期刊
INTERNATIONAL ENDODONTIC JOURNAL
卷 52, 期 6, 页码 790-802出版社
WILEY
DOI: 10.1111/iej.13079
关键词
apical periodontitis; causation criteria; diabetes mellitus; endodontic medicine; root canal treatment; systematic review
资金
- Spanish Ministerio de Educacion, Cultura y Deporte (Programa Nacional de Formacion de Profesorado Universitario, FPU)
- University of Sevilla (Contrato de Acceso al Sistema Espanol de Ciencia, Tecnologia e Innovacion)
- University of Sevilla (Beca de Personal Investigador en Formacion, PIF)
Endodontic Medicine has gained more attention and is becoming a more important issue in Endodontics. As an example, more than one hundred articles on this topic have been published in the last eight years. Several of these studies have found an association between endodontic variables, that is the prevalence of apical periodontitis, the prevalence of root canal treatment (RCT) and the outcome of RCT assessed as root filled teeth (RFT) with radiolucent periapical lesions (RPL) or non-retained RFT, and several systemic diseases, such as diabetes, cardiovascular disease, smoking habits, osteoporosis, inherited coagulopaties, biological medications, low birth weight or physical fitness. However, the demonstration of association does not prove by itself the existence of a cause-effect relationship. Two variables can be related statistically to each other without either variable directly affecting the values of the other thus resulting in a non-causal relationship. Causality is assumed when one variable is shown to contribute to the development of the other, and its removal is shown to reduce the frequency of disease. Therefore, once a significant statistical association has been found between two variables, it is necessary to exclude the presence of bias, which would imply that the association is artefactual, and to analyse if the causation criteria defined by Hill (Proceedings of the Royal Society of Medicine 1965; 58: 295-300) are fulfilled to establish a causal relationship. Only if they are satisfied, can it be concluded that the association is causal. The aim of this study was to analyse the difference between association and causation, applying the criteria of causality to the specific case of the association between endodontic disease and diabetes mellitus.
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