Elsevier

Journal of Endodontics

Volume 42, Issue 10, October 2016, Pages 1427-1434
Journal of Endodontics

Review Article
Association between Systemic Diseases and Apical Periodontitis

https://doi.org/10.1016/j.joen.2016.07.007Get rights and content

Highlights

  • The role of systemic disease and pathogenesis of endodontic infection remains unknown.

  • Overall, the included studies showed a moderate risk of bias.

  • Some biologic markers may play a role in development of apical periodontitis.

  • None of these studies can elucidate a cause-and-effect relationship.

Abstract

Introduction

To date, the relationships between systemic diseases and periapical microbial infection remain unknown. Thus the purpose of this systematic review was to evaluate the relationship between host modifying factors and their association with endodontic pathosis.

Methods

Two reviewers independently conducted a comprehensive literature search. The MEDLINE, Embase, Cochrane, and PubMed databases were searched. In addition, the bibliographies of all relevant articles and textbooks were manually searched. There was no disagreement between the 2 reviewers.

Results

Sixteen articles were identified and included. The overall quality of the studies and the risk of bias were rated to be moderate. Only 3 studies demonstrated a low level of bias.

Conclusions

The results of this review suggest that there may be a moderate risk and correlation between some systemic diseases and endodontic pathosis. More prospective and longitudinal research in this area is warranted to determine greater specificity in these possible interactions to potentially decrease or minimize the effects of systemic disease on the formation of apical periodontitis.

Section snippets

Materials and Methods

The protocol for this systematic review was developed following established guidelines (21). The protocol was prepared and registered on PROSPERO (registration no. CRD42016034111). Also, a well-defined review question was developed by using the patient population, intervention, comparison, and outcome (PICO) framework.

The AMSTAR checklist, the Oxford Systematic Review Appraisal Sheet, Critical Appraisal Skills Programme, and the Grading of Recommendations Assessment, Development and Evaluation

Results

Because of the heterogeneity among the different studies, it was not possible to perform meta-analysis. Figure 1 presents a flowchart of the systematic review process according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Sixteen articles met the inclusion criteria.

In the present review, 8 of the included studies assessed the association between endodontic pathosis and cardiovascular disease (CVD), 5 studies focused on the association between

Discussion

Our review focused on any associations between endodontic pathosis and 5 primary systemic diseases: CVD, DM, liver, hematology disorder(s), and bone mineral density.

Acknowledgments

The authors deny any conflicts of interest related to this study.

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