Faculty of Medicine and Odontology, Oral Medicine, Oral Surgery and Implantology Unit, University of Santiago de Compostela, Santiago de Compostela, Spain.
MedOralRes Group, Health Research Institute of Santiago de Compostela (IDIS), Santiago de Compostela, Spain.
Acta Odontol Scand. 2021 Jul;79(5):344-353. doi: 10.1080/00016357.2020.1859132. Epub 2020 Dec 28.
The aim of this systematic review was to investigate the association between periodontal disease (PD) and inflammatory bowel disease (IBD), and its two major forms Crohn's disease (CD) and ulcerative colitis (UC).
We searched articles in PubMed/MEDLINE, Web of Science, and LILACS published until March 2020. Observational studies evaluating the coexistence of PD in IBD and reported values of clinical periodontal parameters, or radiographic bone loss; and IBD diagnosis established by clinical, radiological, endoscopic and histological criteria were deemed eligible.
A total of 9 studies were included (33,216 individuals). Only one study reported longitudinal data on IBDs onset in patients with PD. Several case-control studies reported coexistence. Meta-analysis showed that the presence of PD was associated with IBD (2.78 [95%CI 1.36-5.69]). PD was strongly associated both with CD (3.41 [95%CI 1.36-8.56]) and UC (3.98 [95%CI 2.02-7.87]).
This review presents clear evidence for an association between PD and IBDs. Future studies should avoid non-longitudinal designs and focus on addressing direction. PD screening may be included in the multidisciplinary management of IBD patients. The mere theoretical possibility that PD may predispose to IBDs may be of key significance due to the rising incidence of diseases.
本系统评价旨在探讨牙周病（PD）与炎症性肠病（IBD）及其两种主要形式——克罗恩病（CD）和溃疡性结肠炎（UC）之间的关联。
我们在 PubMed/MEDLINE、Web of Science 和 LILACS 中检索了截至 2020 年 3 月发表的评估 PD 与 IBD 共存并报告临床牙周参数或影像学骨丢失值的观察性研究；以及采用临床、放射学、内镜和组织学标准确诊的 IBD 诊断的研究。
共纳入 9 项研究（33216 人）。仅有一项研究报告了 PD 患者 IBD 发病的纵向数据。几项病例对照研究报告了共存情况。Meta 分析表明 PD 与 IBD 相关（2.78[95%CI 1.36-5.69]）。PD 与 CD（3.41[95%CI 1.36-8.56]）和 UC（3.98[95%CI 2.02-7.87]）均密切相关。
本综述提供了 PD 与 IBD 之间存在关联的明确证据。未来的研究应避免非纵向设计，并重点关注方向。PD 筛查可纳入 IBD 患者的多学科管理中。由于疾病发病率上升，PD 可能导致 IBD 的理论可能性可能具有重要意义。
