and shaping will be done using hand files and Pro-Taper files. • Irrigation with 5 ml of 5.2 % NaOCl will be done after each instrument usage followed by 17 % EDTA and final rinse of saline. • After drying the canals with paper points ,calcium hydroxide paste intracanal medicament will be placed for 7 days • During the second visit, under dental dam isolation ,the calcium hydroxide medicament will be removed by thorough irrigation with saline./ • Then canals will be dried with paper points and filled with gutta percha and AH plus sealer • At the 3-months and 6 months follow up, the teeth will be evaluated clinically and radiographically. and the serum hs CRP levels and, CIMT levels will be measured and correlated with control group.

GROUP 2 – Control group • 15 subjects will be selected after matching with group 1 based on age, gender , bmi , geographic area , socioeconomic status without apical periodontitis. • Baseline hs-CRP and CIMT levels will be recorded from the subjects • At the 3-months and 6 months follow up the serum hsCRP levels and CIMT will be measured.