Presence of Epstein-Barr Virus in Periapical Pathoses: A Systematic Review and Meta-Analysis.

J Endod

Faculty of Dental Sciences, Department of Oral and Maxillofacial Pathology and Microbiology, Banaras Hindu University, Varanasi, Uttar Pradesh, India.

Published: August 2025


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Article Abstract

Background: Periapical lesions, often arising from polymicrobial infections, exhibit varied clinical manifestations. The role of herpes viruses, particularly Epstein-Barr virus (EBV), in the etiopathogenesis of these conditions remains underexplored despite evidence that suggests its involvement in inflammatory processes.

Objective: This systematic review and meta-analysis aimed to evaluate the presence of EBV in periapical diseases and to assess its probable role in their etiopathogenesis.

Material And Methods: Literature searches were conducted across PubMed, Scopus, Web of Science, and Google Scholar until July 2024. Original research that examined the association of EBV in periapical diseases was included for review. The risk of bias for each study was assessed using the modified Newcastle-Ottawa scale and Review Manager 5.4 was used to generate the results.

Results: A total of 31 studies were included for qualitative synthesis, with 15 contributing to quantitative analysis. Findings revealed higher EBV detection rates in periapical lesions, particularly in symptomatic cases and lesions with larger sizes. Meta-analysis using random effects models also affirmed that EBV-positive transcripts significantly enhanced the risk of periapical lesions and symptomatic cases.

Conclusion: This review highlights a significant association between EBV and periapical lesions, particularly in symptomatic cases and larger lesions. The findings warrant further investigation into the mechanisms by which EBV contributes to the pathogenesis of periapical diseases and the implications for clinical management, including potential antiviral therapies.

Prospero Registration Number: CRD4202344796.

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http://dx.doi.org/10.1016/j.joen.2025.05.002DOI Listing

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