Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Pok Fu Lam, Hong Kong, Hong Kong SAR.
Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Sai Ying Pun, Hong Kong, Hong Kong SAR.
BMC Oral Health. 2024 Sep 11;24(1):1061. doi: 10.1186/s12903-024-04814-5.
A high burden of respiratory pathogens colonizing removable prosthesis surfaces suggests the potential of association between removable prosthesis-wearing and respiratory infections. Therefore, this systematic review and meta-analysis aimed to evaluate the evidence from clinical studies concerning the association between removable prosthesis-wearing and respiratory infections.
Clinical studies that reported respiratory infections associated with adult patients wearing removable prostheses in any centers (hospitals and nursing homes) or communities were included. Literature was searched across five electronic databases (MEDLINE, Cochrane Library, EMBASE, Web of Science, and Scopus) to 28 May 2024. An additional search was performed for unpublished trials and references cited in related studies. The Newcastle-Ottawa Scale was employed for the quality assessment. The certainty assessment was established using GRADE. The results were pooled using a frequentist random-effects meta-analysis and the odds ratios generated.
A total of 1143 articles were identified. Thirteen articles had full-text articles screening and an additional two articles were added through reference linkage. Ultimately, six non-randomized clinical studies reporting various types of pneumonia contributed to this review. Overall odds of having pneumonia among prosthesis wearers were 1.43 (95% CI: 0.76 to 2.69) and 1.27 (95% CI: 1.11 to 1.46) using the random- and fixed-effects models, respectively. The heterogeneity in the meta-analysis was substantial. In subgroup analysis according to the study design, the heterogeneity within prospective studies was much reduced, I = 0% (p = 0.355). The certainty of the evidence evaluated using the GRADE approach was low to very low evidence for prosthesis wearers developing pneumonia based on studies.
There was no conclusive evidence from the non-randomized clinical studies supporting whether prosthesis-wearing is a risk factor for pneumonia based on outcomes from this review.
大量呼吸道病原体定植于可摘义齿表面，这表明佩戴可摘义齿与呼吸道感染之间可能存在关联。因此，本系统评价和荟萃分析旨在评估来自临床研究的证据，这些研究涉及佩戴可摘义齿与呼吸道感染之间的关系。
纳入了在任何中心（医院和养老院）或社区中报告与佩戴可摘义齿的成年患者相关的呼吸道感染的临床研究。文献检索了五个电子数据库（MEDLINE、Cochrane 图书馆、EMBASE、Web of Science 和 Scopus），检索时间截至 2024 年 5 月 28 日。还对未发表的试验和相关研究中引用的参考文献进行了额外搜索。使用纽卡斯尔-渥太华量表对质量进行评估。使用 GRADE 建立确定性评估。使用频率随机效应荟萃分析汇总结果并生成比值比。
共确定了 1143 篇文章。对 13 篇文章进行了全文筛选，并通过参考文献链接添加了另外 2 篇文章。最终，纳入了 6 项非随机对照临床研究，这些研究报告了各种类型的肺炎。总体而言，佩戴义齿者患肺炎的几率为 1.43（95%CI：0.76 至 2.69）和 1.27（95%CI：1.11 至 1.46），分别采用随机效应和固定效应模型。荟萃分析中的异质性很大。根据研究设计进行亚组分析，前瞻性研究中的异质性大大降低，I = 0%（p = 0.355）。使用 GRADE 方法评估证据的确定性为低到极低证据，表明基于本综述的研究结果，佩戴义齿与肺炎的发生之间没有明确的证据。
根据本综述的研究结果，没有来自非随机对照临床研究的明确证据表明佩戴义齿是肺炎的危险因素。
