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Systematic Review

Osteoporosis and Apical Periodontitis Prevalence: A Systematic Review

by
Natália Pestana de Vasconcelos
1,2,
Isabel Silva Martins
1,2,
Américo Santos Afonso
3,
Ana Cristina Braga
4 and
Irene Pina-Vaz
3,5,*
1
Health Science Faculty, University Fernando Pessoa, 4200-150 Porto, Portugal
2
CINTESIS, Faculty of Medicine, University of Porto, 4200-319 Porto, Portugal
3
Faculty of Dental Medicine, University of Porto, 4200-393 Porto, Portugal
4
ALGORITMI Research Centre, LASI, University of Minho, 4710-057 Braga, Portugal
5
CINTESIS@RISE, MEDCIDS, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
*
Author to whom correspondence should be addressed.
Dent. J. 2024, 12(8), 272; https://doi.org/10.3390/dj12080272
Submission received: 4 July 2024 / Revised: 8 August 2024 / Accepted: 19 August 2024 / Published: 22 August 2024
(This article belongs to the Special Issue Feature Review Papers in Dentistry)

Abstract

Osteoporosis is a common systemic bone disorder in the elderly, characterized by low bone mineral density and deterioration of bone structure. Apical periodontitis is an inflammatory response to the microbial infection of root canals, typically characterized by apical bone destruction surrounding the tooth’s apex. This systematic review aimed to determine if osteoporosis affects the prevalence of apical periodontitis in adults. PRISMA guidelines have been followed. It included randomized clinical trials, cross-sectional, cohort, and case-control studies, and excluded non-relevant investigations and various secondary sources. A comprehensive search was performed in PubMed, Scopus, and Web of Science, until 13 March 2024. The Newcastle–Ottawa Scale was used to assess the quality of the three selected studies: two cross-sectional studies and one case-control study. One investigation only included post-menopausal women recruited at a dental university clinic, the other integrated data from the total hospital patients’ population, and the third selected patients referred to the university dental clinic from the university hospital. The findings varied: one study noted a marginal association between low bone mineral density and apical periodontitis, another found a significant association, and the third, with the lowest risk of bias, reported no link. The main limitations were the scarcity of eligible studies and their overall quality. The review was registered in the PROSPERO database (CRD42024523705), applied strict inclusion criteria and thorough searches by experienced and independent reviewers. There is no strong evidence that adult individuals with osteoporosis have a higher probability of developing apical periodontitis. However, clinicians should remain cautious of osteoporosis’s potential impact on apical periodontitis development.
Keywords: bisphosphonates; bone density; endodontics; panoramic radiography; apical periodontitis bisphosphonates; bone density; endodontics; panoramic radiography; apical periodontitis
Graphical Abstract

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MDPI and ACS Style

Pestana de Vasconcelos, N.; Martins, I.S.; Afonso, A.S.; Braga, A.C.; Pina-Vaz, I. Osteoporosis and Apical Periodontitis Prevalence: A Systematic Review. Dent. J. 2024, 12, 272. https://doi.org/10.3390/dj12080272

AMA Style

Pestana de Vasconcelos N, Martins IS, Afonso AS, Braga AC, Pina-Vaz I. Osteoporosis and Apical Periodontitis Prevalence: A Systematic Review. Dentistry Journal. 2024; 12(8):272. https://doi.org/10.3390/dj12080272

Chicago/Turabian Style

Pestana de Vasconcelos, Natália, Isabel Silva Martins, Américo Santos Afonso, Ana Cristina Braga, and Irene Pina-Vaz. 2024. "Osteoporosis and Apical Periodontitis Prevalence: A Systematic Review" Dentistry Journal 12, no. 8: 272. https://doi.org/10.3390/dj12080272

APA Style

Pestana de Vasconcelos, N., Martins, I. S., Afonso, A. S., Braga, A. C., & Pina-Vaz, I. (2024). Osteoporosis and Apical Periodontitis Prevalence: A Systematic Review. Dentistry Journal, 12(8), 272. https://doi.org/10.3390/dj12080272

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