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儿童胃食管反流病与牙酸蚀症的关系:系统评价和荟萃分析。

Association between gastro-oesophageal reflux disease and dental erosion in children: A systematic review and meta-analysis.

机构信息

Department of General Dentistry, Chenggong Hospital, Affiliated to Medical School of Xiamen University (The 73rd Army Hospital of Chinese PLA), Xiamen, Fujian, PR China.

Department of Medical Service, Chenggong Hospital, Affiliated to Medical School of Xiamen University (The 73rd Army Hospital of Chinese PLA), PR China.

出版信息

J Dent. 2022 Oct;125:104247. doi: 10.1016/j.jdent.2022.104247. Epub 2022 Jul 30.

Abstract

OBJECTIVES

To perform systematic review and quantitative analysis of the literature on the association between gastro-oesophageal reflux disease (GERD) and dental erosion in children.

METHODS

Databases were searched for randomised controlled trials, cohort studies, cross-sectional surveys and case-control studies that evaluated the association between GERD and dental erosion in children aged 1-18 years, without limitations on the language or year of publication. Data were pooled in random effects models. Data sources included Embase, MEDLINE, Web of Science, Trip Pro, Cochrane Library, the International Clinical Trials Registry Platform, ClinicaTrials.gov, Open Grey, Proquest Dissertations and Thesis and Google Scholar from inception to June 9, 2022.

RESULTS

Thirteen studies were included, of which twelve were used for meta-analysis. There were strong associations between GERD and enamel erosion with the subject as unit (odds ratio 4.46; 95% confidence interval (CI) 1.93-10.30; n = 6774); dentine erosion with the subject as unit (odds ratio 13.39; 95% CI 4.17-42.94; n = 371); enamel erosion with the tooth as unit (odds ratio 3.29; 95% CI 1.36-7.95; n = 4637); as well as dentine erosion with the tooth as unit (odds ratio 5.91; 95% CI, 2.35-14.86; n = 4637). In cohort studies, GERD was associated with a higher risk of enamel erosion with the subject as a unit (relative risk 1.88, 95% CI 1.22-2.92; n = 1411).

CONCLUSIONS

Gastro-oesophageal reflux disease is associated with dental erosion in children. The heterogeneity of GERD definition should be considered when interpreting the present work.

CLINICAL SIGNIFICANCE

There is a positive association between GERD and dental erosion in children. Dentists should emphasise timely detection and management of the underlying factors of dental erosion in GERD. Future studies should define paediatric GERD according to a universal guideline to better enhance patient care.

摘要

目的

对胃食管反流病(GERD)与儿童牙蚀之间关联的文献进行系统评价和定量分析。

方法

检索了随机对照试验、队列研究、横断面调查和病例对照研究的数据库,评估了年龄在 1-18 岁的儿童中 GERD 与牙蚀之间的关联,对语言或出版年份没有限制。数据以随机效应模型汇总。数据来源包括 Embase、MEDLINE、Web of Science、Trip Pro、Cochrane 图书馆、国际临床试验注册平台、ClinicalTrials.gov、Open Grey、Proquest Dissertations and Thesis 和 Google Scholar,检索时间截至 2022 年 6 月 9 日。

结果

共纳入 13 项研究,其中 12 项用于荟萃分析。GERD 与以个体为单位的釉质侵蚀之间存在强关联(优势比 4.46;95%置信区间(CI)1.93-10.30;n=6774);以个体为单位的牙本质侵蚀(优势比 13.39;95%CI 4.17-42.94;n=371);以个体为单位的釉质侵蚀(优势比 3.29;95%CI 1.36-7.95;n=4637);以及以个体为单位的牙本质侵蚀(优势比 5.91;95%CI,2.35-14.86;n=4637)。在队列研究中,GERD 与以个体为单位的釉质侵蚀风险较高相关(相对风险 1.88,95%CI 1.22-2.92;n=1411)。

结论

胃食管反流病与儿童的牙蚀有关。在解释本研究时,应考虑 GERD 定义的异质性。

临床意义

儿童 GERD 与牙蚀之间存在正相关。牙医应强调及时发现和管理 GERD 中牙蚀的潜在因素。未来的研究应根据通用指南定义儿科 GERD,以更好地提高患者的护理水平。

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