Non-Cochrane · intervention · PM41825436
Effects of Antibiotics and Anti-Inflammatory Drugs on Enamel Development: A Systematic Review with Quantitative Synthesis.
Zamri Nadia, Ngo Hien, Court Elizabeth, et al. · International dental journal · 2026 · PubMed · doi:10.1016/j.identj.2026.109478
Findings
3 findings
| Population | ||||
|---|---|---|---|---|
| Developing enamel in experimental animals (rats, mice) | Amoxicillin, amoxicillin plus clavulanate, or amoxicillin plus NaF | No medication (control) | Enamel thickness Exposure during enamel development | SMD (Cohen's d) 0.79 [0.40, 1.36] GRADE not reported 5 studies |
| Developing enamel in experimental animals (mice) | Antibiotics (amoxicillin, amoxicillin plus clavulanate, erythromycin) and anti-inflammatory drugs (celecoxib, indomethacin, ibuprofen, acetaminophen) | No medication (control) | Enamel phosphorus content Exposure during enamel development | SMD (Cohen's d) 0.46 [-0.31, 1.75] GRADE not reported 4 studies |
| Developing enamel in experimental animals (mice) | Antibiotics (amoxicillin, amoxicillin plus clavulanate, erythromycin) and anti-inflammatory drugs (celecoxib, indomethacin, ibuprofen, acetaminophen) | No medication (control) | Enamel calcium content Exposure during enamel development | SMD (Cohen's d) 0.52 [-0.21, 1.46] GRADE not reported 4 studies |
Included primary studies 12
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Abe 2003 Effects of a Macrolide Antibiotic on Enamel Formation in Rat Incisors-Primary Lesion of Ameloblast at the Transition Stage DOI:10.1292/jvms.65.985 | 2003 | this review only | not stated | not extracted yet |
| de Souza 2016 Amoxicillin diminishes the thickness of the enamel matrix that is deposited during the secretory stage in rats DOI:10.1111/ipd.12184 | 2015 | this review only | Enamel thickness | not extracted yet |
| Feltrin-Souza 2021 In vivo effect of fluoride combined with amoxicillin on enamel development in rats DOI:10.1590/1678-7757-2021-0171 | 2021 | this review only | Enamel thickness | not extracted yet |
| Gao 2020 Effects of applying amoxicillin in juvenile mice on enamel mineralization and the expression of kallikrein‑related peptidase 4 and tight… PMID:32626909 | 2020 | this review only | Enamel calcium content; Enamel phosphorus content | not extracted yet |
| Goncalves 2022 Enamel biomineralization under the effects of indomethacin and celecoxib non-steroidal anti-inflammatory drugs DOI:10.1038/s41598-022-19583-w | 2022 | this review only | Enamel calcium content; Enamel phosphorus content | not extracted yet |
| Gottberg 2014 Prenatal effects by exposing to amoxicillin on dental enamel in Wistar rats. PMID:24121904 | 2014 | this review only | not stated | not extracted yet |
| Kameli 2019 Effects of Amoxicillin on the Structure and Mineralization of Dental Enamel and Dentin in Wistar Rats DOI:10.18502/fid.v16i2.1364 | 2019 | this review only | Enamel thickness | not extracted yet |
| Mihalas 2016 The Role of Chronic Exposure to Amoxicillin/Clavulanic Acid on the Developmental Enamel Defects in Mice DOI:10.1177/0192623315610822 | 2015 | this review only | Enamel calcium content; Enamel phosphorus content | not extracted yet |
| Sabah 2023 Evaluation of the Effects of Amoxicillin on Tooth Development in Rats by Histological and Histomorphometric Study DOI:10.32592/ari.2023.78.4.1333 | 2022 | this review only | Enamel thickness | not extracted yet |
| Sahlberg 2013 Combined effect of amoxicillin and sodium fluoride on the structure of developing mouse enamel in vitro DOI:10.1016/j.archoralbio.2013.03.007 | 2013 | this review only | Enamel thickness | not extracted yet |
| Schmalfuss 2022 Effects of antibiotics on the developing enamel in neonatal mice DOI:10.1007/s40368-021-00677-4 | 2021 | this review only | not stated | not extracted yet |
| Serna Munoz 2018 Effect of antibiotics and NSAIDs on cyclooxygenase-2 in the enamel mineralization DOI:10.1038/s41598-018-22607-z | 2018 | this review only | Enamel calcium content; Enamel phosphorus content | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Developing enamel (animal and in vitro models) | Rats and mice; tooth germ culture (n=12 studies) |
| Intervention | NSAIDs, acetaminophen, amoxicillin, amoxicillin+clavulanate, ampicillin, gentamicin, macrolides, tetracycline, azithromycin, alone or with fluoride | Amoxicillin, amoxicillin+clavulanate, ampicillin, gentamicin, erythromycin, macrolide, tetracycline, celecoxib, indomethacin, ibuprofen, acetaminophen, NaF |
| Comparison | No medication | Untreated or saline control |
| Outcomes | Ameloblast morphology; enamel matrix proteins and enzymes; enamel mineralization (Ca, P); enamel thickness | Enamel thickness (5 studies); Ca and P (4 studies); qualitative ameloblast and matrix outcomes |
| Study designs | In vitro and in vivo experimental studies | 12 experimental studies (in vivo animal and one in vitro) |
| Timing | Not specified | Not specified |