Apical periodontitis and its association with systemic biomarkers: bibliometric analysis of global scientific production and knowledge compilation map

Abstract

Apical periodontitis (AP) is an inflammatory oral disease associated with systemic responses. Studies have indicated the correlation of AP with elevated biomarkers, such as interleukins and C-reactive protein, which may contribute to chronic disease progression. This study conducted a bibliometric analysis to map research trends and identify gaps in the literature regarding AP and systemic biomarkers. A search in the Web of Science Core Collection (July 2024) retrieved 1523 articles, of which 97 met the inclusion criteria. Data extraction included author details, citation metrics, keywords, species studied, biological samples, biomarkers, therapeutic approaches, and pre- and post-treatment comparisons. Bibliometric networks were analyzed using Bibliometrix and VOSviewer. Results indicate a significant rise in publications since 2009, highlighting increasing scientific interest. Brazil contributed the most studies, followed by Turkey and Chile. Research primarily focused on oxidative stress markers and inflammatory cytokines, particularly TNF-alpha and IL-1. Blood was the most commonly analyzed biological sample, followed by saliva and gingival crevicular fluid, reflecting the growing interest in noninvasive diagnostic methods. In addition, an increase in interventional studies suggests a growing emphasis on the systemic benefits of endodontic therapy. However, gaps remain in understanding sex-related differences and the long-term systemic effects of AP. The findings of this research reinforce the systemic impact of AP and the necessity for further studies to clarify its long-term health implications. Future research should prioritize noninvasive biomarker detection and further explore the connection between AP and chronic inflammatory conditions.