SynthesisInternational dental journal2026
Effects of Antibiotics and Anti-Inflammatory Drugs on Enamel Development: A Systematic Review with Quantitative Synthesis.
Synthesis in International dental journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Presumptive Bilirubin-Related Chlorodontia and Developmental Enamel Defects of the Primary Dentition in an Extremely Preterm Infant: A Case Report.Journal of clinical medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the effects of commonly prescribed antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDs) during early life on enamel development through a systematic review with quantitative synthesis.
methodsPubMed, Web of Science, Embase, CINAHL, and Scopus were searched for English-language studies published between 1995 and 2024. In vitro and in vivo experimental studies evaluating antibiotics and/or NSAIDs during tooth development were included. Quantitative meta-analysis was restricted to in vivo animal studies reporting comparable outcomes for enamel thickness or mineral content, while in vitro studies contributed to qualitative mechanistic synthesis. Studies focusing solely on dentine, using questionnaires, lacking extractable data, or classified as grey literature or reviews were excluded.
resultsExperimental exposure to antibiotics and NSAIDs was associated with alterations in ameloblast morphology and function, including changes in tight junction proteins, MMP-20, KLK4, COX-2, and Runx2 expression. Enamel matrix abnormalities such as vacuolar changes and cyst-like lesions were frequently reported. Quantitative synthesis indicated a moderate-to-large pooled effect estimate for reduced enamel thickness associated with amoxicillin exposure (Cohen's d = 0.79, 95% CI: 0.40-1.36), with a trend toward larger effect sizes at higher experimental doses; these estimates were interpreted cautiously due to substantial heterogeneity. NSAIDs were primarily associated with qualitative disturbances in enamel mineralization. Pooled effect estimates for calcium (Cohen's d = 0.52, 95% CI: -0.21 to 1.46) and phosphorus (Cohen's d = 0.46, 95% CI: -0.31 to 1.75) were inconsistent and imprecise.
conclusionsCertain antibiotics and NSAIDs may disrupt ameloblast integrity and enamel biomineralization in experimental animal models. These findings are hypothesis-generating, and further well-designed human observational and mechanistic studies are required before clinical translation. CLINICAL RELEVANCE: This systematic review synthesizes experimental evidence on the biological vulnerability of developing enamel to pharmacological exposure, highlighting potential mechanisms underlying enamel thinning and hypomineralization while underscoring the need for cautious interpretation when extrapolating animal data to human clinical contexts. PROSPERO Registration No.: CRD42025606606.
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