The impact of cardiovascular disease and endodontic outcome: a systematic review of longitudinal studies

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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.

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