唐氏综合征患者的牙周病：系统评价。

Periodontal disease in patients with Down syndrome: A systematic review.

出版信息

J Am Dent Assoc. 2018 Jul;149(7):628-639.e11. doi: 10.1016/j.adaj.2018.03.010. Epub 2018 May 18.

DOI:10.1016/j.adaj.2018.03.010

Abstract

BACKGROUND

The authors systematically reviewed the scientific evidence of an association between periodontal disease and Down syndrome (DS).

TYPES OF STUDIES REVIEWED

In this systematic review, the authors included observational studies in which the investigators assessed the prevalence, incidence, or experience of periodontal disease in patients with DS compared with that in healthy patients. The authors used the Population, Exposure, Comparison, Outcome structure. The population was patients of any age, the exposure was the presence of DS, the comparison was the absence of DS, and the outcome was the presence of periodontal disease. The authors conducted an electronic search in 5 databases through March 2017. Two independent reviewers assessed the risk of bias by using the Fowkes and Fulton scale. The authors performed a meta-analysis to compare periodontal disease among patients with DS and those without DS. The authors calculated a summary effect measure-standard mean difference-when evaluating the means of the oral hygiene index. The authors assessed the strength of evidence from the selected studies by using a modified Grading of Recommendations Assessment, Development and Evaluation system.

RESULTS

The authors included 23 case-control studies in the systematic review and submitted 3 to meta-analysis. In the qualitative analysis, results from most studies showed that the prevalence of some periodontal parameters was higher among patients with DS than among those without DS. Evaluations of the Fowkes and Fulton scale point to many methodological problems in the studies evaluated. Results of the meta-analysis revealed no differences between groups with regard to the oral hygiene index (standard mean difference, 0.05; 95% confidence interval, -0.55 to 0.65; I = 0.0%).

CONCLUSIONS AND PRACTICAL IMPLICATIONS

Further research is required, in particular well-designed studies that avoid the deficiencies identified in the studies in this review.

摘要

背景

作者系统地回顾了牙周病与唐氏综合征（DS）之间关联的科学证据。

研究类型综述

在这项系统综述中，作者纳入了观察性研究，其中研究人员评估了 DS 患者与健康患者相比牙周病的患病率、发病率或患病经历。作者使用了人群、暴露、比较、结局结构。人群为任何年龄的患者，暴露为 DS 的存在，比较为 DS 的不存在，结局为牙周病的存在。作者通过电子搜索在 2017 年 3 月前在 5 个数据库中进行了搜索。两名独立的评审员使用 Fowkes 和 Fulton 量表评估了偏倚风险。作者进行了荟萃分析以比较 DS 患者和无 DS 患者的牙周病。作者在评估口腔卫生指数的均值时计算了汇总效应测量-标准均数差。作者使用改良的推荐评估、制定和评估系统评估了选定研究的证据强度。

结果

作者在系统综述中纳入了 23 项病例对照研究，并提交了 3 项进行荟萃分析。在定性分析中，大多数研究的结果表明，DS 患者的某些牙周参数的患病率高于无 DS 患者。对 Fowkes 和 Fulton 量表的评估表明，评估研究中存在许多方法学问题。荟萃分析的结果表明，两组之间在口腔卫生指数方面没有差异（标准均数差，0.05；95%置信区间，-0.55 至 0.65；I = 0.0%）。