Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany; Centre for Oral Clinical Research, Institute of Dentistry, Barts &The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, United Kingdom.
Department of Periodontology, School of Dentistry, Faculty of Health, Witten/Herdecke University, Witten, Germany.
Arch Oral Biol. 2019 Jun;102:113-121. doi: 10.1016/j.archoralbio.2019.04.004. Epub 2019 Apr 9.
The aim of this systematic review was to evaluate the existing evidence on the association between Thalassemia major (TM) and periodontal condition.
MATERIALS & METHODS: MEDLINE via OVID, EMBASE, and The Cochrane Database (including the Central Register of Controlled Trials (CENTER)), were searched up to September 2018 to identify observational studies eligible for systematic review and meta-analyses. Newcastle-Ottawa Scale (NOS) was used for quality assessment.
The initial search resulted in 172 articles, and of these, 16 articles were included and a qualitative synthesis was carried out. Based on the quantitative data from 14 studies, significant differences were found in gingival index (GI) (p < 0.001), bleeding on probing (p = 0.02) as well as plaque index (PI) (p < 0.01) measures between TM and systemically healthy controls. Additional analyses (young vs. adult) for GI and PI revealed that such significant differences were only observed in adults, even though overall analysis showed no subgroup effect. The majority of the studies qualified as "intermediate quality".
Patients with TM had significantly higher gingival inflammation scores compared to controls. Therefore, routine comprehensive periodontal screening in TM is recommended in order to prevent occurrence of periodontal diseases and eventually reduce the complexity of the oral health care. Also, conduction of further well-designed observational studies is recommended to contribute to this topic.
本系统评价旨在评估地中海贫血症(TM)与牙周状况之间关联的现有证据。
截至 2018 年 9 月,通过 OVID MEDLINE、EMBASE 和 Cochrane 数据库(包括对照试验中央注册中心(CENTRAL))搜索,以确定适合系统评价和荟萃分析的观察性研究。采用纽卡斯尔-渥太华量表(NOS)进行质量评估。
最初的搜索结果产生了 172 篇文章,其中 16 篇文章被纳入并进行了定性综合分析。根据 14 项研究的定量数据,在牙龈指数(GI)(p<0.001)、探诊出血(p=0.02)和菌斑指数(PI)(p<0.01)方面,TM 与系统性健康对照组之间存在显著差异。对 GI 和 PI 的进一步分析(年轻与成年)表明,仅在成年人群中观察到这种显著差异,尽管总体分析未显示亚组效应。大多数研究被评为“中级质量”。
与对照组相比,TM 患者的牙龈炎症评分明显更高。因此,建议对 TM 患者进行常规全面的牙周筛查,以预防牙周疾病的发生,并最终降低口腔保健的复杂性。此外,还建议进行更多设计良好的观察性研究,以促进对此主题的研究。