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Presence of Epstein-Barr Virus in Periapical Pathoses: A Systematic Review and Meta-Analysis

Jagveer Yadav1, Mala Kamboj1, V Gopikrishnan1

  • 1Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pandit BD Sharma University of Health Sciences, Rohtak, Haryana, India.

Journal of Endodontics
|May 11, 2025
PubMed
Abstract

Insights

Epstein-Barr virus (EBV) is significantly associated with periapical lesions, especially symptomatic ones. Higher detection rates and increased risk were found in EBV-positive cases, suggesting a role in disease development.

Area of Science:

  • Oral pathology
  • Infectious disease
  • Virology

Background:

  • Periapical lesions stem from polymicrobial infections with diverse clinical signs.
  • The role of Epstein-Barr virus (EBV) in periapical disease pathogenesis is not well understood.
  • EBV is implicated in various inflammatory processes.

Purpose of the Study:

  • To systematically review and meta-analyze the prevalence of EBV in periapical diseases.
  • To assess the potential role of EBV in the etiopathogenesis of periapical lesions.

Main Methods:

  • Comprehensive literature searches were performed in major scientific databases until July 2024.
  • Included studies focused on the association between EBV and periapical diseases.
  • Risk of bias was assessed using the modified Newcastle-Ottawa scale; meta-analysis was conducted using Review Manager 5.4.

Main Results:

  • 31 studies were included for qualitative synthesis; 15 contributed to quantitative analysis.
  • EBV detection rates were higher in periapical lesions, particularly in symptomatic cases and larger lesions.
  • Meta-analysis confirmed that EBV-positive transcripts significantly increased the risk of periapical lesions and symptomatic presentation.

Conclusions:

  • A significant association exists between EBV and periapical lesions, especially symptomatic and larger ones.
  • Further research is needed to elucidate EBV's pathogenic mechanisms in periapical diseases.
  • Findings suggest potential implications for clinical management, including antiviral strategies.
Keywords:
EndodonticsEpstein-Barr virusherpes viruspathogenicityperiapical lesions

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