Exploring Enamel Hypoplasia and Metabolic Impacts on Dental Structures in Chronic Kidney Disease: A Systematic Review and Meta-Analysis
Background: The loss of mineral homeostasis in patients with chronic kidney disease causes significant dental problems, including enamel hypoplasia and increased tooth damage. The current clinical treatments show an insufficient ability to resolve these metabolic dental complications. This review a...
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ziauddin University
2025-07-01
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| Series: | Pakistan Journal of Medicine and Dentistry |
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| Online Access: | https://ojs.zu.edu.pk/pjmd/article/view/3686 |
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| author | Sadaf Ambreen Amna Farrukh Muhammad Mustafa Ashar Hussain Irum Naz Fatima Ali |
| author_facet | Sadaf Ambreen Amna Farrukh Muhammad Mustafa Ashar Hussain Irum Naz Fatima Ali |
| author_sort | Sadaf Ambreen |
| collection | DOAJ |
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Background: The loss of mineral homeostasis in patients with chronic kidney disease causes significant dental problems, including enamel hypoplasia and increased tooth damage. The current clinical treatments show an insufficient ability to resolve these metabolic dental complications. This review aimed to determine the prevalence, severity, and associated metabolic risk factors of enamel hypoplasia and tooth wear in patients with chronic kidney disease (CKD), and to evaluate the effectiveness of current interventions.
Methods: The present systematic review and meta-analysis were carried out in line with PRISMA 2020 requirements. Thorough research was conducted as far as 2025. The inclusion criteria included human subjects with CKD who were reporting measurable values of enamel hypoplasia, tooth wear, or biomarkers in saliva. Studies were dismissed on the basis of the animal model, the in vitro studies, and unoriginal data. Eight articles were used. Risk of bias was evaluated by the Newcastle-Ottawa tool, and Meta-analyses were being done under the RevMan 5.4.1 utilizing the random-effects models. Dichotomous outcome variables were pooled into odds ratios (ORs) and 95% confidence intervals (CIs) and continuous outcomes standardized mean differences (SMDs). The measure of heterogeneity was represented by the I2 statistic and was visually illustrated by means of forest plots.
Results: In the eight studies identified, the findings were mixed: enamel hypoplasia or mineralization defect, together called CKD-related enamel hypoplasia, had raised DMFT (Decayed, Missing, Filled teeth) index and Developmental Defects of Enamel (DDE) scores in some studies, but not in others. The random-effects pooled analysis proved significant in the difference between the groups, and the compiled odds ratio (OR) was 2.88 (95% CI:1.69 4.91; p < 0.001). Among subgroups of patients with advanced CKD (stage 4 and 5), the effect size was much larger as the OR was 6.05 (95% CI: 2.0118.20; p < 0.001). The result of heterogeneity was about medium (I2 = 65%) in all the studies, but there was no heterogeneity in the subgroup CKD 4 5 (I2 = 0%).
Discussion: CKD produces significant, measurable impacts on dental structures through metabolic pathways. The existing evidence demonstrates this connection but heterogeneous data underlines the necessity for standardizing and conducting multi-site research to enhance appropriate preventive and intervention strategies for these high-risk patients.
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| format | Article |
| id | doaj-art-0c99248acdc34d1b9c5c51e87bfe294f |
| institution | Kabale University |
| issn | 2313-7371 2308-2593 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | ziauddin University |
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| series | Pakistan Journal of Medicine and Dentistry |
| spelling | doaj-art-0c99248acdc34d1b9c5c51e87bfe294f2025-08-20T03:51:29Zengziauddin UniversityPakistan Journal of Medicine and Dentistry2313-73712308-25932025-07-0114310.36283/ziun-pjmd14-3/068Exploring Enamel Hypoplasia and Metabolic Impacts on Dental Structures in Chronic Kidney Disease: A Systematic Review and Meta-AnalysisSadaf Ambreen0Amna Farrukh1Muhammad Mustafa2Ashar Hussain3Irum Naz 4Fatima Ali5Khyber Medical College, Peshawar,Pakistan.Hamdard University Dental Hospital, Karachi, Pakistan.Shahida Islam Dental College, Lodhran Pakistan.Isra University, Hyderabad, Pakistan.Shahida Islam Dental College, Lodhran ,Pakistan.University of ROME, Italy. Background: The loss of mineral homeostasis in patients with chronic kidney disease causes significant dental problems, including enamel hypoplasia and increased tooth damage. The current clinical treatments show an insufficient ability to resolve these metabolic dental complications. This review aimed to determine the prevalence, severity, and associated metabolic risk factors of enamel hypoplasia and tooth wear in patients with chronic kidney disease (CKD), and to evaluate the effectiveness of current interventions. Methods: The present systematic review and meta-analysis were carried out in line with PRISMA 2020 requirements. Thorough research was conducted as far as 2025. The inclusion criteria included human subjects with CKD who were reporting measurable values of enamel hypoplasia, tooth wear, or biomarkers in saliva. Studies were dismissed on the basis of the animal model, the in vitro studies, and unoriginal data. Eight articles were used. Risk of bias was evaluated by the Newcastle-Ottawa tool, and Meta-analyses were being done under the RevMan 5.4.1 utilizing the random-effects models. Dichotomous outcome variables were pooled into odds ratios (ORs) and 95% confidence intervals (CIs) and continuous outcomes standardized mean differences (SMDs). The measure of heterogeneity was represented by the I2 statistic and was visually illustrated by means of forest plots. Results: In the eight studies identified, the findings were mixed: enamel hypoplasia or mineralization defect, together called CKD-related enamel hypoplasia, had raised DMFT (Decayed, Missing, Filled teeth) index and Developmental Defects of Enamel (DDE) scores in some studies, but not in others. The random-effects pooled analysis proved significant in the difference between the groups, and the compiled odds ratio (OR) was 2.88 (95% CI:1.69 4.91; p < 0.001). Among subgroups of patients with advanced CKD (stage 4 and 5), the effect size was much larger as the OR was 6.05 (95% CI: 2.0118.20; p < 0.001). The result of heterogeneity was about medium (I2 = 65%) in all the studies, but there was no heterogeneity in the subgroup CKD 4 5 (I2 = 0%). Discussion: CKD produces significant, measurable impacts on dental structures through metabolic pathways. The existing evidence demonstrates this connection but heterogeneous data underlines the necessity for standardizing and conducting multi-site research to enhance appropriate preventive and intervention strategies for these high-risk patients. https://ojs.zu.edu.pk/pjmd/article/view/3686Chronic Kidney Disease Enamel HypoplasiaTooth Wear Mineral Metabolism DMFT Index Renal Osteodystrophy |
| spellingShingle | Sadaf Ambreen Amna Farrukh Muhammad Mustafa Ashar Hussain Irum Naz Fatima Ali Exploring Enamel Hypoplasia and Metabolic Impacts on Dental Structures in Chronic Kidney Disease: A Systematic Review and Meta-Analysis Pakistan Journal of Medicine and Dentistry Chronic Kidney Disease Enamel Hypoplasia Tooth Wear Mineral Metabolism DMFT Index Renal Osteodystrophy |
| title | Exploring Enamel Hypoplasia and Metabolic Impacts on Dental Structures in Chronic Kidney Disease: A Systematic Review and Meta-Analysis |
| title_full | Exploring Enamel Hypoplasia and Metabolic Impacts on Dental Structures in Chronic Kidney Disease: A Systematic Review and Meta-Analysis |
| title_fullStr | Exploring Enamel Hypoplasia and Metabolic Impacts on Dental Structures in Chronic Kidney Disease: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | Exploring Enamel Hypoplasia and Metabolic Impacts on Dental Structures in Chronic Kidney Disease: A Systematic Review and Meta-Analysis |
| title_short | Exploring Enamel Hypoplasia and Metabolic Impacts on Dental Structures in Chronic Kidney Disease: A Systematic Review and Meta-Analysis |
| title_sort | exploring enamel hypoplasia and metabolic impacts on dental structures in chronic kidney disease a systematic review and meta analysis |
| topic | Chronic Kidney Disease Enamel Hypoplasia Tooth Wear Mineral Metabolism DMFT Index Renal Osteodystrophy |
| url | https://ojs.zu.edu.pk/pjmd/article/view/3686 |
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