牙髓症状与根管微生物群的关联：拟杆菌门、螺旋体和梭杆菌门的系统评价和荟萃分析。
Association between endodontic symptoms and root canal microbiota: a systematic review and meta-analysis of bacteroidetes, spirochaetes and fusobacteriales.
机构信息
Endodontics Department, Faculty of Oral and Dental Medicine, Future University in Egypt, Cairo, Egypt.
Endodontics Department, Faculty of Dentistry, University of Minnesota, Minneapolis, MN, USA.
出版信息
Clin Oral Investig. 2024 Oct 11;28(11):593. doi: 10.1007/s00784-024-05946-2.
OBJECTIVES
This systematic review and meta-analysis aimed to assess the prevalence of Bacteroidetes, Spirochaetes, and Fusobacteriales in symptomatic versus asymptomatic apical periodontitis as a primary objective. The secondary objective was to evaluate the prevalence of these species independently in symptomatic and asymptomatic apical periodontitis.
MATERIALS AND METHODS
An electronic search of the PubMed, Scopus, and Open-Grey databases was carried out from November 2022 to February 2023 and was later updated through July 2024..The risk of bias was assessed using the New Castle Ottawa scale. The quality of evidence was assessed using the Grading of Recommendations. Assessment, Development, and Evaluation.
RESULTS
The initial search resulted in 968 records. Following the removal of duplicates and a review of titles and abstracts, 66 studies underwent full-texts analysis. Twenty studies were deemed eligible for inclusion. For the first outcome, a fixed-effects model was used. In a total of 7 studies with 193 participants, Spirochaetes were more prevalent in symptomatic apical periodontitis (p < .05) with a risk ratio of 1.91 [ 95% CI 1.25-2.92]. No significant difference was observed (p˃.05) in the prevalence of Bacteroidetes (12 studies with 451 participants) and Fusobacteriales (7 studies with 205 participants) in symptomatic vs asymptomatic apical periodontitis with a risk ratio of (.96), and (1.1), [95% CI, .78-1.19], and [95% CI, 0.84.1.44], respectively. The overall quality of evidence was low.
CONCLUSIONS
The confirmation of the prevalence of Bacteroidetes and Fusobacteriales in symptomatic vs asymptomatic apical periodontitis remains uncertain. However, there is an association between Spirochetes and symptomatic apical periodontitis. Additional research is required to address the limitations of the current body of evidence.
CLINICAL RELEVANCE
Identifying key pathogens in symptomatic apical periodontitis can help develop targeted interventions that address the underlying microbial causes.
目的
本系统评价和荟萃分析旨在评估有症状和无症状根尖周炎中拟杆菌门、螺旋体和梭杆菌门的流行率，这是主要目标。次要目标是分别评估这些物种在有症状和无症状根尖周炎中的流行率。
材料和方法
对 PubMed、Scopus 和 Open-Grey 数据库进行了电子检索，检索时间为 2022 年 11 月至 2023 年 2 月，并于 2024 年 7 月进行了更新。使用纽卡斯尔-渥太华量表评估偏倚风险。使用推荐评估、制定与评价分级法评估证据质量。
结果
初始搜索产生了 968 条记录。在去除重复项并对标题和摘要进行审查后，有 66 项研究进行了全文分析。20 项研究被认为符合纳入标准。对于第一个结果，使用固定效应模型。在总共 7 项包含 193 名参与者的研究中，螺旋体在有症状的根尖周炎中更为普遍（p<0.05），风险比为 1.91[95%置信区间 1.25-2.92]。在有症状的根尖周炎和无症状的根尖周炎中，拟杆菌门（12 项研究，451 名参与者）和梭杆菌门（7 项研究，205 名参与者）的流行率无显著差异（p>.05），风险比分别为（0.96）和（1.1）[95%置信区间，.78-1.19]和[95%置信区间，0.84-1.44]。总体证据质量较低。
结论
有症状和无症状根尖周炎中拟杆菌门和梭杆菌门的流行率尚不确定。然而，螺旋体与有症状的根尖周炎之间存在关联。需要进一步的研究来解决当前证据的局限性。
临床意义
确定有症状的根尖周炎中的关键病原体可以帮助开发针对潜在微生物病因的靶向干预措施。
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