Shi Xinyi, Zhu Peijun, Du Mi, Deng Ke, Li Ping, Sáenz-Ravello Gustavo, Xu Shulan, Li An
School of Stomatology, Stomatological Hospital, Southern Medical University, Guangzhou, China.
School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China.
J Periodontal Res. 2025 Apr;60(4):300-314. doi: 10.1111/jre.13346. Epub 2024 Sep 9.
The systematic review aimed to investigate the associations between index-based dietary patterns and the risk and severity of periodontitis. Four public databases were searched for relevant published articles. Two independent researchers conducted the study selection, quality assessment, and data extraction. Methodological quality of the selected studies was evaluated using Joanna Briggs Institute Checklists. The review was registered with PROSPERO (CRD42023395049). Twenty-five studies were eligible for this review, including 23 cross-sectional studies and two prospective cohort studies. The most utilized dietary indices were the Healthy Eating Index (HEI), the Mediterranean Diet Score (MDS), and the Dietary Inflammatory Index (DII). The results indicated a positive association between higher diet quality (i.e., higher HEI and MDSs and lower DII scores) and healthier periodontal status. Subgroup meta-analysis for four studies utilizing HEI and CDC/AAP case definition indicates the protective effect of higher HEI scores on the risk of periodontitis (OR [95% CI] = 0.77[0.68, 0.88]) with statistical significance (Z = 3.91 [p < 0.0001]). Dietary assessment was conducted by validated food frequency questionnaires (FFQ) in 52% of the studies and 24-h dietary recalls in 36% of the studies. One study utilized a validated 15-item questionnaire to measure patients' adherence to the Mediterranean Diet (QueMD). The quality assessment showed that all studies were of high quality. High HEI and MDSs and low DII scores were associated with a low risk of periodontitis and better periodontal conditions. The standardized and repeatable diet guidelines might be provided for preventing periodontitis. Future prospective studies and clinical trials are needed to confirm this causal association.
该系统评价旨在研究基于指数的饮食模式与牙周炎风险及严重程度之间的关联。检索了四个公共数据库以查找相关发表文章。两名独立研究人员进行了研究筛选、质量评估和数据提取。使用乔安娜·布里格斯研究所清单对所选研究的方法学质量进行评估。该评价已在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42023395049）登记。25项研究符合本评价的纳入标准，包括23项横断面研究和2项前瞻性队列研究。使用最多的饮食指数是健康饮食指数（HEI）、地中海饮食评分（MDS）和饮食炎症指数（DII）。结果表明，较高的饮食质量（即较高的HEI和MDS评分以及较低的DII评分）与更健康的牙周状况之间存在正相关。对四项使用HEI和美国疾病控制与预防中心/美国牙周病学会病例定义的研究进行的亚组Meta分析表明，较高的HEI评分对牙周炎风险具有保护作用（OR [95% CI] = 0.77[0.68, 0.88]），具有统计学意义（Z = 3.91 [p < 0.0001]）。52%的研究通过经过验证的食物频率问卷（FFQ）进行饮食评估，36%的研究通过24小时饮食回顾进行评估。一项研究使用经过验证的15项问卷来衡量患者对地中海饮食的依从性（QueMD）。质量评估表明所有研究质量都很高。高HEI和MDS评分以及低DII评分与牙周炎低风险和更好的牙周状况相关。可能会提供标准化且可重复的饮食指南以预防牙周炎。未来需要进行前瞻性研究和临床试验来证实这种因果关联。
