Protocol for a systematic review and meta-analysis of the prevalence of viral infections in acute apical abscesses.

Background: There is no current consensus on the presence of viral infections in acute apical abscesses; therefore, this protocol for a systematic review and meta-analysis is designed to detail the procedures required to investigate the prevalence of viral infections in acute apical abscesses, a common dental condition characterized by pus accumulation due to bacterial infection. Viral infections in oral tissues have been linked to systemic health risks, including chronic inflammation and oncogenesis, which further emphasize the importance of understanding their role in acute apical abscesses.

Methods/design: We adopted a systematic review and meta-analysis protocol design followed by PRISMA guidelines. A priori protocol was registered in PROSPERO with registry number: CRD42023468287. Inclusion criteria will be established according to the PICO framework; hence, we will include original articles with no restriction on publication date or population group. The selective screening of information will be conducted by peers, starting with titles, abstracts, and keywords, and finally reviewing the full text. The risk of bias will be assessed using the ROBINS tool, and the certainty of the evidence will be evaluated following the GRADE guidelines. We will perform a random-effects meta-analysis, utilizing the Freeman-Tukey double arcsine transformation, to estimate the pooled prevalence of viral infections in acute apical abscesses, assess heterogeneity using the Q-test and I² statistic, evaluate potential publication bias with funnel plots and Egger's test, and conduct sensitivity analyses to ensure robust results.

Discussion: At present, no consensus exists regarding the prevalence of viral infections in acute apical abscesses that could inform clinical dental practice. Moreover, the existing body of knowledge on this subject is notably limited. This approach is intended to provide data that will facilitate the improvement of clinical practice and serve as a methodological framework for studying various pathologies. By elucidating the prevalence of viral infections, the findings of this study could enhance diagnostic accuracy and inform more targeted and effective treatment strategies, ultimately improving patient outcomes.