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Does Sickle Cell Anaemia Have a Relationship With Avascular Pulp Necrosis? A Systematic Review
Elidiane Elias Ribeiro1,2, Karin Sá Fernandes3, Erika Sales Joviano Pereira4
1Department of Endodontics, School of Dentistry, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Sickle cell disease (SCD) may be linked to avascular pulp necrosis (APN) in intact teeth. However, current evidence is limited due to significant study limitations and very low certainty.
Area of Science:
- Oral Medicine
- Hematology
- Genetics
Background:
- Sickle cell disease (SCD) is an inherited hemoglobinopathy.
- Avascular pulp necrosis (APN) affects intact teeth.
Purpose of the Study:
- To systematically review the association between SCD and APN in intact teeth.
- To assess the quality of evidence regarding this relationship.
Main Methods:
- A comprehensive search of eight databases up to December 2024.
- Inclusion of four observational studies (cohort and case-control) with 311 individuals with sickle cell anaemia (SCA).
- Risk of bias and certainty of evidence assessed using JBI Critical Appraisal Checklists and GRADE.
Main Results:
- A potential relationship between SCA and APN was identified.
- All included studies had a high risk of bias (≥30%).
- The certainty of evidence was rated as very low.
Conclusions:
- Weak scientific support exists for the association between APN and SCA.
- Methodological limitations in current dental literature hinder definitive conclusions.
- Further high-quality research is needed to clarify the relationship.
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