Dioguardi Mario, Gioia Giovanni Di, Caloro Giorgia Apollonia, Capocasale Giorgia, Zhurakivska Khrystyna, Troiano Giuseppe, Russo Lucio Lo, Muzio Lorenzo Lo
Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy.
Department of Emergency and Organ Transplantation, Nephrology, Dialysis and Transplantation Unit, University of Bari Via Piazza Giulio Cesare, 70124 Bari, Italy.
Dent J (Basel). 2019 May 1;7(2):49. doi: 10.3390/dj7020049.
Alzheimer's disease is classified as a neurodegenerative condition, a heterogeneous group of illnesses characterized by the slow and progressive loss of one or more functions of the nervous system. Its incidence tends to increase gradually from 65 years of age, up to a prevalence of 4% at age 75. The loss of dental elements is more prevalent in this population and might negatively affect the masticatory capacity, quality of life, and pathogenesis of Alzheimer's disease. This study investigated problems related to oral health and the loss of dental elements in elderly patients suffering from Alzheimer's and considered whether local inflammatory processes could affect the etiopathogenesis of Alzheimer's disease. The purpose of this systematic review is to identify a link between the causes leading to tooth loss and the onset/progression of Alzheimer's disease. We also studied whether there is a higher incidence of tooth loss (primary outcome) and edentulism (secondary outcome) among Alzheimer's patients. We searched records in electronic databases such as PubMed, EBSCO, and Web of Science using the following keywords: Alzheimer's Disease AND periodontal, Alzheimer's Disease AND periodontitis, dementia AND (periodontitis OR periodontal) "Alzheimer's Disease" AND "tooth" OR "dental loss," "dementia" AND "edentulous," "Alzheimer's Disease" AND "edentulous," "dementia" AND "tooth" OR "dental loss." The records were screened, and after applying the eligibility and inclusion criteria, nine articles were left, six of which were analyzed for the primary outcome (loss of dental elements) and six for the secondary outcome (tooth loss). Results from this meta-analysis revealed that Alzheimer's disease patients have an increased risk of dental loss (hazard ratio (HR) 1.52, 95% confidence interval (CI) 1.00-2.30, = 0.05) and edentulous condition (HR 2.26, 95% CI 1.70-3.01, < 0.001). A quantitative analysis of the included studies indicated that patients suffering from Alzheimer's disease are characterized by a greater number of lost dental elements and general edentulism compared to the control groups.
阿尔茨海默病被归类为一种神经退行性疾病，是一组异质性疾病，其特征是神经系统的一种或多种功能缓慢且渐进性丧失。其发病率从65岁开始逐渐上升，在75岁时患病率达到4%。牙齿缺失在该人群中更为普遍，可能会对咀嚼能力、生活质量以及阿尔茨海默病的发病机制产生负面影响。本研究调查了阿尔茨海默病老年患者的口腔健康问题和牙齿缺失情况，并探讨了局部炎症过程是否会影响阿尔茨海默病的病因发病机制。本系统评价的目的是确定导致牙齿脱落的原因与阿尔茨海默病的发病/进展之间的联系。我们还研究了阿尔茨海默病患者中牙齿脱落（主要结局）和无牙状态（次要结局）的发生率是否更高。我们使用以下关键词在电子数据库如PubMed、EBSCO和Web of Science中搜索记录：阿尔茨海默病与牙周病、阿尔茨海默病与牙周炎、痴呆与（牙周炎或牙周病）、“阿尔茨海默病”与“牙齿”或“牙齿缺失”、“痴呆”与“无牙”、“阿尔茨海默病”与“无牙”、“痴呆”与“牙齿”或“牙齿缺失”。对记录进行筛选，应用纳入标准后，剩下9篇文章，其中6篇针对主要结局（牙齿缺失）进行分析，6篇针对次要结局（牙齿脱落）进行分析。该荟萃分析的结果显示，阿尔茨海默病患者牙齿脱落的风险增加（风险比（HR）1.52，95%置信区间（CI）1.00 - 2.30，P = 0.05），无牙状态的风险增加（HR 2.26，95%CI 1.70 - 3.01，P < 0.001）。对纳入研究的定量分析表明，与对照组相比，阿尔茨海默病患者的牙齿缺失数量更多，总体无牙状态更普遍。
