The association between apical periodontitis and adverse pregnancy outcomes: a systematic review

Abstract

Background The association between adverse pregnancy outcomes (APOs) and maternal apical periodontitis remains unclear as it has not been examined rigorously or reviewed systematically. Objective To systematically review and critically evaluate the available evidence on the association of maternal apical periodontitis with several APOs. Methods A literature search was conducted using the following electronic databases: Clarivate Analytics’ Web of Science, Scopus, PubMed, and Cochrane Central Register of Controlled Trials (CENTRAL), from inception to 25 February 2021, with no language restrictions. Observational studies including longitudinal clinical trials, cohort, case–control and cross‐sectional studies of prospective and retrospective design were included. Articles with duplicate or overlapping results, abstract‐only papers, case reports, case series, animal studies and reviews were excluded. Two independent reviewers were involved in study selection, data extraction and appraising the included studies; disagreements were resolved by a third reviewer. The Newcastle–Ottawa Scale (NOS) and the adapted form of the NOS were used to assess the quality for case–control and cross‐sectional studies, respectively. Results Two case–control and one cross‐sectional study were included in the current review. The included studies were published between 2015 and 2017, with a total of 1187 participating individuals with an approximate age range of 15 to 40 years. As the included studies reported different outcomes, the heterogeneity of data prevented a meta‐analysis being undertaken. The overall quality of the evidence was ‘Fair’ for two out of three included studies, while one study was categorized as ‘Good’. Discussion Two out of three included primary studies had a substantial number of methodological inconsistencies and flaws, and therefore caution should be exercised in interpreting the results of this systematic review because several important covariates were not considered in the original investigations. Conclusion Based on a limited volume and ‘Fair’ and ‘Good’ quality of evidence, a positive association between maternal apical periodontitis and APOs was observed. However, more ‘Good’ quality clinical studies are needed to confirm the results of the current review. Funding None Registration PROSPERO database (CRD42‐2191987)

Apical periodontitis in mesiobuccal roots of maxillary molars: influence of anatomy and quality of root canal treatment, a CBCT study

“…In agreement with this previous result, in the present study, AP was observed in 54.4% of the teeth [ 17 ]. AP is related to cardiovascular disease and poor outcomes in pregnant women [ 18 19 ]. A recent study demonstrated that high levels of C-reactive protein (CRP) are found in patients with AP [ 20 ].…”

The Aetiology of Tourette Syndrome and Chronic Tic Disorder in Children and Adolescents: A Comprehensive Systematic Review of Case-Control Studies

“…Discrepancies were discussed and adjudicated by a third researcher until consensuses were reached on every item. Studies with scores of 7~9 and 4~6 stars were defined as ‘High’ and ‘Fair’ quality, respectively, while studies with 3 or less than 3 stars were considered to represent ‘Poor’ quality [ 12 ].…”

Association between Endodontic Infection, Its Treatment and Systemic Health: A Narrative Review

“…Attempts have been made to evaluate the effect of apical periodontitis on the development of systemic conditions including cardiovascular diseases (CVDs) [ 33 , 72 , 73 ], diabetes [ 34 , 35 ] and adverse pregnancy outcomes [ 74 ].…”

“…In a recent systemic review, Jakovljevic et al 2021 critically evaluated the available evidence on the association of maternal apical periodontitis with adverse pregnancy outcomes. The authors concluded that based on ‘Fair’ and ‘Good’ quality available evidence, a positive association was observed between maternal apical periodontitis and adverse pregnancy outcomes [ 74 ]. Therefore, it could be suggested that the risk of preeclampsia and low birth-weight preterm birth may be reduced through timely diagnosis and treatment of any source of inflammation, including apical periodontitis, before pregnancy.…”