Unit of Periodontology, UCL Eastman Dental Institute, London, UK.
National Centre for Cardiovascular Prevention and Outcomes, UCL Institute of Cardiovascular Science, London, UK.
Periodontol 2000. 2018 Oct;78(1):98-128. doi: 10.1111/prd.12239.
The purpose of this paper was to identify and summarize current evidence describing periodontal complications associated with obesity. Electronic searches supplemented with manual searches were carried out to identify relevant systematic reviews. Identification, screening, eligibility, and inclusion of studies were performed independently by two reviewers. A MeaSurement Tool to Assess systematic Reviews (AMSTAR) was used to assess the quality and risk of bias of the included reviews. From 430 titles and abstracts screened, 14 systematic reviews were considered as eligible for inclusion in this meta-review. Eight reviews reported on cross-sectional studies investigating the association of obesity and periodontal diseases, 4 included longitudinal studies, 5 addressed response to periodontal therapy, 5 reported on studies investigating biomarkers, and only 2 were related to pediatric population samples. Systematic review summaries in the various study design domains (cross-sectional, longitudinal and experimental) report that obese individuals are more likely to have periodontal diseases, with more severe periodontal conditions, than nonobese individuals, with cross-sectional evidence congruent with longitudinal studies showing that obesity or weight gain increases the risk of periodontitis onset and progression. Published research on the effect of obesity on responses to periodontal therapy, or systemic or local biomarkers of inflammation, is variable and therefore inconclusive based on the evidence currently available, which suggests that overweight/obesity contributes to periodontal complications independently of other risk factors, such as age, gender, smoking, or ethnicity. This evidence supports the need for risk assessments for individual patients to facilitate personalized approaches in order to prevent and treat periodontal diseases.
本文旨在识别和总结目前描述肥胖相关牙周并发症的证据。通过电子检索和手动检索相结合的方式，对相关系统评价进行了检索。两名评审员独立进行了研究的识别、筛选、资格和纳入。使用评估系统评价的测量工具（AMSTAR）来评估纳入的综述的质量和偏倚风险。从筛选出的 430 个标题和摘要中，有 14 篇系统评价被认为符合纳入本荟萃分析的条件。有 8 篇综述报告了横断面研究，调查肥胖与牙周病的关系，4 篇综述包括纵向研究，5 篇综述涉及牙周治疗的反应，5 篇综述报告了关于生物标志物的研究，只有 2 篇与儿科人群样本有关。在各种研究设计领域（横断面、纵向和实验）的系统评价摘要中报告称，肥胖个体比非肥胖个体更容易患有牙周病，且牙周状况更严重，横断面证据与纵向研究一致，表明肥胖或体重增加会增加牙周炎发病和进展的风险。关于肥胖对牙周治疗反应或全身或局部炎症生物标志物影响的研究结果存在差异，因此根据目前可用的证据尚无法得出结论，这表明超重/肥胖会增加牙周并发症的风险，而与其他风险因素（如年龄、性别、吸烟或种族）无关。这一证据支持对个体患者进行风险评估，以促进个性化治疗方法的应用，从而预防和治疗牙周病。
