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No language restriction was applied. Two independent reviewers first screened titles and abstracts and then the full texts that were initially included. The reference lists of the identified publications were examined for additional titles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 33 papers were identified. <jats:italic>In vitro<\/jats:italic> studies (<jats:italic>N<\/jats:italic>\u00a0=\u00a011) revealed that pulpal cells can be stimulated by various inflammatory agents to produce <jats:styled-content style=\"fixed-case\">RANKL<\/jats:styled-content>, whilst many studies did not consider the <jats:styled-content style=\"fixed-case\">RANKL<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">OPG<\/jats:styled-content> ratio. Animal studies (<jats:italic>N<\/jats:italic>\u00a0=\u00a09) mostly focused on the time course and development of periapical lesions in relation to the <jats:styled-content style=\"fixed-case\">RANKL<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">OPG<\/jats:styled-content> system. Levels of <jats:styled-content style=\"fixed-case\">RANKL<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">OPG<\/jats:styled-content> in the necrotizing pulp were not investigated. Human studies (<jats:italic>N<\/jats:italic>\u00a0=\u00a013) showed a steady\u2010state expression of <jats:styled-content style=\"fixed-case\">OPG<\/jats:styled-content> in the odontoblast layer. Conflicting results have been reported regarding the role of <jats:styled-content style=\"fixed-case\">RANKL<\/jats:styled-content> in active apical periodontitis, again because the correlation of this molecule with its inhibitor (<jats:styled-content style=\"fixed-case\">OPG<\/jats:styled-content>) was often disregarded.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is relatively little information currently available that would highlight the specific role of <jats:styled-content style=\"fixed-case\">RANKL<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">OPG<\/jats:styled-content> in pulpal and periapical disease. <jats:styled-content style=\"fixed-case\">OPG<\/jats:styled-content> may play a protective role against internal resorption, whilst an increased periapical <jats:styled-content style=\"fixed-case\">RANKL<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">OPG<\/jats:styled-content> ratio might indicate bone resorption.<\/jats:p><\/jats:sec>","DOI":"10.1111\/j.1365-2591.2012.02105.x","type":"journal-article","created":{"date-parts":[[2012,7,9]],"date-time":"2012-07-09T13:45:18Z","timestamp":1341841518000},"page":"99-111","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["The receptor activator of <scp>NF<\/scp>\u2010\u03ba<scp>B<\/scp> ligand\u2010osteoprotegerin system in pulpal and periapical disease"],"prefix":"10.1111","volume":"46","author":[{"given":"G. 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