Ferreira Rafael, Michel Raphaella Coelho, Greghi Sebastião Luiz Aguiar, Resende Maria Lúcia Rubo de, Sant'Ana Adriana Campos Passanezi, Damante Carla Andreotti, Zangrando Mariana Schutzer Ragghianti
Division of Periodontics, Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil.
PLoS One. 2016 Jun 29;11(6):e0158339. doi: 10.1371/journal.pone.0158339. eCollection 2016.
The aim of this systematic literature review was to evaluate which type of periodontal preventive and therapeutic approaches presents superior outcomes in patients with Down syndrome (DS). Studies reporting different methods of periodontal care from DS patients were considered eligible. Included clinical studies should indicate at least two periodontal parameters in different periods of assessment. Screening of the articles, data extraction and quality assessment were conducted independently and in duplicate. Electronic search according to the PICO search, with both Key-words and MESH terms were conducted in MEDLINE, EMBASE and CENTRAL databases until March 2016. Manual search was conducted in four journals, namely Journal of Periodontology, Journal of Clinical Periodontology, Journal of Periodontal Research and Special Care in Dentistry and their electronic databases were searched. Electronic and manual search resulted in 763 papers, and of them 744 were excluded after title/abstract assessment. The full text of 19 potentially eligible publications was screened and 9 studies met inclusion criteria. The results demonstrated the importance to introduce youngest DS patients in preventive programs, as well as participation of parents, caregivers or institutional attendants in supervising/performing oral hygiene. In studies with higher frequency of attendance, all age groups presented superior preventive and therapeutic results, irrespective of the therapeutic approach used (surgical/nonsurgical/periodontal care program). The important factors for reducing periodontal parameters were the frequency of the appointments and association with chlorhexidine/plaque disclosing agents as adjuvant treatment. This systematic review demonstrated that early introduction in periodontal care, participation of parents/caregivers/institutional attendants, frequency of attendance and association with chemical adjuvants (independently of the periodontal treatment adopted) seems to improve periodontal outcomes in preventive and periodontal treatment of DS patients. Registration number (Prospero): CRD42016038433.
本系统文献综述的目的是评估哪种类型的牙周预防和治疗方法在唐氏综合征（DS）患者中具有更好的效果。报道DS患者不同牙周护理方法的研究被认为符合条件。纳入的临床研究应在不同评估阶段至少表明两个牙周参数。文章筛选、数据提取和质量评估由两人独立进行。根据PICO检索式，使用关键词和医学主题词（MESH）在MEDLINE、EMBASE和CENTRAL数据库中进行电子检索，检索截至2016年3月。在四种期刊上进行了手工检索，即《牙周病学杂志》《临床牙周病学杂志》《牙周病研究杂志》和《牙科特殊护理杂志》，并检索了它们的电子数据库。电子检索和手工检索共得到763篇论文，其中744篇在标题/摘要评估后被排除。对19篇潜在符合条件的出版物的全文进行了筛选，9项研究符合纳入标准。结果表明，将最年幼的DS患者纳入预防计划以及让父母、护理人员或机构护理人员参与监督/进行口腔卫生护理非常重要。在就诊频率较高的研究中，所有年龄组无论采用何种治疗方法（手术/非手术/牙周护理计划）均呈现出更好的预防和治疗效果。降低牙周参数的重要因素是就诊频率以及与洗必泰/菌斑显示剂联合作为辅助治疗。本系统综述表明，早期进行牙周护理、父母/护理人员/机构护理人员的参与、就诊频率以及与化学佐剂联合使用（无论采用何种牙周治疗方法）似乎能改善DS患者牙周预防和治疗的效果。注册号（国际前瞻性系统评价注册库）：CRD42016038433。
