Hunter Emma, De Moura Brito Luciana, Piyasena Prabhath, Petrauskiene Egle, Congdon Nathan, Tsakos Georgios, Virgili Gianni, Mathur Manu, Woodside Jayne V, Leles Cláudio, McKenna Gerald
Centre for Public Health, Queen's University Belfast, Belfast, UK
Federal University of Goiás, Goiânia, Brazil.
BMJ Open. 2024 Dec 4;14(12):e085479. doi: 10.1136/bmjopen-2024-085479.
This study aims to comprehensively explore the consequences of edentulism on community-dwelling adults in low-income, middle-income and high-income countries.
Systematic review and Synthesis Without Meta-Analysis (SWiM).
MEDLINE, Embase, Scopus, Web of Science and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched from inception to 21 March 2023, in addition to grey literature searches, reference cross-checking and study recommendations.
Interventional and observational epidemiological studies of community-dwelling completely edentulous adults aged 18 years and above, residing in low-income, middle-income and high-income countries were included. Animal studies, studies of children and adolescents, studies of exclusively non-community-dwelling individuals and studies exclusive to partially dentate, dentate and treated edentulous individuals were excluded. There were no language restrictions. Search terms were designed to identify relevant articles, which examined the impact of edentulism on oral health-related quality of life, frailty, general health, physical health, mental health, nutritional status, employability, education, socioeconomic status and mortality.
Data were extracted manually by two authors. Risk of bias was assessed using the QualSyst Tool. Articles were synthesised and reported using SWiM guidelines.
The seven broad outcome areas included mortality, frailty, mental health, general health, quality of life, health behaviour and nutrition. We identified no studies assessing the impact of edentulism on productivity or other economic outcomes, and no randomised trials of treatment for edentulism with any of these outcomes. Among 364 articles identified from database searches and 38 additional articles from reference cross-checks and professional recommendations, title and abstract screening resulted in a full text review of 58. Among these, 32 were subsequently included for narrative synthesis, with sample sizes ranging from 539 to 237 023 participants. All studies (n=32) contributing to the synthesis reported negative impact of edentulism on outcomes including mortality, frailty, mental health, general health, cognition and nutrition.
Edentulism has a consistently negative impact on the health outcomes examined in this review. Randomised trials are needed to evaluate interventions reducing the burden of edentulism, specifically with regard to economic and productivity outcomes.
CRD42022320049.
本研究旨在全面探讨无牙对低收入、中等收入和高收入国家社区居住成年人的影响。
非荟萃分析的系统评价与综合分析（SWiM）。
检索了MEDLINE、Embase、Scopus、Web of Science和Cochrane对照试验中央注册库（CENTRAL），检索时间从建库至2023年3月21日，此外还进行了灰色文献检索、参考文献交叉核对和研究推荐。
纳入对居住在低收入、中等收入和高收入国家的18岁及以上社区居住的完全无牙成年人进行的干预性和观察性流行病学研究。排除动物研究、儿童和青少年研究、仅针对非社区居住个体的研究以及仅针对部分牙列、有牙列和已治疗无牙个体的研究。无语言限制。检索词旨在识别相关文章，这些文章探讨了无牙对口腔健康相关生活质量、衰弱、总体健康、身体健康、心理健康、营养状况、就业能力、教育、社会经济地位和死亡率的影响。
由两位作者手动提取数据。使用QualSyst工具评估偏倚风险。文章根据SWiM指南进行综合分析和报告。
七个主要结果领域包括死亡率、衰弱、心理健康、总体健康、生活质量、健康行为和营养。我们未发现评估无牙对生产力或其他经济结果影响的研究，也未发现针对这些结果进行无牙治疗的随机试验。在数据库检索中识别出的364篇文章以及参考文献交叉核对和专业推荐中另外38篇文章中，标题和摘要筛选后有58篇进行全文审查。其中，32篇随后被纳入叙述性综合分析，样本量从539名至237023名参与者不等。所有纳入综合分析的研究（n = 32）均报告无牙对包括死亡率、衰弱、心理健康、总体健康、认知和营养等结果有负面影响。
无牙对本综述中所研究的健康结果始终具有负面影响。需要进行随机试验来评估减轻无牙负担的干预措施，特别是在经济和生产力结果方面。
PROSPERO注册号：CRD42022320049。
