Apical periodontitis-induced oxidative stress and its systemic implications

Apical periodontitis (AP) is a chronic inflammatory disease of periradicular tissues driven by microbial infection of the root canal. Once regarded as a localized dental condition, growing evidence suggests a connection between AP and systemic oxidative stress. Excess production of reactive oxygen species (ROS) and reactive nitrogen species in AP lesions contributes to lipid peroxidation, protein oxidation, and DNA damage, linking AP to cardiovascular disease and diabetes mellitus. Shared biomarkers, such as malondialdehyde, 8-isoprostanes, 8-oxo-2'-deoxyguanosine, and myeloperoxidase, support the biological plausibility of systemic associations. Root canal treatment has been shown to reduce systemic oxidative burden, reinforcing the need for timely diagnosis and interdisciplinary care. Longitudinal and interventional studies using standardized biomarker panels can confirm causality.