Successful Root Canal Treatment may improve Metabolic Health, suggests research
According to findings from a new longitudinal cohort study, successful root canal treatment was linked to better glucose and lipid metabolism and reduced systemic inflammation. This study was published in the BMC Journal of Translational Medicine by Yuchen Zhang and fellow researchers. Apical periodontitis (AP) is one of the most common dental diseases and is recognized for increasing systemic inflammatory burden. In this longitudinal study, metabolic changes over two years were monitored by using serum metabolomics and investigated how these systemic changes relate to metabolic syndrome indicators, inflammatory biomarkers, and blood and intracanal microbiomes.
In this self-controlled longitudinal cohort study, 65 patients with apical periodontitis were studied. Blood serum was collected at five time points: pre-operative baseline, 3 months, 6 months, 1 year, and 2 years after treatment. Nuclear magnetic resonance (NMR) spectroscopy quantified the serum metabolites. The study investigated the postoperative metabolic changes that may be present, their correlations with indicators of metabolic syndrome and inflammatory biomarkers, and their relations to blood and intracanal microbiomes. A dynamic Bayesian model was used to find the regulatory metabolites governing the longitudinal changes in metabolism.
Results
The study demonstrated significant systemic metabolic improvement after successful endodontic treatment.
Of the metabolites, 24 (54.5%) showed significant postoperative changes.
Early benefits included a significant reduction in branched-chain amino acids (BCAAs) at the 3-month review, indicating better metabolic and inflammatory control.
Long-term benefits were represented by a significant reduction in glucose and pyruvate at 2-year follow-up, indicative of improved glycaemic regulation.
These were accompanied by cholesterol, choline, and fatty acid reductions, while tryptophan progressively increased, indicating improved anti-inflammatory metabolic pathways.
Stronger correlations were observed between metabolic changes and clinical metabolic syndrome indicators, inflammatory biomarkers, and pre-operative blood and intracanal microbiomes.
Dynamic Bayesian analysis highlighted that metabolites linked to the tricarboxylic acid cycle were central regulators driving long-term metabolic changes.
Successful endodontic treatment among apical periodontitis patients was associated with an improved glucose and lipid metabolic profile and reduced systemic inflammation, which may suggest a potential role in the reduction of future risk for cardiometabolic disease. These findings emphasize the systemic benefits of treating AP and reinforce the importance of considering oral infections as integral parts of whole-body health.
Reference:
Zhang, Y., Le Guennec, A., Pussinen, P. et al. Successful endodontic treatment improves glucose and lipid metabolism: a longitudinal metabolomic study. J Transl Med 23, 1195 (2025). https://doi.org/10.1186/s12967-025-07110-0
