Department for Evidence-based Medicine and Clinical Epidemiology, University for Continuing Education Krems (Danube University Krems), Dr. Karl Dorrek Str. 30, 3500, Krems, Austria.
Universitätszahnklinik Wien GmbH (School of Dentistry Vienna), Sensengasse 2a, 1090, Vienna, Austria.
Syst Rev. 2019 Feb 25;8(1):61. doi: 10.1186/s13643-019-0977-9.
Periodontal diseases are responsible for a vast burden of disease globally and are associated with other severe illnesses such as cardiovascular diseases or diabetes. Tests for early diagnosis of periodontal diseases and effective treatments are available. The effectiveness of screening for periodontal diseases to detect periodontal diseases at an early stage during periodic health examinations at primary care facilities, however, is unclear. The objective of this systematic review is to assess the benefits and risks of screening for periodontal diseases in adults during the periodic health examinations.
We will use two methodological approaches: (1) a systematic review to assess the effectiveness and risk of harms of screening for periodontal diseases during periodic health examinations and (2) an overview of systematic reviews to determine the effectiveness of treatment approaches for early periodontal disease. We will search electronic databases (Ovid MEDLINE, Embase.com , the Cochrane Library, Epistemonikos, Centre for Reviews and Dissemination databases, PubMed (non-MEDLINE content)) for published studies as well as sources for grey literature to detect unpublished studies. Two authors will independently screen abstracts and full texts using pre-defined eligibility criteria, select studies, extract data, and assess the risk of bias of included studies or reviews. In general, we will conduct a systematic narrative synthesis. Criteria for conducting meta-analyses were defined a priori. Our primary outcomes of interest are tooth loss, loosening of teeth, and depletion of bone tissue. Secondary outcomes are gingivitis/gum inflammation, pocket depths, dental hygiene, lifestyle modifications (e.g., smoking, alcohol, nutrition), and toothache. We consulted a panel of experts and patient representatives to prioritize these outcomes. Two investigators will assess independently the certainty of the evidence for each outcome using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach.
We anticipate that our review will highlight the gaps in the available evidence about the effectiveness of screening for periodontal diseases during periodic health examinations. Implications for screening programs may be based on linked evidence about the validity of available screening tools and the effectiveness of early treatment.
PROSPERO CRD42017081150.
牙周病在全球范围内造成了巨大的疾病负担，并且与其他严重疾病如心血管疾病或糖尿病有关。目前已有用于早期诊断牙周病和有效治疗的方法。然而，在基层医疗机构的定期健康检查中，通过筛查来早期发现牙周病的效果尚不清楚。本系统评价的目的是评估在成年人的定期健康检查中筛查牙周病的获益与风险。
我们将采用两种方法学途径：（1）系统评价，评估在定期健康检查中筛查牙周病的有效性和危害风险；（2）系统评价概述，以确定早期牙周病治疗方法的有效性。我们将检索电子数据库（Ovid MEDLINE、Embase.com、Cochrane 图书馆、Epistemonikos、Cochrane 中心评价和传播数据库、PubMed（非 MEDLINE 内容））和灰色文献来源，以发现未发表的研究。两名作者将根据预先设定的纳入标准，独立筛选摘要和全文，选择研究，提取数据，并评估纳入研究或综述的偏倚风险。一般情况下，我们将进行系统的叙述性综合。事先定义了进行荟萃分析的标准。我们主要关注的结局指标是牙齿缺失、牙齿松动和骨组织流失。次要结局指标包括牙龈炎/牙龈炎症、牙周袋深度、口腔卫生、生活方式改变（如吸烟、饮酒、营养）和牙痛。我们咨询了专家组和患者代表，以确定这些结局的优先级。两名调查员将使用 GRADE（推荐评估、制定与评价）方法，独立评估每个结局的证据确定性。
我们预计，我们的综述将突出在定期健康检查中筛查牙周病的有效性方面现有证据的差距。筛查项目的意义可能基于对现有筛查工具的有效性和早期治疗效果的相关证据。
PROSPERO CRD42017081150。
