Department of Surgical Science, CIR-Dental School, University of Turin, Turin, Italy.
Department of Public Health and Infectious Disease, Sapienza University, Rome, Italy.
Oral Dis. 2024 Apr;30(3):865-876. doi: 10.1111/odi.14645. Epub 2023 Jun 20.
The objective of this systematic review and meta-analysis of observational studies was to assess whether herpes simplex virus type 1 (HSV-1) can infect endodontic periapical lesions.
Studies with cross-sectional design investigating HSV-1 in periapical tissues of patients with symptomatic and asymptomatic acute and chronic apical periodontitis were searched through MEDLINE, Scopus, Embase, Web of Science, and Google Scholar. Pooled HSV-1 prevalence proportion with 95% confidence interval (95CI) in periapical lesions was assessed with both fixed-effect and random-effects models, with/without adjustment for study quality and publication bias. Result robustness was investigated through sensitivity and subgroup analyses.
Literature search, performed twice, provided 84 items, and eight remained for the meta-analysis; globally, there were 194 patients mostly adults. The pooled HSV-1 prevalence proportions, assessed with various methods, were 6.9% (95CI, 3.8-11.3%, fixed-effect); 6.8% (95CI, 3.6-11.0%, random-effects); 8.1% (95CI, 4.4-14.5%, quality-adjusted); and 4.8% (95CI, 2.0-11.4%; adjusted for small-study effect).
The results indicated that HSV-1 can colonize the periapical tissues of 3%-11% patients with periapical diseases. Such data do not imply a causative role of HSV-1 in disease development and advancement. Well-designed and large-sized prospective cohort studies should be added in the literature panorama.
本系统评价和观察性研究的目的是评估单纯疱疹病毒 1 型（HSV-1）是否能感染牙髓根尖周病变。
通过 MEDLINE、Scopus、Embase、Web of Science 和 Google Scholar 搜索了横断面设计研究，以调查有症状和无症状的急性和慢性根尖周炎患者根尖组织中的 HSV-1。使用固定效应和随机效应模型，评估了未调整和调整研究质量和发表偏倚后的根尖病变中 HSV-1 总流行率（95%置信区间[95%CI]）。通过敏感性和亚组分析来研究结果的稳健性。
两次文献搜索共提供了 84 项，其中 8 项用于荟萃分析；全球共有 194 名患者，大多数为成年人。使用不同方法评估的 HSV-1 总流行率分别为 6.9%（95%CI，3.8-11.3%，固定效应）；6.8%（95%CI，3.6-11.0%，随机效应）；8.1%（95%CI，4.4-14.5%，质量调整）；4.8%（95%CI，2.0-11.4%，调整小样本效应）。
结果表明，HSV-1 可定植于 3%-11%的根尖周病患者的根尖周组织中。这些数据并不意味着 HSV-1 在疾病发展和进展中起因果作用。应在文献综述中增加设计良好和样本量大的前瞻性队列研究。
