Association between rheumatoid arthritis and pulpal-periapical pathology: a systematic review

ObjectivesRheumatoid arthritis (RA) is a debilitating disease where numerous pro-inflammatory cytokines have a proven role in its pathology. These cytokines are also involved in the pathogenesis of apical periodontitis (AP) where they have a pro-inflammatory role and induce bone resorption. Patients with RA may therefore be more prone to develop pulpal-periapical pathology (PPP). This study systematically reviewed the existing literature evaluating the association between RA and PPP.Materials and methodsStudies including human participants with both RA and PPP were included. The search was performed in PubMed, Web of Science, and The Cochrane Library databases using keywords and Medical Subject Headings (MeSH) search terms. The risk of bias was assessed using Newcastle-Ottawa Quality Assessment Scale. The following parameters were extracted and analyzed by the reviewers; author, journal, year, design of the study, diagnostic criteria for periapical pathology, the association between rheumatoid arthritis and periapical pathology, and the evidence level.ResultsThe search identified 142 records. Inclusion criteria were as follows; studies in the English language, including human participants only, including patients with RA and PPP, cohort studies, cross-sectional studies, clinical trials, and case-control studies. According to the inclusion criteria, 5 studies were included in this systematic review. Three of the five studies reported significant association between RA and PPP.ConclusionsExisting evidence suggests there may be an association between RA and PPP.Clinical relevanceClinicians should be aware that RA patients can be more prone to develop PPP which may result in a reduced quality of life.

Journal

CLINICAL ORAL INVESTIGATIONS

Year

2023

Volume

27

Issue

12

Pages

7019-7028

ISSN

1432-6981

eISSN

1436-3771

DOI

10.1007/s00784-023-05305-7

WoS UID

WOS:001082624900001