Herpesviruses in Periapical Pathoses: An Updated Systematic Review

Apical periodontitis represents a chronic inflammation and destruction of periradicu‐ lar tissue caused by polymicrobial infection of endodontic origin. The aim of this systematic review was to make an update on findings related to Epstein-Barr virus (EBV) and human cytomegalovirus (HCMV) presence in periapical pathoses and to correlate these findings with clinical, histopathological and radiographic features of periapical lesions. Methods were based on the preferred reporting items for systemat‐ ic reviews and meta-analyses (PRISMA) statement. A search was performed using PubMed, Web of Science and SCOPUS. Search key words included the following medical subjects heading terms: (periapical disease OR apical periodontitis OR periapical lesions OR periapical abscess) AND (viruses OR herpesvir*). A manual search involved references from articles retrieved for possible inclusion. The search, evalua‐ tion, and critical appraisal of articles were performed by two independent judges. Collected data were analyzed using the measures of descriptive statistics. The final review has included twenty nine articles related to herpesviral presence periapical pathoses. Qualitative analysis indicated that EBV HCMV, and HHV-8 were the most prevalent species in periapical pathoses. Our findings suggest that there is wide variety of herpesviruses detection rates in periapical pathoses in relation to their clinical, histopathological and radiographic features.