Postgraduate Program in Dentistry of Niterói, Faculty of Dentistry, Federal Fluminense University, Niterói, Rio de Janeiro, Brazil.
Postgraduate Program in Dentistry, Department of Specific Formation, School of Dentistry, Health Institute of Nova Friburgo, Fluminense Federal University, Nova Friburgo, RJ, Brazil.
Clin Oral Investig. 2021 Oct;25(10):5613-5627. doi: 10.1007/s00784-021-04074-5. Epub 2021 Aug 15.
To perform a systematic review/meta-analysis to elucidate the scientific basis for the association between genetic variations and risk of external apical root resorption (EARR) in orthodontic patients.
Four databases (PubMed, Web of Science, Scopus, LILACS) were electronically searched until November 22, 2020, followed by manual and gray literature search. Case-control or cross-sectional studies that evaluated genes involved in the susceptibility of orthodontic patients to EARR were eligible. Two reviewers applied the inclusion and exclusion criteria, extracted qualitative data, as well as assessed methodological quality using instrument proposed for genetic studies. For synthesis results, narrative and quantitative data (meta-analysis) were performed. The certainty of the evidence was tested using the GRADE Working Group approach.
Of 201 articles in total, 16 studies were included in the review. Of these, 11 presented moderate and 5 of high methodological quality. In the narrative analysis, from 16 studies, 15 studies (10 genes) showed a significant association with EARR and 9 studies were included in the meta-analysis. Only the polymorphism rs208294 in P2RX7 (dominant model) was associated with EARR (OR = 0.52, 95%CI = 0.29-0.95, p = 0.03) and presented a very low certainty of the evidence.
Narrative analyses of individual studies demonstrated an association of many genes. The number of studies for each genetic variation was very low, and methodological heterogeneity between the studies was observed. Quantitative analyses (meta-analysis) could only show an involvement for P2RX7 (rs208294) in the risk of orthodontic patients to EARR at a very low certainty of evidence. (CRD42018085411).
The knowledge regarding the molecular aspects involved in the etiology of EARR will allow orthodontists to use a personalized treatment and early diagnosis of risk patients. This systematic review demonstrates that more studies are necessary to unravel the role of genetic variation for patients' risk to EARR during orthodontic tooth movement.
系统评价/荟萃分析阐明遗传变异与正畸患者根尖外吸收（EARR）风险之间关联的科学基础。
电子检索了 4 个数据库（PubMed、Web of Science、Scopus、LILACS），检索时间截至 2020 年 11 月 22 日，之后进行了手动和灰色文献搜索。评估了与正畸患者 EARR 易感性相关基因的病例对照或横断面研究符合纳入标准。两位综述作者应用纳入和排除标准，提取定性数据，并使用遗传研究推荐的工具评估方法学质量。对于综合结果，进行了叙述性和定量数据（荟萃分析）。使用 GRADE 工作组方法测试证据的确定性。
总共 201 篇文章中，有 16 项研究纳入了综述。其中 11 项研究为中度方法学质量，5 项为高度方法学质量。在叙述性分析中，16 项研究中有 15 项（10 个基因）显示与 EARR 有显著关联，9 项研究纳入了荟萃分析。只有 P2RX7 中的多态性 rs208294（显性模型）与 EARR 相关（OR=0.52，95%CI=0.29-0.95，p=0.03），证据确定性极低。
个体研究的叙述性分析表明许多基因与 EARR 相关。对于每种遗传变异，研究数量非常少，并且研究之间存在方法学异质性。定量分析（荟萃分析）仅显示 P2RX7（rs208294）与正畸患者 EARR 风险有关，证据确定性极低。（CRD42018085411）。
关于 EARR 病因学中涉及的分子方面的知识将使正畸医生能够进行个性化治疗并早期诊断风险患者。本系统评价表明，需要进行更多的研究来阐明遗传变异对正畸牙齿移动过程中患者 EARR 风险的作用。
