Department of Pediatric Dentistry, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil.
Department of Oral and Maxillofacial Surgery, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil.
Arch Oral Biol. 2018 Mar;87:180-190. doi: 10.1016/j.archoralbio.2017.12.025. Epub 2017 Dec 28.
Studies have observed the presence of extra-intestinal manifestations of celiac disease (CD), including involvement of the oral cavity, such that developmental defects of enamel (DDE) occur. Thus, the aim of this review was to access the polled prevalence of DDE in individuals with CD, and to establish the strength of the association between these two variables.
To carry out the systematic review, four electronic databases and the Grey Literature were searched, complemented by a manual search of reference lists within the selected articles. Two pairs of independent reviewers selected the articles, and perform the data extractions and bias risk assessment Studies evaluating the presence of DDE in individuals with CD as well as in healthy individuals and which performed the DDE diagnosis by direct visualization of tooth enamel changes and the CD diagnosis were included. Meta-analyses were performed using the software R.
Of 557 studies, 45 were selected for review, encompassing 2840 patients. The prevalence of DDE in people with CD was 50% (95% CI 0.44-0.57, I = 88%). In a general analysis, it was observed that patients with CD had a significantly higher prevalence of enamel defects compared to healthy people (RR: 2.31, 95% CI: 1.71-3.12, I = 98%). Only developmental defects of enamel diagnosed using Aine's method were associated with the disease (RR: 3.30, 95% CI 2.39-4.56, I = 75%). In a sensitivity analysis involving the deciduous, mixed and permanent dentitions, only individuals with deciduous dentition were observed to have association with the disease (RR: 2.34, 95% CI 1.25-4.39, I = 39%).
Patients with enamel developmental defects should be screened for the possibility of their having celiac disease.
研究观察到乳糜泻（CD）存在肠外表现，包括口腔受累，从而导致釉质发育不全（DDE）的发生。因此，本研究旨在评估 CD 患者 DDE 的流行率，并确定这两个变量之间的关联强度。
为了进行系统评价，我们检索了四个电子数据库和灰色文献，并对所选文章的参考文献进行了手动检索。由两对独立的审查员对文章进行选择，并进行数据提取和偏倚风险评估。评估 CD 患者和健康个体中 DDE 存在情况，并通过直接观察牙釉质变化诊断 DDE 和 CD 的研究被纳入本研究。使用 R 软件进行荟萃分析。
从 557 篇研究中，有 45 篇被选择进行综述，共纳入 2840 名患者。CD 患者 DDE 的患病率为 50%（95%CI 0.44-0.57，I=88%）。在一般分析中，观察到 CD 患者的釉质缺陷患病率明显高于健康人群（RR：2.31，95%CI：1.71-3.12，I=98%）。只有使用 Aine 方法诊断的发育性牙釉质缺陷与疾病相关（RR：3.30，95%CI 2.39-4.56，I=75%）。在涉及乳牙、混合牙列和恒牙的敏感性分析中，仅观察到患有乳牙的个体与疾病相关（RR：2.34，95%CI 1.25-4.39，I=39%）。
应筛查具有牙釉质发育缺陷的患者，以了解其患有乳糜泻的可能性。
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