Advertisement

Association of Chronic Systemic Medications with the Incidence, Prevalence, or Healing of Endodontic Disease: A Systematic Review

Published:October 13, 2022DOI:https://doi.org/10.1016/j.joen.2022.10.004

      Abstract

      Introduction

      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.

      Methods

      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.

      Results

      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.

      Conclusions

      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.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Endodontics
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Fouad A.F.
        • Burleson J.
        The effect of diabetes mellitus on endodontic treatment outcome: data from an electronic patient record.
        J Am Dent Assoc. 2003; 134 (quiz 117–8): 43-51
        • Khalighinejad N.
        • Aminoshariae A.
        • Kulild J.C.
        • et al.
        Association of End-stage Renal Disease with Radiographically and Clinically Diagnosed Apical Periodontitis: A Hospital-based Study.
        J Endod. 2017; 43: 1438-1441
        • Piras V.
        • Usai P.
        • Mezzena S.
        • et al.
        Prevalence of Apical Periodontitis in Patients with Inflammatory Bowel Diseases: A Retrospective Clinical Study.
        J Endod. 2017; 43: 389-394
        • Cotti E.
        • Mezzena S.
        • Schirru E.
        • et al.
        Healing of Apical Periodontitis in Patients with Inflammatory Bowel Diseases and under Anti-tumor Necrosis Factor Alpha Therapy.
        J Endod. 2018; 44: 1777-1782
        • Jalali P.
        • Glickman G.N.
        • Schneiderman E.D.
        • Schweitzer J.L.
        Prevalence of Periapical Rarefying Osteitis in Patients with Rheumatoid Arthritis.
        J Endod. 2017; 43: 1093-1096
        • Katz J.
        • Rotstein I.
        Prevalence of Periapical Lesions in Patients with Osteoporosis.
        J Endod. 2021; 47: 234-238
        • Aminoshariae A.
        • Kulild J.C.
        • Mickel A.
        • Fouad A.F.
        Association between Systemic Diseases and Endodontic Outcome: A Systematic Review.
        J Endod. 2017; 43: 514-519
        • Aminoshariae A.
        • Kulild J.
        • Fouad A.F.
        The impact of cardiovascular disease and endodontic outcome: a systematic review of longitudinal studies.
        Clin Oral Investig. 2020; 24: 3813-3819
        • Nagendrababu V.
        • Segura-Egea J.J.
        • Fouad A.F.
        • et al.
        Association between diabetes and the outcome of root canal treatment in adults: an umbrella review.
        Int Endod J. 2020; 53: 455-466
        • Maeda T.
        • Matsunuma A.
        • Kurahashi I.
        • et al.
        Induction of osteoblast differentiation indices by statins in MC3T3-E1 cells.
        J Cell Biochem. 2004; 92: 458-471
        • Lai E.H.
        • Yang C.N.
        • Lin S.K.
        • et al.
        Metformin Ameliorates Periapical Lesions through Suppression of Hypoxia-induced Apoptosis of Osteoblasts.
        J Endod. 2018; 44: 1817-1825
        • Xiong H.
        • Wei L.
        • Hu Y.
        • et al.
        Effect of alendronate on alveolar bone resorption and angiogenesis in rats with experimental periapical lesions.
        Int Endod J. 2010; 43: 485-491
        • Bohora A.
        • Kokate S.
        Evaluation of the role of probiotics in endodontic treatment: a preliminary study.
        J Int Soc Prevent Communit Dent. 2017; 7: 46
        • Peddis N.
        • Musu D.
        • Ideo F.
        • et al.
        Interaction of biologic therapy with apical periodontitis and periodontitis: a systematic review.
        Aust Dent J. 2019; 64: 122-134
        • Cotti E.
        • Abramovitch K.
        • Jensen J.
        • et al.
        The Influence of Adalimumab on the Healing of Apical Periodontitis in Ferrets.
        J Endod. 2017; 43: 1841-1846
        • Alghofaily M.
        • Tordik P.
        • Romberg E.
        • et al.
        Healing of Apical Periodontitis after Nonsurgical Root Canal Treatment: The Role of Statin Intake.
        J Endod. 2018; 44: 1355-1360
        • Lai E.H.
        • Hong C.Y.
        • Kok S.H.
        • et al.
        Simvastatin alleviates the progression of periapical lesions by modulating autophagy and apoptosis in osteoblasts.
        J Endod. 2012; 38: 757-763
        • Lin S.-K.
        • Kok S.-H.
        • Lee Y.-L.
        • et al.
        Simvastatin as a novel strategy to alleviate periapical lesions.
        J Endod. 2009; 35: 657-662
        • Liu L.
        • Zhang C.
        • Hu Y.
        • Peng B.
        Protective effect of metformin on periapical lesions in rats by decreasing the ratio of receptor activator of nuclear factor kappa B ligand/osteoprotegerin.
        J Endod. 2012; 38: 943-947
        • Yip N.
        • Liu C.
        • Wu D.
        • Fouad A.F.
        The association of apical periodontitis and type 2 diabetes mellitus: A large hospital network cross-sectional case-controlled study.
        J Am Dent Assoc. 2021; 152: 434-443
        • Hsiao A.
        • Glickman G.
        • He J.
        A retrospective clinical and radiographic study on healing of periradicular lesions in patients taking oral bisphosphonates.
        J Endod. 2009; 35: 1525-1528
        • Kang B.
        • Cheong S.
        • Chaichanasakul T.
        • et al.
        Periapical disease and bisphosphonates induce osteonecrosis of the jaws in mice.
        J Bone Miner Res. 2013; 28: 1631-1640
        • Mattila K.J.
        • Nieminen M.S.
        • Valtonen V.V.
        • et al.
        Association between dental health and acute myocardial infarction.
        Bmj. 1989; 298: 779-781
        • DeStefano F.
        • Anda R.F.
        • Kahn H.S.
        • et al.
        Dental disease and risk of coronary heart disease and mortality.
        Bmj. 1993; 306: 688-691
        • Margulis A.V.
        • Pladevall M.
        • Riera-Guardia N.
        • et al.
        Quality assessment of observational studies in a drug-safety systematic review, comparison of two tools: the Newcastle-Ottawa Scale and the RTI item bank.
        Clin Epidemiol. 2014; 6: 359-368
        • Alyahya L.
        • Myers G.L.
        Denosumab Use as a Predictor Variable for External Cervical Resorption: A Case-Control Study.
        J Endod. 2021; 47: 366-373
        • Assaf A.T.
        • Amberg V.
        • Smeets R.
        • et al.
        Evaluation of Periodontal Space Widening in Patients with Antiresorptive Drug-related Osteonecrosis of the Jaws (ARONJ) on Panoramic Radiographs.
        Anticancer Res. 2018; 38: 5305-5314
        • Näsström K.
        • Möller B.
        • Petersson A.
        Effect on human teeth of renal transplantation: a postmortem study.
        Scand J Dent Res. 1993; 101: 202-209
        • Olczak-Kowalczyk D.
        • Gozdowski D.
        • Pawłowska J.
        • Grenda R.
        The status of dental and jaw bones in children and adolescents after kidney and liver transplantation.
        Ann Transplant. 2012; 17: 72-81
        • Pettiette M.T.
        • Zhong S.
        • Moretti A.J.
        • Khan A.A.
        Potential correlation between statins and pulp chamber calcification.
        J Endod. 2013; 39: 1119-1123
        • Skallsjö K.
        • Johansson J.E.
        • Jonasson P.
        • Hasséus B.
        Apical periodontitis as potential source of infection in patients with lymphoma treated with chemotherapy.
        Clin Oral Investig. 2020; 24: 133-140
        • Page M.J.
        • McKenzie J.E.
        • Bossuyt P.M.
        • et al.
        The PRISMA 2020 statement: an updated guideline for reporting systematic reviews.
        Bmj. 2021; 372: n71
        • Wang H.W.
        • Lai E.H.
        • Yang C.N.
        • et al.
        Intracanal Metformin Promotes Healing of Apical Periodontitis via Suppressing Inducible Nitric Oxide Synthase Expression and Monocyte Recruitment.
        J Endod. 2020; 46: 65-73
        • Tounta T.S.
        Diagnosis of osteoporosis in dental patients.
        J Frailty Sarcopenia Falls. 2017; 2: 21-27
        • López-López J.
        • Castellanos-Cosano L.
        • Estrugo-Devesa A.
        • et al.
        Radiolucent periapical lesions and bone mineral density in post-menopausal women.
        Gerodontology. 2015; 32: 195-201
        • Adachi J.D.
        • Bensen W.G.
        • Hodsman A.B.
        Corticosteroid-induced osteoporosis.
        Semin Arthritis Rheum. 1993; 22: 375-384
        • Üstün K.
        • Erciyas K.
        • Kısacık B.
        • et al.
        Host modulation in rheumatoid arthritis patients with TNF blockers significantly decreases biochemical parameters in periodontitis.
        Inflammation. 2013; 36: 1171-1177
        • Ikeda M.
        • Karakawa A.
        • Takizawa H.
        • et al.
        Effects of Anti-RANKL Antibody and Zoledronic Acid on Periapical Lesion Development in Mice.
        J Endod. 2022; 48: 632-640
        • Xiong H.
        • Peng B.
        • Wei L.
        • et al.
        Effect of an estrogen-deficient state and alendronate therapy on bone loss resulting from experimental periapical lesions in rats.
        J Endod. 2007; 33: 1304-1308
        • Ramis-Alario A.
        • Soto-Peñaloza D.
        • Tarazona-Alvarez B.
        • et al.
        Comparison of the diagnostic efficacy of 2D radiography and cone beam computed tomography in persistent apical periodontal disease: A PRISMA-DTA systematic review and meta-analysis.
        Oral Surg Oral Med Oral Pathol Oral Radiol. 2021; 132: e153-e168
        • Yu V.S.
        • Messer H.H.
        • Yee R.
        • Shen L.
        Incidence and impact of painful exacerbations in a cohort with post-treatment persistent endodontic lesions.
        J Endod. 2012; 38: 41-46
        • Fouad A.F.
        Endodontic Infections and Systemic Disease Chapter 16, in Endodontic Microbiology.
        in: Fouad A.F. 2nd Ed. Wiley Publishing, 2017: 384-408
        • Grey A.
        • Bolland M.J.
        • Wattie D.
        • et al.
        The antiresorptive effects of a single dose of zoledronate persist for two years: a randomized, placebo-controlled trial in osteopenic postmenopausal women.
        J Clin Endocrinol Metab. 2009; 94: 538-544
        • Aghaloo T.L.
        • Cheong S.
        • Bezouglaia O.
        • et al.
        RANKL inhibitors induce osteonecrosis of the jaw in mice with periapical disease.
        J Bone Miner Res. 2014; 29: 843-854
        • Cotti E.
        • Careddu R.
        • Schirru E.
        • et al.
        A Case of SAPHO Syndrome with Endodontic Implications and Treatment with Biologic Drugs.
        J Endod. 2015; 41: 1565-1570
        • Qi W.X.
        • Lin F.
        • He A.N.
        • et al.
        Incidence and risk of denosumab-related hypocalcemia in cancer patients: a systematic review and pooled analysis of randomized controlled studies.
        Curr Med Res Opin. 2013; 29: 1067-1073
        • Mavridou A.M.
        • Bergmans L.
        • Barendregt D.
        • Lambrechts P.
        Descriptive Analysis of Factors Associated with External Cervical Resorption.
        J Endod. 2017; 43: 1602-1610
        • Patel S.
        • Saberi N.
        External cervical resorption associated with the use of bisphosphonates: a case series.
        J Endod. 2015; 41: 742-748
        • Kaur M.
        • Nagpal M.
        • Singh M.
        Osteoblast-n-Osteoclast: Making Headway to Osteoporosis Treatment.
        Curr Drug Targets. 2020; 21: 1640-1651