Influence of systemic inflammatory biomarkers on periapical healing after root canal therapy

Abstract

Periapical healing following root canal therapy is a complex biological process influenced by microbial elimination, host immune response, and systemic health status. Growing evidence suggests that systemic inflammatory biomarkers may serve as valuable indicators of an individual's inflammatory burden and could influence the repair of periapical tissues after endodontic treatment. Biomarkers such as C-reactive protein, interleukins, tumor necrosis factor-alpha, erythrocyte sedimentation rate, and blood cell–derived inflammatory indices have been investigated for their potential role in predicting healing outcomes and identifying patients at increased risk of delayed tissue regeneration. Chronic systemic inflammatory conditions, including diabetes, cardiovascular disease, obesity, and autoimmune disorders, may further alter immune regulation and bone remodeling, thereby affecting treatment success. Advances in biomarker analysis, molecular diagnostics, and artificial intelligence have created new opportunities for personalized endodontic care through improved risk assessment and treatment monitoring. Understanding the relationship between systemic inflammation and periapical healing may enhance clinical decision-making, facilitate individualized treatment planning, and improve long-term prognosis. Continued research is necessary to establish standardized biomarker profiles and validate their routine application in endodontic practice.