BES Research Grant Winners – Previous Recipients
With our core objective being to promote and advance endodontology the grants that we offer to BES members as lead researchers is an essential part of progressing and advancing the future of endodontology.
In recent years the BES has awarded a number of grants for such project work and below are successful research submissions which have been accepted for funding by the BES Research Panel:
Professor Chris Lynch
‘An ex-vivo model to determine dental pulp responses to heat and light-curing of dental restorative materials ‘ - Journal of Dentistry Nov 2018.
View the research paper here: Prof Chris Lynch Paper 2018
Dr Satnam Singh Virdee
'Effects of dentine extracellular matrix components (dECMs) on mesenchymal stem cells derived from human periapical lesions (PL-MSCs) - an in vitro study'
View the research paper here: Dr Satnam Singh Virdee Research Paper
Dr Asmaa Al-Taie
'Micro-CT assessment of the sealing ability of BioRoot RCS using two root canal obturation techniques'
View the research paper here: Dr Asmaa Al-Taie Research Paper
Dr David Edwards
'Exploring irreversible pulpitis and its treatment’s effects on peripheral and central mechanisms: ExtirPate study'
View the research paper here: Dr David Edwards Research Paper
Dr Sadia Niazi
Successful endodontic treatment reduces serum levels of cardiovascular disease risk biomarkers—high-sensitivity C-reactive protein, asymmetric dimethylarginine, and matrix metalloprotease-2
Clinical Significance Statement: Apical Periodontitis is a co-morbidity and modifiable risk factor for the development of cardiometabolic diseases. Well-executed endodontic treatment, by abrogating apical periodontitis is crucial for successful outcome and have a positive impact on patient’s general health.
Apical periodontitis - a chronic inflammatory disease of the periradicular tissues is caused by the complex interactions between the root canal microbiota, microbial virulence factors and host immune response. Apical periodontitis manifests itself in different ways, ranging from completely asymptomatic and detected as a periapical radiolucency on a radiograph, to being symptomatic - presenting with pain and abscess. Apical periodontitis global prevalence is 52% at individual level, showing that half of the world’s population has at least one tooth with apical periodontitis. The NHS in England and Wales have reported that over 1 million teeth received RCT between 2001 and 2004, costing the NHS around GBP 50.5 million. According to the American Association of Endodontists, more than 25 million root canal treatments are performed each year in United States. In Europe, it is reported that almost 23 million endodontic treatments are undertaken yearly. Therefore, the global burden of root canal treatment is high- with two root canal treatments per patient. Root canal treatment for apical periodontitis may need re-intervention since the failure rates are still unacceptably high (17% primary RCT; 20% re-treatment).
The effect of apical periodontitis extends beyond dental implications. It can result in translocation of microbes and inflammatory mediators into the circulation. Elevated levels of inflammatory bioactive molecules can induce persistent low-grade systemic inflammation leading to impact on patient’s general health.
This Novel research led by Dr Sadia Niazi and funded by the British Endodontic Society and European Society of Endodontology has raised the significance of Apical Periodontitis as a co-morbidity and modifiable risk factor for the development of cardiometabolic diseases – a leading cause of death worldwide, responsible for about 30% of total global mortality – with expected rise in the incidence by approximately 10% over the next 20 years, and threefold increase in healthcare cost.
This longitudinal interventional cohort study confirmed the increased systemic inflammatory burden of cardiovascular disease risk biomarkers including high-sensitivity C-reactive protein (hs-CRP), fibroblast growth factor-23, Interleukin-1β, and asymmetric dimethylarginine (ADMA), along with metabolic syndrome indicators in apical periodontitis patients compared to controls (1). The effect on these serum inflammatory mediators is dose-dependent and can be affected by the increase in the size of periapical pathology (1). At 2- years post endodontic treatment (root canal re-treatment and peri-apical surgery), when complete resolution of clinical symptoms and periradicular healing was achieved, the serum levels of specific cardiovascular disease risk biomarkers – hs-CRP, ADMA and MMP-2 significantly reduced along with improvement in metabolic syndrome indicators and better glycaemic control (2). These results also elucidate that these are potential prognostic biomarkers of successful root canal re-treatment and peri-apical surgery, as they reduced at 2-year recall in cases which showed evidence of clinical and radiographic success (2).
Therefore, this study highlights the importance of a successful clinical and radiographic outcome which is crucially dependent on well-executed endodontic treatment as fundamental in improving patients’ general health by achieving reduction in systemic inflammatory burden and improvement in metabolic syndrome indicators. This elevates our role as dentists, far beyond just saving the teeth, as this evidence generated supports that good oral health including abrogation of apical periodontitis will ensures good general health of our patients.
As dentist, following are that steps we can need to take to improve our patients’ oral and general health:
1) Early career dentists should engage in CPD courses and with their Local Endodontic Society to enhance their Endodontology knowledge and skills, which will enable them to perform successful root canal treatment.
2) We need to educate our patients and public about maintenance of good oral health, timely treatment of caries to prevent development of root canal infections. Similarly, timely treatment of root canal infections to prevent its negative impact on general health.
3) Based on this evidence, we need to have clear guidelines for treatment of both symptomatic and asymptomatic cases especially in vulnerable patients to reduce the risk of development of adverse systemic health event.
1. Bakhsh A, Moyes D, Proctor G, Mannocci F, Niazi SA. The impact of apical periodontitis, non-surgical root canal retreatment and periapical surgery on serum inflammatory biomarkers. Int Endod J. 2022;55(9):923-37.https://www.mdpi.com/2076-3417/13/6/3952
2. Al-Abdulla N, Bakhsh A, Mannocci F, Proctor G, Moyes D, Niazi SA. Successful endodontic treatment reduces serum levels of cardiovascular disease risk biomarkers-high-sensitivity C-reactive protein, asymmetric dimethylarginine, and matrix metalloprotease-2. Int Endod J. 2023. https://doi.org/10.1111/iej.13979
Dr Sadia Niazi
[BDS, MSc, PhD, M Endo (RCS England & RCS Edinburgh), FHEA]
View the research paper here: Dr Sadia Niazi Research Paper
From Contaminated Gloves and Nosocomial Endodontic Infections to Global Cardiometabolic Risk'
View the research paper here: Dr Sadia Niazi Research Paper
Professor Owen Addison & Professor Shannon Patel
'Research the impact of AGP’s (Aerosol generating procedures) in dentistry with respect to Covid 19 - Mechanisms of Atomization from Rotary Dental Instruments and Its Mitigation'
View the research paper here: Professor Owen Addison & Professor Shannon Patel Research Paper
Professor David Wood & Doctor Brian Nattress
'Research the impact of AGP’s (Aerosol generating procedures) in dentistry with respect to Covid 19 - Dental Mitigation Strategies to Reduce Aerosolization of SARS-CoV-2'
View the research paper here: Professor David Wood & Doctor Brian Nattress Research Paper
More research papers will be added in due course.