Leite Fábio R M, Nascimento Gustavo G, Demarco Flávio F, Gomes Brenda P F A, Pucci Cesar R, Martinho Frederico C
Department of Semiology and Clinics, Postgraduate Program in Dentistry, UFPel, Federal University of Pelotas, School of Dentistry, Pelotas, Rio Grande do Sul, Brazil.
Department of Restorative Dentistry, Postgraduate Program in Dentistry, UFPel, Federal University of Pelotas, School of Dentistry, Pelotas, Rio Grande do Sul, Brazil.
J Endod. 2015 May;41(5):579-87. doi: 10.1016/j.joen.2015.01.020. Epub 2015 Mar 17.
This systematic review and meta-regression analysis aimed to calculate a combined prevalence estimate and evaluate the prevalence of different Treponema species in primary and secondary endodontic infections, including symptomatic and asymptomatic cases.
The MEDLINE/PubMed, Embase, Scielo, Web of Knowledge, and Scopus databases were searched without starting date restriction up to and including March 2014. Only reports in English were included. The selected literature was reviewed by 2 authors and classified as suitable or not to be included in this review. Lists were compared, and, in case of disagreements, decisions were made after a discussion based on inclusion and exclusion criteria. A pooled prevalence of Treponema species in endodontic infections was estimated. Additionally, a meta-regression analysis was performed.
Among the 265 articles identified in the initial search, only 51 were included in the final analysis. The studies were classified into 2 different groups according to the type of endodontic infection and whether it was an exclusively primary/secondary study (n = 36) or a primary/secondary comparison (n = 15). The pooled prevalence of Treponema species was 41.5% (95% confidence interval, 35.9-47.0). In the multivariate model of meta-regression analysis, primary endodontic infections (P < .001), acute apical abscess, symptomatic apical periodontitis (P < .001), and concomitant presence of 2 or more species (P = .028) explained the heterogeneity regarding the prevalence rates of Treponema species.
Our findings suggest that Treponema species are important pathogens involved in endodontic infections, particularly in cases of primary and acute infections.
本系统评价和Meta回归分析旨在计算合并患病率估计值，并评估不同密螺旋体物种在牙髓病感染中的患病率，包括有症状和无症状病例。
检索MEDLINE/PubMed、Embase、Scielo、Web of Knowledge和Scopus数据库，检索时间无起始日期限制，截至并包括2014年3月。仅纳入英文报告。由2位作者对所选文献进行评审，并分类为适合或不适合纳入本评价。对列表进行比较，如有分歧，则根据纳入和排除标准进行讨论后做出决定。估计牙髓病感染中密螺旋体物种的合并患病率。此外，进行了Meta回归分析。
在初始检索中识别出的265篇文章中，最终分析仅纳入51篇。根据牙髓病感染类型以及它是单纯的原发性/继发性研究（n = 36）还是原发性/继发性比较（n = 15），将这些研究分为2个不同组。密螺旋体物种的合并患病率为41.5%（95%置信区间，35.9 - 47.0）。在Meta回归分析的多变量模型中，原发性牙髓病感染（P <.001）、急性根尖脓肿、有症状的根尖周炎（P <.001）以及2种或更多种物种的同时存在（P =.028）解释了密螺旋体物种患病率的异质性。
我们的研究结果表明，密螺旋体物种是参与牙髓病感染的重要病原体，特别是在原发性和急性感染病例中。
