Dental X-rays and Meningioma Risk: A 2018 Review & Meta-analysis

Objectives: To determine the risk of developing meningiomas after exposure to dental ionizing radiation at diagnostic levels. This research is based on published studies.
Methods: A systematic review was conducted using databases including PubMed, Medline, Cochrane Library and Scopus. Data extracted from the studies was tabulated and a meta-analysis performed using RevMan 5, a meta-analysis tool provided by Cochrane Reviews.
Results: Nine articles related to the topic that met the criteria for inclusion were included in this systematic review. After evaluating the methodology and statistical analysis of each study, 6 were ultimately included in the meta-analysis. Some articles also reported a history of exposure to different sources of diagnostic ionizing radiation, producing multiple subgroups for a single study. Eight subgroups were created and a total of 8103 cases and 21514 controls were pooled from accepted studies. Forest plots were created using the Review Manager (RevMan) v5.3 software (Cochrane Collaboration, 2012) that produced a weighted Odds Ratio (OR) at the 95% Confidence Interval (CI) of 1.13 (1.06-1.19) for meningioma risk. Regardless of the weighted OR, most of the subgroups reported no increased risk of developing meningioma with exposure to ionizing radiation. A few of the subgroups had an OR greater than 1.00, but their calculated 95% CI crossed below 1.00.
Conclusions: Recent studies have found a positive association between exposure to ionizing radiation and risk of developing meningiomas. However, in 2015 this association was looked at using a meta-analysis of pooled studies and did not find an association. Similarly, in our study no association was found between ionizing radiation and development of meningiomas. The data were weighted heavily for one of subgroups due to a larger patient pool. Regardless of the weight, the majority of subgroups showed no significant association, further strengthening this conclusion.