Araújo Milena Moreira, Martins Carolina Castro, Costa Lidiane Cristina Machado, Cota Luís Otávio Miranda, Faria Rodrigo Lamounier Araújo Melo, Cunha Fabiano Araújo, Costa Fernando Oliveira
Department of Dental Clinics, Oral Pathology, and Oral Surgery, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Belo Horizonte, Brazil.
J Clin Periodontol. 2016 Mar;43(3):216-28. doi: 10.1111/jcpe.12510. Epub 2016 Mar 6.
The aim of this systematic review and meta-analysis was to assess the scientific evidence on the association between depression and periodontitis.
An electronic search was conducted in three databases until October 2015 (PROSPERO-CRD42014006451). Hand searches and grey literature were also included. Search retrieved 423 potentially studies. Two independent reviewers selected the studies, extracted data and assessed risk bias through a modified version of Newcastle-Ottawa scale. Meta-analysis was performed for the presence/absence of periodontitis (dichotomic). Summary effect measures and odds ratio (OR) 95% CI were calculated.
After selecting the studies, 15 were included in the systematic review (eight cross-sectional, six case-control and one cohort study). Six studies reported that depression was associated with periodontitis, whereas nine studies did not. The majority of studies had low risk of bias by methodological quality assessment. Meta-analysis of seven cross-sectional studies showed no significant association between depression and periodontitis (OR = 1.03, 95% CI = 0.75-1.41).
Findings from the present systematic review showed a great heterogeneity among the studies and the summary effect measure of the meta-analysis cannot affirm an association between depression and periodontitis. Future studies with different designs in distinct populations should be conducted to investigate this association.
本系统评价和荟萃分析旨在评估抑郁症与牙周炎之间关联的科学证据。
截至2015年10月，在三个数据库中进行了电子检索（PROSPERO-CRD42014006451）。还包括手工检索和灰色文献。检索到423项潜在研究。两名独立评审员选择研究、提取数据并通过改良版纽卡斯尔-渥太华量表评估风险偏倚。对是否存在牙周炎（二分法）进行荟萃分析。计算汇总效应量和比值比（OR）95%置信区间。
在选择研究后，15项研究纳入系统评价（8项横断面研究、6项病例对照研究和1项队列研究）。6项研究报告抑郁症与牙周炎有关，而9项研究则未发现关联。根据方法学质量评估，大多数研究的偏倚风险较低。对7项横断面研究的荟萃分析显示抑郁症与牙周炎之间无显著关联（OR = 1.03，95%置信区间 = 0.75 - 1.41）。
本系统评价的结果显示各研究之间存在很大异质性，荟萃分析的汇总效应量不能肯定抑郁症与牙周炎之间存在关联。未来应在不同人群中开展不同设计的研究来调查这种关联。
