牙周炎中的疱疹病毒：一项伞状综述

Herpesviruses in Periodontitis: An Umbrella Review.

作者信息

Jakovljevic Aleksandar, Andric Miroslav, Jacimovic Jelena, Milasin Jelena, Botero Javier Enrique

机构信息

Department of Pathophysiology, School of Dental Medicine, University of Belgrade, Belgrade, Serbia.

Department of Oral Surgery, School of Dental Medicine, University of Belgrade, Belgrade, Serbia.

出版信息

Adv Exp Med Biol. 2022;1373:139-155. doi: 10.1007/978-3-030-96881-6_7.

DOI:10.1007/978-3-030-96881-6_7

PMID:35612796

Abstract

BACKGROUND

Despite numerous studies indicating a high prevalence of herpesviruses in both apical and marginal periodontitis samples, their exact role in the pathogenesis of a periodontal disease is still unclear.

OBJECTIVE

This umbrella review aimed to summarize data on herpesviruses detection in marginal periodontitis (MP) and apical periodontitis of endodontic origin (APEO) samples.

METHODS

The study protocol has been drafted a priori and registered to the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42020215922). The literature search was conducted using the following electronic databases: Clarivate Analytics' Web of Science, Scopus, PubMed and Cochrane Database of Systematic Reviews, from inception to October 2020, with no language restrictions. Systematic reviews with or without meta-analysis that evaluated the association between the occurrence of herpesviruses and different forms of periodontal diseases were included. Other types of studies, including narrative reviews, were excluded. Two reviewers independently performed a literature search, data extraction, and quality assessment of included studies. Any disagreements or doubts were resolved by a third reviewer. The quality of the reviews was assessed using the AMSTAR 2 tool (A measurement tool to assess systematic reviews).

RESULTS

Six systematic reviews were included in the current review. One was graded as high quality, another one was graded as moderate quality, whereas the other four were graded as critically low-quality reviews. The presence of herpesviruses in subgingival samples was associated with an increased risk of MP, supported by the corresponding meta-analyses. Although the association was strong (OR > 3.0), the confidence intervals were wide, heterogeneity was significant, and studies were of small sample size. In addition, publication bias was detected. Contrary, data from systematic reviews that assessed APEO and herpesviruses did not show any significant associations.

CONCLUSIONS

Low-quality studies with high uncertainty suggest a strong association between herpesviruses and MP, but not with APEO.

摘要

背景

尽管大量研究表明疱疹病毒在根尖周炎和边缘性牙周炎样本中具有较高的患病率，但其在牙周疾病发病机制中的确切作用仍不清楚。

目的

本伞状综述旨在总结边缘性牙周炎（MP）和牙髓源性根尖周炎（APEO）样本中疱疹病毒检测的数据。

方法

研究方案已预先制定并在国际前瞻性系统评价注册库（PROSPERO）（CRD42020215922）中注册。使用以下电子数据库进行文献检索：科睿唯安的Web of Science、Scopus、PubMed和Cochrane系统评价数据库，检索时间从建库至2020年10月，无语言限制。纳入评估疱疹病毒的发生与不同形式牙周疾病之间关联的系统评价，无论是否进行荟萃分析。排除其他类型的研究，包括叙述性综述。两名评审员独立进行文献检索、数据提取和纳入研究的质量评估。任何分歧或疑问由第三名评审员解决。使用AMSTAR 2工具（一种评估系统评价的测量工具）评估综述的质量。

结果

本综述纳入了六项系统评价。一项被评为高质量，另一项被评为中等质量，而其他四项被评为极低质量的综述。龈下样本中疱疹病毒的存在与MP风险增加相关，相应的荟萃分析支持这一结论。尽管关联强度较大（OR>3.0），但置信区间较宽，异质性显著，且研究样本量较小。此外，检测到发表偏倚。相反，评估APEO和疱疹病毒的系统评价数据未显示任何显著关联。