Does bisphosphonate increase the risk of dental pulp and periapical alterations? An emergent clinical concept from a systematic review
Bibliographic record
Abstract
Background: Bisphosphonate (Bp) are related to in vivo alterations of dental pulp, so, the objective of this systematic review was to evaluate the influence of Bp use on the prevalence of dental pulp and periapical alterations. Material and Methods: This systematic review was guided by PRISMA-2020 and registered in PROSPERO (CRD42022302614). After screening 1,743 articles in 7 scientific databases (PubMed, Lilacs, Livivo, Scopus, Embase, Web of Science, EBSCO) and three grey-literature databases (Open Grey, Google Scholar, and ProQuest), two articles were included, and The Newcastle-Ottawa Quality Assessment Scale Cohort Studies was used to assess the risk of bias (RoB). Results: The two included articles were cross-sectional and a cohort retrospective study. The cross-sectional study described 13 patients in zoledronate use with 17 teeth showing dental pulp calcification (65%) or pulp necrosis (76%). The cohort study described 1,644,953 patients, a frequency of 0.52% of periapical lesions in general population and in 645 patients in use of Bp a significantly higher frequency of 1.86% (odds ratio = 3.52, CI95% = 3.25-3.82). Meta-analysis was not performed due heterogeneity of outcomes. The cross-sectional study showed a high risk of bias, and the cohort study showed a low risk of bias. Conclusions: This emerging systematic review suggests that Bp increases dental pulp and periapical alterations. However, studies with large samples and control groups are needed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.027 | 0.096 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.007 | 0.006 |
| Bibliometrics | 0.007 | 0.007 |
| Science and technology studies | 0.000 | 0.002 |
| Scholarly communication | 0.004 | 0.004 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.003 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".