Enamel defects in children with celiac disease: A systematic review

Celiac disease (CD) is a chronic autoimmune enteropathy triggered by gluten ingestion, affecting 1% of the global population. Oral manifestations, including enamel defects (ED), are common and may serve as early diagnostic markers. This systematic review aims to analyze the prevalence of ED in children with CD compared to healthy controls. Following the PRISMA guidelines, a comprehensive search was conducted across 13 electronic databases (PubMed, Scopus, Sci-enceDirect, Google Scholar, Web of Science, Ovid, BMJ evidence-based medicine, proQuest, Grey-lit. org, Ethos, Lilivo, Clinical trials gov, Meta register of controlled trials) to identify relevant studies according to specific eligibility criteria. The PECO question was formulated as follows: Population: human subjects ≤18 years old; Exposure: diagnosed with CD; Comparison: healthy controls; Outcome: prevalence of ED. Two independent reviewers screened and selected studies, performed data extraction, and assessed the risk of bias using the MINORS tool. The initial search yielded 2374 articles. A total of 20 studies met all the eligibility criteria. The findings consistently demonstrated a significantly higher likelihood of ED in children with CD. The MINORS tool indicates generally moderate to high methodological quality across the included studies. Children diagnosed with CD have a statistically significant higher chance of exhibiting ED compared to healthy controls. Pediatric dentists play a crucial role in early detection, aiding in the timely diagnosis and management of CD.