Faculty of Health Sciences, University of Brasília (UnB), Brasília, Brazil.
School of Dentistry, Federal University of Santa Maria (UFSM), Santa Maria, Brazil.
Caries Res. 2019;53(6):585-598. doi: 10.1159/000500855. Epub 2019 Jul 5.
This systematic review and meta-analysis were undertaken to assess the responsiveness of validated oral health-related quality of life (OHRQoL) questionnaires to dental caries interventions in children, adolescents, and young adults. Studies eligible were randomized clinical trials (RCTs), controlled clinical trials (CCTs), and prospective case series (PCS), which had OHRQoL questionnaires answered before and after caries intervention(s). The main outcome was improvement in OHRQoL mean scores following caries intervention. Twenty-six studies were selected for the quality assessment and 14 were selected for the meta-analysis. Most of the studies were PCS with a single group pretest and posttest study design (n = 19). Five studies were CCT and only 2 were RCT. The numbers of participants were 3,522 in the control group (baseline = 2,002; final = 1,520) and 5,917 in the test group (baseline = 3,102; final = 2,815). The age of the subjects ranged from 3 to 19 years. All studies showed significant improvement in OHRQoL following caries intervention. Most of nonrandomized studies (n = 15) had low or moderate risk of bias. The meta-analysis showed the effect of caries interventions (standardized weighted mean differences = -1.24; 95% CI: -1.68 to -0.81; p < 0.001). However, high heterogeneity between the studies was found. The Grading of Recommendations Assessment, Development and Evaluation approach classified the quality of evidence as very low and its strength weak. In conclusion, there is evidence that the OHRQoL of children and adolescents improved following caries intervention procedures, but the quality of the evidence was very low. In spite of that, caries interventions are highly recommended as abstaining from treatment is likely to result in a deterioration of OHRQoL.
本系统评价和荟萃分析旨在评估经过验证的口腔健康相关生活质量（OHRQoL）问卷对儿童、青少年和年轻人龋齿干预的反应能力。合格的研究为随机临床试验（RCT）、对照临床试验（CCT）和前瞻性病例系列（PCS），这些研究在龋齿干预前后回答了 OHRQoL 问卷。主要结果是龋齿干预后 OHRQoL 平均评分的改善。选择了 26 项研究进行质量评估，选择了 14 项研究进行荟萃分析。大多数研究为 PCS，采用单一组预测试和后测试研究设计（n=19）。五项研究为 CCT，仅有两项为 RCT。对照组的参与者人数为 3522 人（基线=2002 人；最终=1520 人），试验组为 5917 人（基线=3102 人；最终=2815 人）。受试者的年龄范围为 3 至 19 岁。所有研究均显示龋齿干预后 OHRQoL 显著改善。大多数非随机研究（n=15）的偏倚风险为低或中。荟萃分析显示龋齿干预的效果（标准化加权平均差异=-1.24；95%CI：-1.68 至-0.81；p<0.001）。然而，研究之间存在高度异质性。推荐评估、制定和评估方法将证据质量归类为极低，其强度较弱。总之，有证据表明儿童和青少年的 OHRQoL 在龋齿干预后得到改善，但证据质量非常低。尽管如此，仍强烈推荐龋齿干预，因为如果不进行治疗，很可能会导致 OHRQoL 恶化。
