Effects of estrogen deficiency on the progression of apical periodontitis. A systematic review of preclinical studies.

Bárbara Romagna Rossetti, Angélica Fensterseifer Lemos, Bruna Barcelos Só, Theodoro Weissheimer, Manoela Domingues Martins, Marcus Vinícius Reis Só

Archives of oral biology 2022 Oct

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To answer the review's question "Does estrogen deficiency influence on the progression of apical periodontitis?" Systematic searches were performed in MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, EMBASE, and Grey Literature Report databases, without restriction for language or year of publication. The eligibility criteria were based on the PICOS strategy, as follows: (P) animals with estrogen deficiency; (I) induction of apical periodontitis; (C) animals without estrogen deficiency (control group or sham surgery); (O) bidimensional and/or tridimensional measures of apical periodontitis progression; (S) studies in animal models. Risk of bias was performed with SYRCLE Risk of Bias tool. Certainty of evidence was assessed with GRADE. In total, 12 studies were included according to eligibility criteria. All studies (100%) demonstrated that the estrogen deficiency influence the apical periodontitis progression. Most studies performed a histomorphometric analysis evaluating bone loss area (58.3%), radiographic bone loss area (41.7%), bone volume assessment with microcomputed tomography (25%), fluorescence microscopy lesion area in mm2 (16.7%), and radiographic density assessment in one study (8.3%). The most frequent period of analysis was 21 days after lesion induction (75%). GRADE assessment showed a moderate certainty of evidence. The included studies demonstrated several limitations regarding randomization, blinding and description of baseline characteristics. All studies showed that an hypoestrogenic condition can favor an increased progression of apical periodontitis. Further clinical studies are necessary to confirm this correlation. In animal models, the estrogen deficiency significantly impact on the progression of apical periodontitis generating larger lesions comparing to healthy sham animals. Copyright © 2022 Elsevier Ltd. All rights reserved.

Citation

Bárbara Romagna Rossetti, Angélica Fensterseifer Lemos, Bruna Barcelos Só, Theodoro Weissheimer, Manoela Domingues Martins, Marcus Vinícius Reis Só. Effects of estrogen deficiency on the progression of apical periodontitis. A systematic review of preclinical studies. Archives of oral biology. 2022 Oct;142:105496