Department of Periodontology, School of Dental Medicine, University of Bern, Bern, Switzerland.
Research Section, School of Dental Medicine, University of Bern, Bern, Switzerland.
Clin Oral Investig. 2018 Sep;22(7):2463-2474. doi: 10.1007/s00784-018-2523-x. Epub 2018 Jun 22.
Considering the increasing number of elderly people, dementia has gained an important role in today's society. Although the contributing factors for dementia have not been fully understood, chronic periodontitis (CP) seems to have a possible link to dementia.
To conduct a systematic review including meta-analysis in order to assess potential differences in clinical periodontal variables between patients with dementia and non-demented individuals.
The following focused question was evaluated: is periodontitis associated with dementia? Electronic searches in two databases, MEDLINE and EMBASE, were conducted. Meta-analysis was performed with the collected data in order to find a statistically significant difference in clinical periodontal variables between the group of dementia and the cognitive normal controls.
Forty-two articles remained for full text reading. Finally, seven articles met the inclusion criteria and only five studies provided data suitable for meta-analysis. Periodontal probing depth (PPD), bleeding on probing (BOP), gingival bleeding index (GBI), clinical attachment level (CAL), and plaque index (PI) were included as periodontal variables in the meta-analysis. Each variable revealed a statistically significant difference between the groups. In an attempt to reveal an overall difference between the periodontal variables in dementia patients and non-demented individuals, the chosen variables were transformed into units that resulted in a statistically significant overall difference (p < 0.00001).
The current findings indicate that compared to systemically healthy individuals, demented patients show significantly worse clinical periodontal variables. However, further epidemiological studies including a high numbers of participants, the use of exact definitions both for dementia and chronic periodontitis and adjusted for cofounders is warranted.
These findings appear to support the putative link between CP and dementia. Consequently, the need for periodontal screening and treatment of elderly demented people should be emphasized.
随着老年人数量的增加，痴呆症在当今社会变得越来越重要。尽管痴呆症的致病因素尚未完全了解，但慢性牙周炎（CP）似乎与痴呆症有一定的联系。
进行系统评价和荟萃分析，以评估痴呆症患者与非痴呆症个体之间临床牙周变量的潜在差异。
评估了以下重点问题：牙周炎与痴呆症有关吗？在 MEDLINE 和 EMBASE 两个数据库中进行了电子检索。对收集的数据进行荟萃分析，以寻找痴呆症组和认知正常对照组之间临床牙周变量的统计学显著差异。
有 42 篇文章被保留下来进行全文阅读。最终，有 7 篇文章符合纳入标准，只有 5 项研究提供了适合荟萃分析的数据。牙周探诊深度（PPD）、探诊出血（BOP）、牙龈出血指数（GBI）、临床附着水平（CAL）和菌斑指数（PI）被纳入荟萃分析的牙周变量。每个变量在组间均显示出统计学显著差异。为了揭示痴呆症患者和非痴呆症个体之间牙周变量的总体差异，选择的变量被转换为具有统计学显著总体差异的单位（p<0.00001）。
目前的研究结果表明，与系统性健康个体相比，痴呆症患者的临床牙周变量明显更差。然而，需要进一步进行包括大量参与者的流行病学研究，使用针对痴呆症和慢性牙周炎的确切定义，并调整混杂因素。
这些发现似乎支持 CP 与痴呆症之间的假定联系。因此，应该强调对老年痴呆症患者进行牙周筛查和治疗的必要性。
