Unité de Médecine Bucco-Dentaire, Hôpital Pellegrin, CHU de Bordeaux, Bordeaux, France.
Laboratoire BioTis, Inserm 1026, Université de Bordeaux, Bordeaux, France.
J Oral Pathol Med. 2018 Oct;47(9):808-815. doi: 10.1111/jop.12739. Epub 2018 Jul 5.
Oropharyngeal features are frequent and often understated in the treatment clinical guidelines of systemic sclerosis in spite of important consequences on comfort, aesthetics, nutrition and daily life. The aim of this systematic review was to assess a correlation between the oropharyngeal manifestations of systemic sclerosis and patients' health-related quality of life.
A systematic search was conducted using four databases [PubMed , Cochrane Database , Dentistry & Oral Sciences Source and SCOPUS ] up to January 2018, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Grey literature and hand search were also included. Study selection, risk bias assessment (Newcastle-Ottawa scale) and data extraction were performed by two independent reviewers. The review protocol was registered on PROSPERO database with the code CRD42018085994.
From 375 screened studies, 6 cross-sectional studies were included in the systematic review. The total number of patients included per study ranged from 84 to 178. These studies reported a statistically significant association between oropharyngeal manifestations of systemic sclerosis (mainly assessed by maximal mouth opening and the Mouth Handicap in Systemic Sclerosis Scale) and an impaired quality of life (measured by different scales). Studies were unequal concerning risk of bias mostly because of low level of evidence, different recruiting sources of samples and different scales to assess the quality of life.
This systematic review demonstrates a correlation between oropharyngeal manifestations of systemic sclerosis and impaired quality of life, despite the low level of evidence of included studies. Large-scaled studies are needed to provide stronger evidence of this association.
尽管口咽表现对舒适度、美观、营养和日常生活有重要影响，但在系统性硬化症的系统治疗临床指南中，这些表现常常被忽视。本系统评价的目的是评估系统性硬化症的口咽表现与患者健康相关生活质量之间的相关性。
根据系统评价和荟萃分析的首选报告项目，我们使用四个数据库[PubMed、Cochrane 数据库、牙科学和口腔科学来源以及 SCOPUS]进行了系统搜索，截至 2018 年 1 月。灰色文献和手工搜索也被包括在内。由两名独立的审查员进行研究选择、风险偏倚评估（纽卡斯尔-渥太华量表）和数据提取。该综述方案在 PROSPERO 数据库中以注册号 CRD42018085994 进行了注册。
从 375 项筛选研究中，共纳入 6 项横断面研究进行系统评价。每项研究纳入的患者人数从 84 到 178 不等。这些研究报告了系统性硬化症的口咽表现（主要通过最大张口度和系统性硬化症口手残疾量表评估）与生活质量受损之间存在统计学显著关联（通过不同的量表评估）。由于证据水平低、样本来源不同以及评估生活质量的量表不同，研究存在偏倚风险的不平等。
本系统评价表明，系统性硬化症的口咽表现与生活质量受损之间存在相关性，尽管纳入研究的证据水平较低。需要进行大规模研究以提供更有力的证据支持这一关联。
