This systematic review assessed the success rates of endodontic treatment in HIV-positive (HIV+) patients. Registered in PROSPERO (CRD42020216495), the study addressed whether success rates differ between HIV+ and non-HIV patients. Two reviewers searched Medline-PubMed, Scopus, Web of Science, EMBASE, and Lilacs. Eligibility criteria included studies evaluating primary endodontic treatment success with at least 12 months of follow-up. Risk of bias was assessed using the Newcastle-Ottawa scale, and evidence certainty was measured with the GRADE approach. From 252 studies, four case-control studies (282 individuals) met the criteria. Three studies focused on teeth with pulp necrosis and chronic apical periodontitis, while one included pulp necrosis and irreversible pulpitis. The success rate was 89.67% for HIV+ patients and 94.13% for non-HIV patients, with no significant differences between groups. The evidence had a very low certainty level. Findings suggest similar endodontic treatment success rates in HIV+ and non-HIV individuals, but the low certainty of evidence must be considered. PROSPERO - CRD42020216495.
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