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夜间佩戴假牙对睡眠质量的影响:一项系统评价与荟萃分析。

The effect of nocturnal wear of dentures on the sleep quality: a systematic review and meta-analysis.

作者信息

Emami Elham, Nguyen Huy Phan The, Rompré Pierre, Lavigne Gilles J, Huynh Nelly T

机构信息

Faculty of Dentistry, Pavillon Roger-Gaudry, Université de Montréal, C.P. 6128, succ. Centre-ville, Montreal, Quebec, H3C 3J7, Canada.

School of Public Health, Université de Montréal, 7101, avenue du Parc, 3e étage Montréal, Montreal, Québec, H3N 1X9, Canada.

出版信息

Sleep Breath. 2017 Mar;21(1):9-18. doi: 10.1007/s11325-016-1369-1. Epub 2016 Jun 25.

Abstract

PURPOSE

The effect of nocturnal wear of denture on sleep quality and integrity is still not well understood. Therefore, this systematic review was conducted to provide evidence on this topic.

METHODS

Electronic searches were conducted from 1964 up to September 2015, using MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials. Only publications in English or French, in which sleep quality of edentate adult individuals wearing dentures at night was compared to those not wearing were included in the review. Random effects models were used to pool the effect sizes.

RESULTS

A total of 10 studies were included in the systematic review and 5 in the meta-analysis. No statistically significant difference between sleeping with denture and without denture was found for the Apnea-Hypopnea Index (AHI; Standard Mean Difference = -0.60, 95 % CI -1.67-0.47; Z = -1.10; p = 0.27). However, there was considerable heterogeneity in the studies included in the meta-analysis (Tau = 1.34; Q-value = 59.32, df = 4 (P < 0.0001); I = 93.3 %). When results from randomized controlled trials (RCTs) were pooled in subgroup analyses of AHI, there was a tendency towards favoring sleeping without dentures (P = 0.059) and no evidence of heterogeneity between studies (Tau = 0.000; Q-value = 0.06, df = 1 (P = 0.80); I = 0.000 %).

CONCLUSION

The current evidence suggests that there is no difference in the sleep quality and integrity of individuals wearing or not wearing their denture during sleep. However, the results of randomized controlled trials favoring sleeping without dentures and the likely presence of bias in the previous studies indicate the need for further randomized controlled trials for the development of clinical guideline.

摘要

目的

夜间佩戴假牙对睡眠质量和完整性的影响仍未得到充分理解。因此,进行了这项系统评价以提供关于该主题的证据。

方法

从1964年至2015年9月进行电子检索,使用MEDLINE、EMBASE和Cochrane对照试验中央注册库。纳入本评价的仅为英文或法文出版物,其中比较了夜间佩戴假牙的无牙成年个体与未佩戴假牙个体的睡眠质量。采用随机效应模型合并效应量。

结果

系统评价共纳入10项研究,荟萃分析纳入5项研究。对于呼吸暂停低通气指数(AHI;标准均差=-0.60,95%可信区间-1.67至0.47;Z=-1.10;p=0.27),佩戴假牙睡眠与不佩戴假牙睡眠之间未发现统计学显著差异。然而,荟萃分析中纳入的研究存在相当大的异质性(Tau=1.34;Q值=59.32,自由度=4(P<0.0001);I=93.3%)。当在AHI的亚组分析中汇总随机对照试验(RCT)的结果时,有不佩戴假牙睡眠更有利的趋势(P=0.059),且研究之间无异质性证据(Tau=0.000;Q值=0.06,自由度=1(P=0.80);I=0.000%)。

结论

当前证据表明,睡眠期间佩戴或不佩戴假牙的个体在睡眠质量和完整性方面没有差异。然而,随机对照试验的结果支持不佩戴假牙睡眠,且先前研究可能存在偏倚,这表明需要进一步进行随机对照试验以制定临床指南。

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