1 Australian Research Centre for Population Oral Health, School of Dentistry, The University of Adelaide, South Australia, Australia.
J Dent Res. 2017 Jul;96(8):864-874. doi: 10.1177/0022034517709737. Epub 2017 Jun 5.
The objective of this study was to verify whether oral conditions (tooth loss, periodontal disease, dental caries) are negatively associated with health-related quality of life (HRQoL) in adults. A search was carried out on PubMed, EMBASE, Web of Science, Scopus, SciELO, and LILACS databases until the end of July 2016 with no date restrictions. Quantitative observational studies written in English were included and data extraction was performed independently by 2 reviewers. HRQoL was investigated as the outcome, and tooth loss, periodontal diseases, and dental caries were exposures. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used and the quality of the selected studies was assessed by using the Joanna Briggs Institute Meta-Analysis of Statistics assessment and review instrument (JBI-MAStARI). Twenty-one studies were included. The sample sizes ranged from 88 to 15,501 subjects; 20 studies were cross-sectional designs, while 1 was a case-control study. Case definitions of the exposures were different across the studies, mainly for tooth loss, which was defined according to 11 different criteria. Fifteen studies were of "high" and 6 of "medium" quality. Eight HRQoL instruments were identified, and the most frequent was the EuroQol ( n = 8). Ten of 16 studies reported a negative impact of tooth loss on HRQoL. Four of 7 studies reported that periodontal disease impairs HRQoL, and 1 study showed that periodontal disease is positively associated with HRQoL. All studies that assessed dental caries reported a negative association between this condition and HRQoL. Despite the different definitions and measures of tooth loss and dental caries, the majority of the available evidence reported a negative impact of these conditions on HRQoL. Mixed and inconclusive findings were observed for the association between periodontal disease and HRQoL. Longitudinal prospective studies are suggested to improve the strength of the findings.
本研究旨在验证口腔状况（牙齿缺失、牙周病、龋齿）是否与成年人的健康相关生活质量（HRQoL）呈负相关。我们在 PubMed、EMBASE、Web of Science、Scopus、SciELO 和 LILACS 数据库中进行了检索，检索时间截至 2016 年 7 月底，未对检索时间设限。纳入的研究为英文撰写的定量观察性研究，由 2 名评审员独立进行数据提取。将 HRQoL 作为研究结果，牙齿缺失、牙周病和龋齿作为暴露因素。我们使用了《系统评价和荟萃分析的首选报告项目》（PRISMA）指南，并使用 Joanna Briggs 研究所荟萃分析统计评估和审查工具（JBI-MAStARI）评估了所选研究的质量。共纳入 21 项研究。样本量范围为 88 至 15501 例；20 项研究为横断面设计，1 项为病例对照研究。暴露因素的病例定义在不同研究中存在差异，主要是牙齿缺失，其定义依据了 11 种不同的标准。15 项研究为“高质量”，6 项为“中质量”。共确定了 8 种 HRQoL 工具，其中最常用的是 EuroQol（n=8）。16 项研究中有 10 项报告了牙齿缺失对 HRQoL 的负面影响。7 项研究中有 4 项报告牙周病会损害 HRQoL，1 项研究表明牙周病与 HRQoL 呈正相关。所有评估龋齿的研究均报告了这种疾病与 HRQoL 之间存在负相关。尽管牙齿缺失和龋齿的定义和测量方法不同，但现有大多数证据均报告了这些状况对 HRQoL 的负面影响。牙周病与 HRQoL 之间的关联存在混合和不确定的结果。建议开展前瞻性纵向研究以提高研究结果的可信度。
