Background The existence of an association between cardiovascular diseases (CVDs) and apical periodontitis (AP) remains unclear because results obtained from previous clinical studies and reviews are inconsistent or inconclusive. Objective To conduct an umbrella review to determine whether there is an association between CVDs and the prevalence of the AP in adults. Methods The protocol of the review was registered in the PROSPERO database (CRD42020185753). The literature search was conducted using the following electronic databases: Clarivate Analytics’ Web of Science Scopus, PubMed, and Cochrane Database of Systematic Reviews (CDSR), from inception to May, 2020, with no language restrictions. Systematic reviews with or without meta‐analysis that evaluated the association between CVDs and AP were included. Other types of studies, including narrative reviews, were excluded. Two reviewers independently performed a literature search, data extraction, and quality assessment of included studies. Any disagreements or doubts were resolved by a third reviewer. The quality of the reviews was assessed using the AMSTAR 2 tool (A measurement tool to assess systematic reviews), with 16 items. A final categorization of the systematic reviews classified each as of “high” , “moderate” , “low” , or “critically low” quality. Results Four systematic reviews were included in the current review. Three reviews were graded by AMSTAR 2 as “moderate ” quality, whereas one review was graded as “critically low ” quality. Discussion Only one systematic review included a meta‐analysis. Substantial heterogeneity amongst the primary studies included within each systematic review was notable in preventing pooled analysis. Conclusions From the limited and moderate to low quality evidence available, the current umbrella review concluded that a weak association exists between CVDs and AP. In future, well‐designed, longitudinal clinical studies with long‐term follow‐up are required.

Background: The association between adverse pregnancy outcomes (APOs) and maternal apical periodontitis remains unclear as it has not been examined rigorously or reviewed systematically.Objective: To systematically review and critically evaluate the available evidence on the association of maternal apical periodontitis with several APOs.Methods: A literature search was conducted using the following electronic databases: Clarivate Analytics’ Web of Science, Scopus, PubMed, and Cochrane Central Register of Controlled Trials (CENTRAL), from inception to 25 February 2021, with no language restrictions. Observational studies including longitudinal clinical trials, cohort, case–control and cross‐sectional studies of prospective and retrospective design were included. Articles with duplicate or overlapping results, abstract‐only papers, case reports, case series, animal studies and reviews were excluded. Two independent reviewers were involved in study selection, data extraction and appraising the included studies; disagreements were resolved by a third reviewer. The Newcastle–Ottawa Scale (NOS) and the adapted form of the NOS were used to assess the quality for case–control and cross‐sectional studies, respectively.Results: Two case–control and one cross‐sectional study were included in the current review. The included studies were published between 2015 and 2017, with a total of 1187 participating individuals with an approximate age range of 15 to 40 years. As the included studies reported different outcomes, the heterogeneity of data prevented a meta‐analysis being undertaken. The overall quality of the evidence was ‘Fair’ for two out of three included studies, while one study was categorized as ‘Good’.Discussion: Two out of three included primary studies had a substantial number of methodological inconsistencies and flaws, and therefore caution should be exercised in interpreting the results of this systematic review because several important covariates were not considered in the original investigations.Conclusion: Based on a limited volume and ‘Fair’ and ‘Good’ quality of evidence, a positive association between maternal apical periodontitis and APOs was observed. However, more ‘Good’ quality clinical studies are needed to confirm the results of the current review.Funding: NoneRegistration: PROSPERO database (CRD42‐2191987)