The Association of Dental Pulp Stones to Cardiovascular and Renal Diseases: A Systematic Review and Meta-Analysis

Pulp stone (PS) is a dystrophic calcification in the tooth's pulp chamber and was suggested in the literature to be associated with other calcifications in the body. This study aimed to investigate the association of PS to cardiovascular diseases (CVD) and renal stones (RS).Three databases were searched until June 2021 in addition to manual searching of Google Scholar and grey literature. Original studies were only included and critically appraised using an adapted version of the Newcastle-Ottawa scale. The odds ratio (OR) effect measure was calculated using the Mantel-Haenszel statistical test (95% confidence interval [CI]) to investigate the association of PS with CVD and or RS (P value ˂ .05).The database search identified 4933 studies, and 19 studies were finally included. The risk of bias was low in 13 studies, moderate in 4 studies, and high in 2 studies. The meta-analysis of the moderate and low risk of bias studies revealed a significant association between PS and CVD (OR, 3.35; 95% CI, 1.91-5.89; P < .001, I2 = 65%), but no association was found between PS and RS. The results also revealed an association between PS and CVD in patients older than 40 (OR, 8.78; 95% CI, 3.64-21.17; P < .001, I2 = 0%).The current study results showed an association between PS and CVD, but no association was found between PS and RS. PS in patients older than 40 years, compared with younger patients (<40 years), was associated with CVD.