Alghofaily Maha, Fouad Ashraf F
Restorative Dental Sciences, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Department of Endodontics, School of Dentistry, The University of Alabama at Birmingham, Birmingham, Alabama.
J Endod. 2022 Dec;48(12):1458-1467. doi: 10.1016/j.joen.2022.10.004. Epub 2022 Oct 13.
Recently, the use of long-term systemic medications, including biologicals, to manage various chronic systemic diseases has increased. The association between these medications and the pathogenesis or healing of endodontic diseases remains poorly understood. This systematic review aimed to evaluate the relationship between the long-term use of systemic medications and the incidence, prevalence, and/or healing of endodontic diseases and conditions.
A comprehensive literature review was conducted using the electronic MEDLINE Ovid, Scopus, Embase, Cochrane, and PubMed databases followed by manual searching and citation mining for all articles eligible per the inclusion criteria.
A total of 2470 citations were screened, and 12 articles met the inclusion criteria and were included in this review. The selected studies included 9 cohort or cross-sectional studies and 3 case-control studies with a low to moderate overall risk of bias mostly. Some medications were associated with either an increased or decreased prevalence of apical periodontitis, whereas other medications were associated with an incidence of pulp calcification or cervical root resorption.
Systemic medications may be associated with the incidence, prevalence, or healing of endodontic diseases and conditions, but the level of evidence is low. This warrants more well-designed longitudinal clinical studies on the role of chronic systemic medications as well as controlling for medications when the systemic diseases are studied.
最近，包括生物制剂在内的长期全身性药物在治疗各种慢性全身性疾病中的使用有所增加。这些药物与牙髓病的发病机制或愈合之间的关联仍知之甚少。本系统评价旨在评估长期使用全身性药物与牙髓病的发病率、患病率和/或愈合之间的关系。
使用电子MEDLINE Ovid、Scopus、Embase、Cochrane和PubMed数据库进行全面的文献综述，随后对符合纳入标准的所有文章进行手动检索和引文挖掘。
共筛选了2470条引文，12篇文章符合纳入标准并纳入本综述。所选研究包括9项队列研究或横断面研究以及3项病例对照研究，总体偏倚风险大多为低到中度。一些药物与根尖周炎患病率的增加或降低有关，而其他药物与牙髓钙化或牙根颈吸收的发生率有关。
全身性药物可能与牙髓病的发病率、患病率或愈合有关，但证据水平较低。这需要更多关于慢性全身性药物作用的精心设计的纵向临床研究，以及在研究全身性疾病时对药物进行控制。
