Genetic variation involved in the risk to external apical root resorption in orthodontic patients: a systematic review

Objective To perform a systematic review/meta-analysis to elucidate the scientific basis for the association between genetic variations and risk of external apical root resorption (EARR) in orthodontic patients. Materials and methods Four databases (PubMed, Web of Science, Scopus, LILACS) were electronically searched until November 22, 2020, followed by manual and gray literature search. Case-control or cross-sectional studies that evaluated genes involved in the susceptibility of orthodontic patients to EARR were eligible. Two reviewers applied the inclusion and exclusion criteria, extracted qualitative data, as well as assessed methodological quality using instrument proposed for genetic studies. For synthesis results, narrative and quantitative data (meta-analysis) were performed. The certainty of the evidence was tested using the GRADE Working Group approach. Results Of 201 articles in total, 16 studies were included in the review. Of these, 11 presented moderate and 5 of high methodological quality. In the narrative analysis, from 16 studies, 15 studies (10 genes) showed a significant association with EARR and 9 studies were included in the meta-analysis. Only the polymorphism rs208294 in P2RX7 (dominant model) was associated with EARR (OR = 0.52, 95%CI = 0.29-0.95, p = 0.03) and presented a very low certainty of the evidence. Conclusion Narrative analyses of individual studies demonstrated an association of many genes. The number of studies for each genetic variation was very low, and methodological heterogeneity between the studies was observed. Quantitative analyses (meta-analysis) could only show an involvement for P2RX7 (rs208294) in the risk of orthodontic patients to EARR at a very low certainty of evidence. (CRD42018085411).

Automated summary

This systematic review/meta-analysis aimed to explore the scientific basis for the association between genetic variations and risk of external apical root resorption (EARR) in orthodontic patients. Results showed an association of multiple genes with EARR, but with low certainty of evidence and methodological heterogeneity between studies. Quantitative analyses only demonstrated an involvement of P2RX7 (rs208294) in EARR risk with very low certainty of evidence.