Department of Oral Surgery and Policlinical Ambulance, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Str. 45, 58448 Witten, Germany.
Faculty of Health, Institute for Medical Biometry and Epidemiology, Witten/Herdecke University, Alfred-Herrhausen-Str. 50, 58448 Witten, Germany.
Int J Environ Res Public Health. 2021 May 14;18(10):5238. doi: 10.3390/ijerph18105238.
Systematic scleroderma is a rare chronic autoimmune disease of unknown aetiology. The aim of this study was to identify the prevalence of orofacial pathognomonic conditions in patients with systemic scleroderma using only randomised prospective studies that investigated the treatment of oral and maxillofacial changes, highlighted associations between the disease and Sjogren's syndrome, and/or analysed the effect of oral hygiene.
The literature was systematically reviewed based on Cochrane Library, EMBASE, PubMed, Scopus, and Web of Science articles published up to March 2020. The primary endpoint of this analysis was defined as an estimation of the prevalence of oral mucosal changes in different areas of the oral cavity (oral mucosa, tongue, lip, periodontal status, bones, and other regions) in patients suffering from scleroderma. Therefore, a systematic literature search (Cochrane Library, EMBASE, PubMed, Scopus, and Web of Science) was conducted and limited by the publication date (1950-03/2020) and the publication language (English). Extracted frequencies were pooled using methods for meta-analysis. In order to obtain the highest level of evidence, only prospective study reports were considered to be eligible.
After full-text screening, 14 (766 patients) out of 193 publications were eligible for the final analysis. Twelve studies produced reliable results in the final data sets. Calculation of the pooled effect estimate (random effects model) revealed a prevalence of 57.6% (95% CI: 40.8-72.9%) for the main area "lip". For the area "oral mucosa", a prevalence of 35.5% (95% CI: 15.7-62.0%) was calculated. The prevalence for "other regions" was only based on studies with salivary changes and was calculated to be 25.4% (95% CI: 14.2-41.3%).
The most pathognomonic conditions in the orofacial region in patients with systemic scleroderma affect the lips, oral mucosa, and salivary glands.
系统性硬皮病是一种罕见的慢性自身免疫性疾病，病因不明。本研究旨在通过仅使用随机前瞻性研究来确定系统性硬皮病患者的口腔特征性疾病的患病率，这些研究调查了口腔和颌面变化的治疗、强调了疾病与干燥综合征之间的关联，和/或分析了口腔卫生的效果。
根据 Cochrane 图书馆、EMBASE、PubMed、Scopus 和 Web of Science 文章，系统地回顾了文献，这些文章的出版时间截至 2020 年 3 月。本分析的主要终点定义为估计患有硬皮病的患者口腔不同区域（口腔黏膜、舌、唇、牙周状况、骨骼和其他区域）的口腔黏膜变化的患病率。因此，进行了系统的文献检索（Cochrane 图书馆、EMBASE、PubMed、Scopus 和 Web of Science），并受限于出版日期（1950-03/2020）和出版语言（英语）。使用荟萃分析方法对提取的频率进行了汇总。为了获得最高水平的证据，仅考虑了前瞻性研究报告作为合格报告。
在全文筛选后，193 篇出版物中有 14 篇（766 例患者）符合最终分析标准。12 项研究在最终数据集内产生了可靠的结果。计算汇总效应估计值（随机效应模型）显示，主要区域“唇”的患病率为 57.6%（95%CI：40.8-72.9%）。对于“口腔黏膜”区域，计算出的患病率为 35.5%（95%CI：15.7-62.0%）。对于“其他区域”的患病率仅基于唾液变化的研究，计算出的患病率为 25.4%（95%CI：14.2-41.3%）。
系统性硬皮病患者口腔区域最具特征性的疾病影响嘴唇、口腔黏膜和唾液腺。
