Department of Public Health Dentistry, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India.
Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Vishwa Vidyapeetham, India.
Asian Pac J Cancer Prev. 2021 Oct 1;22(10):3061-3074. doi: 10.31557/APJCP.2021.22.10.3061.
Individual studies conducted in Asian countries have reported higher risk of periodontitis among smokeless tobacco (SLT) users in comparison to non-users. Therefore, a systematic review was conducted to summarize the available evidence on this topic.
Prominent electronic databases were searched using pre-decided MeSH terms and keywords. Screening of titles and abstracts, full text reading, quality assessment and data extraction was done by two investigators independently. The Newcastle-Ottawa scale was used for risk of bias assessment of eligible studies. Meta-analysis was performed for four periodontal outcomes (periodontal pocket depth, loss of attachment, clinical attachment level and gingival recession). A sensitivity analysis was also performed.
Of the 546 citations, 367 were screened for eligibility. Finally, 89 studies were shortlisted for full text reading, of which, 36 were found eligible for qualitative analysis. Most of the studies were conducted in India (n=22), were of cross-sectional design (n=33), utilized purposive sampling and 24 studies were included for meta-analysis (n=28) and done on hospital-based population (n=26). Only 13 (37.1%) studies achieved a score of more than 50% (5/10 stars) on quality assessment scale. SLT users had higher odds of greater periodontal pocket depth greater than 4 mm (OR=3.64), gingival recession (OR=1.71) and loss of attachment 4-5 mm (OR=2.83) and mean difference of 1.7 mm for Clinical Attachment Level compared to non-users.
The studies included in this review suggests that SLT users have poorer periodontal health in comparison to non-users. But most of this evidence comes from cross-sectional studies. Longitudinal studies with rigorous methodology are required to support this elucidation. Registration: This systematic review protocol has been registered in PROSPERO (CRD42019122964).
亚洲国家的个别研究报告称，与非使用者相比，使用无烟烟草 (SLT) 的人患牙周炎的风险更高。因此，进行了系统评价以总结有关此主题的现有证据。
使用预先确定的 MeSH 术语和关键词搜索主要的电子数据库。两名研究人员独立进行标题和摘要筛选、全文阅读、质量评估和数据提取。使用纽卡斯尔-渥太华量表评估合格研究的偏倚风险。对四个牙周病结局（牙周袋深度、附着丧失、临床附着水平和牙龈退缩）进行了荟萃分析。还进行了敏感性分析。
在 546 条引文中有 367 条进行了筛选以确定其是否符合纳入标准。最后，有 36 项研究符合纳入标准并进行了定性分析。大多数研究来自印度（n=22），采用横断面设计（n=33），使用目的抽样，有 24 项研究纳入荟萃分析（n=28），且均在医院人群中进行（n=26）。只有 13 项（37.1%）研究的质量评估量表评分超过 50%（5/10 星）（n=13）。与非使用者相比，使用 SLT 的人牙周袋深度大于 4 毫米的可能性更高（OR=3.64）、牙龈退缩（OR=1.71）和附着丧失 4-5 毫米（OR=2.83），临床附着水平的平均值差异为 1.7 毫米。
本综述中纳入的研究表明，与非使用者相比，SLT 用户的牙周健康状况较差。但大部分证据来自横断面研究。需要采用严格的方法学的纵向研究来支持这一结论。注册：本系统评价方案已在 PROSPERO（CRD42019122964）中注册。
