Niederau Christian, Alman Eda, Rizk Marta, Becker Kathrin, Marx Nikolaus, Coenen Franziska A, Knaup Isabel, Wolf Michael, Craveiro Rogerio Bastos
Department of Orthodontics, Dental Clinic, University Hospital RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Germany.
Department of Orthodontics and Dentofacial Orthopaedics, Charité Universitätsmedizin Berlin, Campus CBF, CC 03, Berlin, Germany.
Clin Oral Investig. 2025 Jan 22;29(1):76. doi: 10.1007/s00784-024-05774-4.
Information on the oral health of patients with anorexia nervosa remains not satisfactory. The aim of this systematic review is to evaluate oral health parameters in anorexic patients compared to healthy individuals. Furthermore, potential clinical implications for orthodontic treatment are discussed from an orthodontic perspective.
Electronic databases were searched for case-control and controlled clinical trial studies on dentofacial manifestations in anorexic patients up to 2/2024. Study selection, data extraction and risk of bias assessment was done independently by two authors. Random-effects meta-analyses of mean differences (MDs) or relative risks (RRs) with their 95% confidence intervals (CIs) were conducted, followed by sensitivity analyses.
Eleven out of 573 initially identified studies were included. They involved oral health analyses of general anorexic patients ≥ 12 years (mean age 18.4). The meta-analysis showed that anorexia nervosa was associated with a significantly increased caries experience (DMFT), plaque accumulation and gingival inflammation (BOP). PH and salivary flow rate were significantly altered in patients with anorexia nervosa, although no significant relationship between α-amylase levels and anorexia nervosa was demonstrated.
These data enabled us to formulate modalities for anorexia-specific orthodontic treatments. Based on the results, patients with anorexia nervosa exhibit an increased risk of caries and gingival inflammatory signs.
The systematic information on dentofacial manifestations obtained in this study should be considered to better manage the oral health of anorexia patients.
神经性厌食症患者口腔健康方面的信息仍不尽人意。本系统评价的目的是评估与健康个体相比，厌食症患者的口腔健康参数。此外，从正畸角度探讨了正畸治疗的潜在临床意义。
检索电子数据库，查找截至2024年2月有关厌食症患者牙颌面表现的病例对照研究和对照临床试验研究。两名作者独立进行研究选择、数据提取和偏倚风险评估。对平均差（MDs）或相对风险（RRs）及其95%置信区间（CIs）进行随机效应荟萃分析，随后进行敏感性分析。
最初确定的573项研究中有11项被纳入。这些研究涉及对年龄≥12岁（平均年龄18.4岁）的一般厌食症患者的口腔健康分析。荟萃分析表明，神经性厌食症与龋齿经历（DMFT）显著增加、牙菌斑堆积和牙龈炎症（BOP）有关。神经性厌食症患者的pH值和唾液流速有显著改变，尽管未发现α-淀粉酶水平与神经性厌食症之间存在显著关系。
这些数据使我们能够制定针对厌食症的正畸治疗方案。基于这些结果，神经性厌食症患者患龋齿和牙龈炎症体征的风险增加。
本研究中获得的关于牙颌面表现的系统信息应被考虑用于更好地管理厌食症患者的口腔健康。
