Yehia Zakaria, Silbereisen Angelika, Koletsi Despina, Arabzadehtousi Mahla, Tsilingaridis Georgios, Bostanci Nagihan
Division of Periodontology and Oral Health, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Orthodontics, Folktandvården Stockholms län AB, Folktandvården Eastmaninstitutet, Stockholm, Sweden.
Evid Based Dent. 2024 Dec;25(4):213-214. doi: 10.1038/s41432-024-01055-x. Epub 2024 Aug 25.
The systematic review aimed to review the existing evidence, to identify and appraise the effectiveness of periodontal prevention and treatment modalities in individuals diagnosed with Down syndrome (DS) and to determine the estimates of the effects of implemented periodontal prevention and treatment strategies compared to chromosomally normal (CN) individuals.
The systematic review was conducted and reported in conformity with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The study protocol was registered in the Open Science Framework. Electronic and manual searches, in accordance with PICO framework and delineated inclusion/exclusion criteria, were conducted in multiple databases.
The initial search identified 11,704 studies. After removing duplicates, 9,048 remained. Title and abstract screening narrowed these to 281 for full-text review. Ultimately, 16 studies met the inclusion criteria, with 4 eligible for quantitative data synthesis. Results of the meta-analysis indicated that professional tooth cleaning in combination with oral hygiene reinforcement was less effective in the reduction of PPD in patients with DS compared to those without DS (Mean difference (MD): 0.23; 95% Confidence Interval (CI): 0.14 to 0.32; p < 0.001).
These findings suggest that conventional periodontal treatment is less effective in managing periodontitis in patients with DS. Thus, tailored periodontal care strategies that address the specific needs of individuals with DS should be implemented to improve treatment outcomes for this population The presence of moderate to high risk of bias in the included studies underscores the need for rigorously designed research that minimizes bias through effective blinding, randomization, control of confounding factors, and inclusion of diverse treatment outcomes to further investigate these associations.
Based on the best available evidence, professional tooth cleaning combined with oral hygiene instructions appears to be less effective in reducing pocket depths in individuals with DS compared to those without DS. https://doi.org/10.17605/OSF.IO/UXTCG.
本系统评价旨在回顾现有证据，识别和评估针对被诊断为唐氏综合征（DS）的个体的牙周预防和治疗方法的有效性，并确定与染色体正常（CN）个体相比，实施的牙周预防和治疗策略的效果估计值。
本系统评价按照PRISMA（系统评价和Meta分析的首选报告项目）指南进行并报告。研究方案已在开放科学框架中注册。根据PICO框架和划定的纳入/排除标准，在多个数据库中进行了电子和手动检索。
初步检索识别出11704项研究。去除重复项后，剩余9048项。通过标题和摘要筛选，将这些研究缩小至281项进行全文审查。最终，16项研究符合纳入标准，其中4项有资格进行定量数据综合分析。Meta分析结果表明，与非DS患者相比，专业牙齿清洁联合强化口腔卫生在降低DS患者的牙周袋深度方面效果较差（平均差（MD）：0.23；95%置信区间（CI）：0.14至0.32；p＜0.001）。
这些发现表明，传统的牙周治疗在管理DS患者的牙周炎方面效果较差。因此，应实施针对DS个体特定需求的定制化牙周护理策略，以改善该人群的治疗效果。纳入研究中存在中度至高度偏倚风险，这突出表明需要进行严格设计的研究，通过有效的盲法、随机化、控制混杂因素以及纳入多样化的治疗结果来尽量减少偏倚，以进一步研究这些关联。
基于现有最佳证据，与非DS个体相比，专业牙齿清洁联合口腔卫生指导在降低DS个体的牙周袋深度方面似乎效果较差。https://doi.org/10.17605/OSF.IO/UXTCG
