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胃食管反流病和牙侵蚀的流行率及相关性:综述概述。

Prevalence and association of gastroesophageal reflux disease and dental erosion: An overview of reviews.

机构信息

School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, Athens, Goudi 11527, Greece.

School of Dentistry, National and Kapodistrian University of Athens, 2 Thivon Str, Athens, Goudi 11527, Greece.

出版信息

J Dent. 2023 Jun;133:104520. doi: 10.1016/j.jdent.2023.104520. Epub 2023 Apr 15.

Abstract

OBJECTIVES

The aim of this overview of reviews was to retrieve and evaluate the available evidence concerning the prevalence and association between gastroesophageal reflux disease (GERD) and erosive tooth wear (ETW).

DATA

A literature search was conducted in electronic databases and relative systematic reviews with or without meta-analyses were located. Updated supplemental search was also undertaken to identify additional primary studies.

SOURCES

Medline (via Pubmed), Embase, Scopus, Cochrane Register of Systematic Reviews, PROSPERO and Epistemonikos.org database were searched. Additional search of the gray literature, abstracts of conferences and meetings as well as manual search of the reference lists of retrieved studies, was also performed.

STUDY SELECTION

The search retrieved 116 systematic reviews of which 10 were considered eligible and eight additional primary studies.

CONCLUSIONS

GERD constitutes a risk factor for ETW and there is a positive association between the two conditions. In the present overview, despite the heterogeneity between studies and the low level of evidence, it was clearly supported that individuals with GERD have an increased probability of also presenting with signs of ETW. In special groups of population, a high association was found between GERD and ETW. The geographic location may affect the association between GERD and ETW, while regarding the effect of flow rate, buffering capacity of saliva and oral microbial changes caused by GERD, the results were controversial.

CLINICAL SIGNIFICANCE

Appropriate preventive dental care should be considered for individuals with GERD and a multidisciplinary medical and dental approach for the management of individuals with ETW is advised. The results of this study can be used by dentists dealing with typical and atypical GERD signs and symptoms in the oral environment, but also by the physicians and gastroenterologists who need to motivate their patients for oral examination.

摘要

目的

本综述旨在检索和评估有关胃食管反流病(GERD)与侵蚀性牙磨损(ETW)的患病率和相关性的现有证据。

资料来源

在电子数据库中进行了文献检索,并找到了具有或不具有荟萃分析的系统评价。还进行了更新的补充搜索,以确定其他的初级研究。

研究选择

搜索共检索到 116 篇系统评价,其中 10 篇被认为符合条件,另外还有 8 项初级研究。

结论

GERD 是 ETW 的危险因素,两者之间存在正相关关系。在本综述中,尽管研究之间存在异质性且证据水平较低,但仍明确表明 GERD 患者发生 ETW 迹象的可能性增加。在特殊人群中,GERD 和 ETW 之间存在高度相关性。地理位置可能会影响 GERD 和 ETW 之间的关联,而关于 GERD 引起的唾液流速、缓冲能力和口腔微生物变化对其的影响,结果则存在争议。

临床意义

应考虑对 GERD 患者进行适当的预防性口腔护理,并建议对 ETW 患者进行多学科的医疗和牙科综合管理。本研究的结果可用于处理口腔环境中典型和非典型 GERD 体征和症状的牙医,也可用于需要促使其患者进行口腔检查的内科医生和胃肠病学家。

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