Exploring Enamel Hypoplasia and Metabolic Impacts on Dental Structures in Chronic Kidney Disease: A Systematic Review and Meta-Analysis
DOI:
https://doi.org/10.36283/ziun-pjmd14-3/068Keywords:
Chronic Kidney Disease , Enamel Hypoplasia, Tooth Wear , Mineral Metabolism , DMFT Index , Renal Osteodystrophy , Oral Manifestations, Systematic Review, Meta-AnalysisAbstract
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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