The impact of cardiovascular disease and endodontic outcome: a systematic review of longitudinal studies
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REVIEW
The impact of cardiovascular disease and endodontic outcome: a systematic review of longitudinal studies Anita Aminoshariae 1
&
J. Kulild 2 & Ashraf F. Fouad 3
Received: 1 July 2020 / Accepted: 15 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives To date, the relationship between cardiovascular disease (CVD) and endodontic treatment outcomes remains elusive with mixed reports. Thus, the purpose of this systematic review of longitudinal cohort studies was to evaluate whether CVD was a risk factor for endodontic outcome. Materials and methods Two reviewers independently conducted a comprehensive electronic database search to July 2020. The bibliographies of all relevant articles, textbooks, and gray literature were manually searched. The methodological quality of evidence was appraised by the Newcastle-Ottawa Scale and GRADE. The authors considered any publication on CVD and endodontic outcome. Endodontic outcome referred to either healing or survival of endodontically treated tooth. Risk ratio (RR) with 95% confidence interval (CI) was used. Results Three articles met the inclusion criteria with a low risk of bias. Patients with CVD demonstrated a 67% higher risk for negative endodontic outcomes compared with patients who were healthy (RR = 1.67, P = 0.001, 95% confidence interval 1.53– 1.81). Conclusion With the limitations of this systematic review, the overall confidence by GRADE was moderate suggesting that CVD might be a risk factor for endodontic outcomes. Clinical relevance The results support an association between CVD and endodontic outcomes. Keywords Cardiovascular disease . Coronary disease . Endodontic outcome . Endodontic treatment . Heart failure . Systematic review
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00784-020-03596-8) contains supplementary material, which is available to authorized users. * Anita Aminoshariae [email protected] Ashraf F. Fouad [email protected] 1
Department of Endodontics, Case School of Dental Medicine, 2123 Abington Road, A 280, Cleveland, OH 44106, USA
2
Department of Endodontics, UMKC School of Dentistry, Kansas City, MO, USA
3
Department of Endodontics, School of Dentistry, University of North Carolina, 1098 First Dental Building, CB #7450, Chapel Hill, NC 27599, USA
Systemic health and bioburdens may have an impact on the outcome of endodontic treatment [1, 2]. In a previous systematic review, the authors reported that there might be an association between cardiovascular disease (CVD) and endodontic outcomes [3]. However, the authors could not perform a metaanalysis since there was heterogeneity among the studies and studies with different study designs were included in that systematic review (case-controlled studies and cohort studies). A recent article reported that CVD had no impact on the success of endodontic treatment [4]. To date, the relationship between CVD and the outcomes of endodontic treatment remains elusive. Both Wang et al. [1] and M
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