Umbrio Liana Rita Nicole, Pham Hieu Michael, Barmak Abdul B, Assery Nasser, Kotsailidi Elli Anna
Department of General Dentistry, Eastman Institute for Oral Health, University of Rochester, New York, NY, USA.
Department of Periodontology, Eastman Institute for Oral Health, University of Rochester, New York, NY, USA.
Evid Based Dent. 2025 Jul 22. doi: 10.1038/s41432-025-01179-8.
To evaluate the effect of selective serotonin reuptake inhibitors (SSRIs) on periodontal status through a systematic review and meta-analysis.
Nine databases were searched for clinical studies up to September 2024 to identify clinical studies comparing periodontal parameters such as probing depth (PD), clinical attachment level (CAL), marginal bone level (MBL), and gingival and plaque indices (GI and PI) between SSRI-users and non-users. Study selection, data extraction, and risk of bias assessment were performed independently by two authors. Random-effects meta-analyses of mean differences (MD) were performed. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to assess the quality of available evidence.
Five cross-sectional studies, including a total of 1254 patients (54.15% females) and 13170 teeth, were included. The use of SSRIs was significantly associated with inferior MBL (MD, 0.10; 95% confidence interval, 0.01 to 0.20) compared to non-users. No significant differences were observed in PD, CAL, and GI between SSRI-users and non-users. The overall quality of evidence was low, and all studies presented a moderate risk of bias.
Based on a low level of available scientific evidence, the use of SSRIs has a marginal yet significant effect on MBL. However, there is no direct association between SSRIs usage and periodontal parameters such as PD, CAL, and GI. Nonetheless, further research is warranted.
通过系统评价和荟萃分析评估选择性5-羟色胺再摄取抑制剂（SSRIs）对牙周状况的影响。
检索9个数据库，查找截至2024年9月的临床研究，以确定比较使用SSRIs者和未使用者之间牙周参数（如探诊深度（PD）、临床附着水平（CAL）、边缘骨水平（MBL）以及牙龈和菌斑指数（GI和PI））的临床研究。由两位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（MD）进行随机效应荟萃分析。采用推荐分级评估、制定和评价方法评估现有证据的质量。
纳入5项横断面研究，共1254例患者（女性占54.15%）和13170颗牙齿。与未使用者相比，使用SSRIs与较差的MBL显著相关（MD，0.10；95%置信区间，0.01至0.20）。在使用SSRIs者和未使用者之间，PD、CAL和GI未观察到显著差异。证据的总体质量较低，所有研究均存在中度偏倚风险。
基于现有科学证据水平较低，使用SSRIs对MBL有微小但显著的影响。然而，SSRIs的使用与PD、CAL和GI等牙周参数之间没有直接关联。尽管如此，仍有必要进行进一步研究。
