Clinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, CH-8032 Zurich, Switzerland.
Department of Dental Biomaterials, School of Dentistry, National and Kapodistrian University of Athens, 10679 Athens, Greece.
Int J Environ Res Public Health. 2021 Aug 29;18(17):9111. doi: 10.3390/ijerph18179111.
The aim of the present study was to systematically assess existing evidence on the possible association between chronic endodontic infections and cardiovascular disease (CVD). An electronic database search was implemented until 2 October 2020. The main outcome was risk of CVD diagnosis. Risk of bias was assessed through the ROBINS-I tool, while random effects meta-analyses were conducted. The quality of the evidence was assessed with the Grading of Recommendations Assessment, Development, and Evaluation. Twenty-one studies were eligible for inclusion, while 10 were included in the quantitative synthesis. Risk for CVD diagnosis in patients with chronic endodontic infection was 1.38 times those without infection (RR = 1.38; 95% CIs: 1.06, 1.80; = 0.008). Risk of bias ranged from moderate to serious, while the quality of the evidence was graded as very low. Indications for an identified association between chronic endodontic infection and CVDs do exist; however, they are not grounded on high-quality evidence at present. Further research for an establishment of an association based on temporal sequence of the two entities and on unbiased well-conducted cohort studies would be highly valued.
本研究旨在系统评估慢性根管感染与心血管疾病（CVD）之间可能存在关联的现有证据。截至 2020 年 10 月 2 日，进行了电子数据库检索。主要结局是 CVD 诊断的风险。通过 ROBINS-I 工具评估偏倚风险，同时进行随机效应荟萃分析。使用推荐评估、制定和评估的分级系统评估证据质量。有 21 项研究符合纳入标准，其中 10 项纳入定量综合分析。患有慢性根管感染的患者诊断为 CVD 的风险是无感染患者的 1.38 倍（RR = 1.38；95%CI：1.06，1.80； = 0.008）。偏倚风险从中度到严重不等，证据质量被评为极低。慢性根管感染与 CVD 之间存在关联的迹象确实存在；然而，目前这些关联的证据并不是高质量的。基于这两个实体的时间顺序和无偏的、精心设计的队列研究来进一步研究建立关联将是非常有价值的。
