School of Dentistry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
School of Dentistry, Institute of Health Sciences, Federal University of Pará, Belém-Pará, Brazil.
J Stroke Cerebrovasc Dis. 2020 Aug;29(8):104873. doi: 10.1016/j.jstrokecerebrovasdis.2020.104873. Epub 2020 Jun 8.
This systematic review aims to evaluate the association between tooth loss and stroke. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines were followed. The PECO strategy was used to limit the eligibility criteria. The following databases were used on searches: PubMed, Scopus, Web of Science, The Cochrane Library, LILACS and OpenGrey. We included observational studies performed in adults (Population), in which patients with tooth loss (Exposition) and patients without tooth loss (Comparison) were observed to investigate the association between tooth loss and stroke (Outcome). After searches, the results were submitted to a selection process, followed by data extraction, quality assessment and risk of bias evaluation. The certainty of the evidence was evaluated through GRADE approach. A total of 925 potential studies were retrieved by the searches and 9 were included in this review. Seven of the included articles described an association between tooth loss and stroke. Low risk of bias and a low certainty of the evidence were identified to all studies. The certainty of the evidence may be associated with the observational nature of the included studies. Even though an association between tooth loss and stroke was suggested, the low strength of the current evidence indicated the need for further investigations with a better methodological design to conclude this question.
本系统评价旨在评估牙齿缺失与中风之间的关联。本研究遵循了系统评价和荟萃分析的首选报告项目（PRISMA）指南。采用了 PECO 策略来限制纳入标准。在检索中使用了以下数据库：PubMed、Scopus、Web of Science、The Cochrane Library、LILACS 和 OpenGrey。我们纳入了在成年人中进行的观察性研究（人群），在这些研究中，观察了有牙齿缺失（暴露）和无牙齿缺失（对照）的患者，以调查牙齿缺失与中风之间的关联（结局）。搜索完成后，我们对结果进行了筛选，然后进行了数据提取、质量评估和偏倚风险评估。通过 GRADE 方法评估证据的确定性。通过检索共获得了 925 项潜在研究，其中 9 项研究纳入了本综述。纳入的 9 篇文章中有 7 篇描述了牙齿缺失与中风之间的关联。所有研究的偏倚风险均较低，证据的确定性也较低。证据的确定性可能与纳入研究的观察性质有关。尽管提示了牙齿缺失与中风之间存在关联，但目前证据的强度较低，表明需要进一步进行设计更好的方法学研究来得出这个问题的结论。
