Guangdong Provincial Key Laboratory of Stomatology, Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-Sen University, Guangzhou, China.
The Department of Stomatology, Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.
J Clin Periodontol. 2021 Feb;48(2):180-204. doi: 10.1111/jcpe.13395. Epub 2020 Nov 11.
The objective of this study was to evaluate the relationship of periodontal disease with depression and anxiety via a systematic review and meta-analysis.
We systematically searched the EMBASE, PubMed, Web of Science, PsycINFO, and SinoMed databases (until August 4, 2019) with language restricted to English and Chinese. Case-control, cross-sectional, and cohort studies that calculated the risk ratio (RR), odds ratio (OR)/prevalence OR (POR), and hazard ratio (HR) of depression/anxiety with periodontal disease or the OR/POR/RR/HR of periodontal disease caused by depression/anxiety were included. Observational studies that reported the depression/anxiety scale score of patients with periodontal disease and healthy periodontal subjects aged ≥14 years were also included. We used the standard format to extract the following information from each included study: author/s, survey year, study design, age of participants, periodontal disease definition, depression/anxiety measurement, and summary of results. The Newcastle-Ottawa scale was used to ascertain the quality of the included citations.
After screening, 40 studies were included. A meta-analysis of the case-control studies showed that periodontal disease was positively associated with depression (OR = 1.70, 95% confidence interval [CI] = 1.01-2.83). A meta-analysis of 12 studies showed that periodontal disease was significantly correlated with anxiety (OR = 1.36, 95% CI = 1.11-1.66). A meta-analysis of 18 studies showed that subjects with periodontal disease had higher depression scale score (standardized mean difference [SMD] = 1.05, 95% CI = 0.68-1.41) and anxiety scale score (SMD = 0.70, 95% CI = 0.44-0.96).
Periodontal disease is associated with emotional disorders. However, the high degree of heterogeneity among studies should be considered. More high-quality prospective studies are required to confirm the relationship.
本研究旨在通过系统评价和荟萃分析评估牙周病与抑郁和焦虑的关系。
我们系统地检索了 EMBASE、PubMed、Web of Science、PsycINFO 和 SinoMed 数据库（截至 2019 年 8 月 4 日），语言限制为英语和中文。纳入了计算牙周病与抑郁/焦虑风险比（RR）、优势比（OR）/患病率 OR（POR）和牙周病与抑郁/焦虑的危害比（HR）的病例对照、横断面和队列研究，以及报告了牙周病患者和健康牙周受试者（年龄≥14 岁）抑郁/焦虑量表评分的研究。我们使用标准格式从每项纳入研究中提取以下信息：作者/年份、研究设计、参与者年龄、牙周病定义、抑郁/焦虑测量以及结果总结。使用纽卡斯尔-渥太华量表评估纳入文献的质量。
经过筛选，共纳入 40 项研究。病例对照研究的荟萃分析显示，牙周病与抑郁呈正相关（OR=1.70，95%置信区间 [CI] 1.01-2.83）。12 项研究的荟萃分析显示，牙周病与焦虑显著相关（OR=1.36，95%CI 1.11-1.66）。18 项研究的荟萃分析显示，患有牙周病的受试者抑郁量表评分较高（标准化均数差 [SMD] 1.05，95%CI 0.68-1.41）和焦虑量表评分较高（SMD 0.70，95%CI 0.44-0.96）。
牙周病与情绪障碍有关。然而，应该考虑到研究之间存在高度异质性。需要更多高质量的前瞻性研究来证实这种关系。
