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International Dental Journal Dec 2017Dental plaque accumulation and inadequate personal oral hygiene (OH) are known major risk factors of periodontitis. Nevertheless, the magnitude of their effects has not... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Dental plaque accumulation and inadequate personal oral hygiene (OH) are known major risk factors of periodontitis. Nevertheless, the magnitude of their effects has not yet been the subject of a meta-analysis.
MATERIAL AND METHODS
The Medline and Scopus databases were searched up to May 2016. Observational studies were eligible if they assessed associations between OH and periodontitis in adult subjects. A multivariate random-effects meta-analysis was used to pool the effects of fair/poor OH versus good OH on periodontitis across studies. The associations between oral care habits and periodontitis were also assessed.
RESULTS
A total of 50 studies were eligible; 15 were used for pooling the effect of fair OH versus good OH and poor OH versus good OH on periodontitis, with pooled odds ratios (ORs) of 2.04 [95% confidence interval (CI): 1.65-2.53] and 5.01 (95% CI: 3.40-7.39), respectively. Eleven studies examined oral care habits measured according to toothbrushing regularity and dental visit frequency; pooled ORs of 0.66 (95% CI: 0.47-0.94) and 0.68 (95% CI: 0.47-0.98) were obtained, respectively.
CONCLUSIONS
Fair to poor OH increases the risk of periodontitis by two- to five-fold. This risk can be reduced by regular toothbrushing and dental visits.
Topics: Humans; Oral Hygiene; Periodontitis; Risk Factors
PubMed: 28646499
DOI: 10.1111/idj.12317 -
Journal of Clinical Periodontology Oct 2017To systematically review the literature in order to investigate a potential association between periodontitis and halitosis. (Meta-Analysis)
Meta-Analysis Review
AIM
To systematically review the literature in order to investigate a potential association between periodontitis and halitosis.
METHODS
Electronic searches were performed in four different databases: PubMed, Scopus, Web of Science and Scielo. Population-based observational studies that tested the association between periodontitis and halitosis were included. Additionally, meta-analysis, meta-regression and subgroup analyses were performed to synthesize the evidence.
RESULTS
A total of 1,107 articles were identified in electronic searches; out of which, five were included within the meta-analysis. Pooled estimates revealed that individuals with periodontitis presented 3.16 times higher odds (OR 3.16; 95% CI: 1.12-8.95) of having halitosis. Meta-regression and subgroups analyses showed that criteria used for halitosis and periodontitis assessment explained nearly 45% and 24% of heterogeneity between studies, respectively.
CONCLUSIONS
Positive association between periodontitis and halitosis was found in pooled results of population-based observational studies. However, this evidence is derived from cross-sectional studies.
Topics: Halitosis; Humans; Periodontitis; Risk Factors
PubMed: 28749582
DOI: 10.1111/jcpe.12786 -
Climacteric : the Journal of the... Dec 2010Osteoporosis and periodontitis are frequent disorders that affect aging populations. It has been hypothesized that both conditions may be related. (Review)
Review
BACKGROUND
Osteoporosis and periodontitis are frequent disorders that affect aging populations. It has been hypothesized that both conditions may be related.
OBJECTIVE
To determine whether dental osteoporosis is a local manifestation of systemic bone loss having similar etiology and risk factors, or whether it is an independent process depending primarily on factors that cause periodontitis.
METHODS
A systematic review of clinical trials assessing the relationship between osteoporosis and periodontitis was carried out. An electronic search was made based on Internet search engines, MEDLINE (from 1966 to December 2009) and the Cochrane Controlled Clinical Trials Register.
RESULTS
A total of 145 studies dealing with the relationship osteoporosis-periodontitis were identified. Of them, 35 were considered suitable for selection. Studies on maxillary and/or mandible radiological findings have a positive correlation in the majority of the cases (18 positive vs. three negative), whereas the findings on clinical periodontal examination are inconclusive (six positive vs. five negative). There were ten studies in which a diagnosis of osteoporosis was made, based on the existence of non-traumatic fracture, while there were nine studies using radiographs for diagnosis, of which six studies were found to have a positive correlation. There was only one study based on a clinical periodontal examination that found a positive correlation.
CONCLUSIONS
The majority of the studies suggested a relationship between osteoporosis and periodontitis. Further well-controlled studies are needed to better elucidate the inter-relationship between systemic and oral bone loss and to clarify whether dentists could usefully give an early warning for osteoporosis risk.
Topics: Aged; Alveolar Bone Loss; Bone Density; Female; Fractures, Bone; Humans; MEDLINE; Middle Aged; Osteoporosis; Periodontitis; Risk Factors
PubMed: 20690866
DOI: 10.3109/13697137.2010.500749 -
Andrology May 2021There is increasing evidence that periodontitis may affect male sexual health (MSH) (erectile function, production of sex hormones, and semen quality). However, a...
BACKGROUND
There is increasing evidence that periodontitis may affect male sexual health (MSH) (erectile function, production of sex hormones, and semen quality). However, a limited number of clinical studies demonstrate the association between MSH and periodontitis.
OBJECTIVES
The aim of this study was to explore the relationship between periodontitis and MSF.
MATERIALS AND METHODS
A comprehensive systematic review of the published literature in MEDLINE, PubMed, Scopus, Cochrane, EMBASE, and Web of Science databases from the earliest available online indexing year until October 2020 was performed, in accordance with the PRISMA guidelines. Keywords related to periodontitis were combined with words describing MSH.
RESULT
A total of 19 studies were included and discussed in the systematic review. The number of study participants ranged from 53 to 197,136 individuals, aged between 18 and 95 years (mean age, 41.2 years). Six studies did not report the age of the participants. Out of nine studies, eight found a significant association between erectile dysfunction (ED) and periodontitis. Only three studies evaluated the association between sex hormone levels and periodontitis, and two of these studies showed that patients with periodontitis are expected to exhibit higher levels of testosterone. Finally, out of five studies, two demonstrated a significant association between semen quality and periodontitis.
DISCUSSION
The findings in this review were limited by the quality and the few available studies. Results from the observational studies might have been affected by recall bias and confounded by cofactors.
CONCLUSION
The results of this systematic review revealed a significant association between periodontitis and ED, although the responsible mechanisms remain unclear. The potential associations between sex hormone levels, semen quality, and periodontitis are yet to be demonstrated. In order to improve patient management, dentists and physicians need to be aware of the association between male sexual health problems and periodontitis.
Topics: Erectile Dysfunction; Gonadal Steroid Hormones; Humans; Male; Periodontitis; Semen Analysis; Sexual Health
PubMed: 33319469
DOI: 10.1111/andr.12961 -
Journal of Clinical Periodontology Jan 2023Systemic inflammation is implicated in the onset and progression of several chronic diseases. Periodontitis is a potential trigger of systemic inflammation. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Systemic inflammation is implicated in the onset and progression of several chronic diseases. Periodontitis is a potential trigger of systemic inflammation.
PURPOSE
To comprehensively appraise all the evidence on the effects of the treatment of periodontitis on systemic inflammation assessed by serum C-reactive protein (CRP) levels.
DATA SOURCES
Six electronic databases were searched up to 10 February 2022 to identify and select articles in English language only.
STUDY SELECTION
Twenty-six randomized controlled clinical trials reporting changes amongst 2579 participants about CRP levels at 6 months or more after treatment.
DATA EXTRACTION
Two reviewers independently extracted data and rated the quality of studies. Meta-analyses were performed using random and fixed effect models.
RISK OF BIAS
Risk of bias (RoB 2.0 tool) and quality of evidence (GRADEpro GDT tool) analyses were completed.
DATA SYNTHESIS
Treatment of periodontitis reduced CRP levels by 0.69 mg/L (95% confidence interval: -0.97 to -0.40) after 6 months, but limited evidence was retrieved from studies with longer follow-ups. Similar findings were observed in participants with other co-morbidities in addition to periodontitis. Greatest reductions were observed in participants with concentrations of CRP >3 mg/L at baseline.
LIMITATIONS
High level of heterogeneity.
CONCLUSIONS
Treatment of periodontitis reduces serum CRP levels (up to 6 months follow-up) to a degree equivalent to that observed after traditional lifestyle or drug interventions. This evidence supports a causal association between periodontitis and systemic inflammation.
Topics: Humans; C-Reactive Protein; Randomized Controlled Trials as Topic; Periodontitis; Inflammation
PubMed: 35946825
DOI: 10.1111/jcpe.13709 -
Journal of Dentistry May 2016Probiotics might be beneficial to prevent or treat caries, gingivitis or periodontitis. We aimed to appraise trials assessing probiotics for managing caries and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Probiotics might be beneficial to prevent or treat caries, gingivitis or periodontitis. We aimed to appraise trials assessing probiotics for managing caries and periodontal disease.
DATA
We included randomized controlled trials comparing the efficacy of probiotics versus (placebo) control with regards to Streptococcus mutans [SM], lactobacilli [LB], periodontal pathogens numbers, gingivitis, oral hygiene, caries incidence/experience increment, or periodontitis. Meta-analysis and trial-sequential-analysis were performed.
SOURCES
Three electronic databases (Medline, Embase, Central) were screened.
STUDY SELECTION
50 studies (3247 participants) were included. Studies were mainly performed in children and used lactobacilli (45); bifidobacteria (12) or other genus (3). Probiotics significantly increased the chance of reducing SM (OR: 2.20, 95% CI: 1.23/3.92) or LB (OR: 2.84; 1.34/6.03)<10(4)CFU/ml. Such reduction was confirmed for SM counts (standardized mean differences: -1.18, 95% CI: -1.64/-0.72), but not LB (SMD: 0.33; 0.15/0.52). For periodontal pathogens, no significant difference was found. Probiotics significantly reduced bleeding-on-probing (SMD: -1.15; -1.68/-0.62) and gingival index (SMD: -0.86; -1.52/-0.20), but not plaque index (SMD: -0.34; -0.89/0.21). Caries incidence was not significantly reduced (OR: 0.60; 0.35/1.04), neither was caries experience (SMD: -0.26; -0.55/0.03) or CAL (SMD: -0.46; -0.84/0.08). In contrast, probing-pocket depths (SMD: -0.86; -1.55/-0.17) were significantly reduced. Data was quantitatively insufficient for conclusive findings, and risk of bias was high.
CONCLUSION
Current evidence is insufficient for recommending probiotics for managing dental caries, but supportive towards managing gingivitis or periodontitis. Future studies should only record bacterial numbers alongside accepted disease markers or indicators.
CLINICAL SIGNIFICANCE
Probiotic therapy could be used for managing periodontal diseases. For caries, further studies should ascertain both efficacy and safety.
Topics: Dental Caries; Humans; Periodontitis; Probiotics
PubMed: 26965080
DOI: 10.1016/j.jdent.2016.03.002 -
Frontiers in Immunology 2021Periodontitis is an inflammatory disease that destroys both soft and hard periodontal tissues. However, a complex periodontal cytokine network remains unclear. This... (Meta-Analysis)
Meta-Analysis
AIM
Periodontitis is an inflammatory disease that destroys both soft and hard periodontal tissues. However, a complex periodontal cytokine network remains unclear. This systematic review explored multiple cytokine gene polymorphisms in the pathogenesis of periodontitis.
MATERIAL AND METHODS
A systematic search was performed using the databases from previous publications, which indicated the association between cytokine polymorphisms and periodontitis pathogenesis. Meta-analysis was conducted using fixed or randomized models to calculate the significance of multiple cytokine polymorphisms. A total of 147 articles were analyzed with polymorphisms in 12 interleukins [Th1 (IL-2, IFN-γ, and TNF-α), Th2 (IL-4 and IL-13), Th17 (IL-1α, IL-1β, IL-6, and IL-17), and Treg cytokines (IL-10 and TGF-β)]. Doi plot was used to probe the occurrence of publication bias.
RESULTS
The polymorphisms of IL-2 and TNF-α of Th1 cytokine family may be associated with the pathogenesis or the prevention of periodontitis risk, while the polymorphism of IFN-γ is not related to periodontitis risk. The polymorphisms for IL-4 and IL-13 of Th2 cytokine family are not found to be associated with the pathogenesis of periodontitis. For the polymorphisms of the members of Th17 cytokine family, different IL-1α polymorphisms may have inverse actions in the pathogenesis of periodontitis. IL-1β is a noteworthy cytokine biomarker in periodontitis development and progression. IL-6 may have a protective function in the inflammatory responses of periodontitis, and IL-17 has a weak relationship the inflammatory responses. The polymorphisms for the members of Treg cell cytokines may have a protective function against periodontitis risk. LFK indexes show the major asymmetry due to publication bias.
CONCLUSION
IL-1β is a notable cytokine biomarker in periodontitis risk. Treg cytokines favor an anti-inflammatory and protective environment. Further data are needed to confirm the present conclusion due to publication bias.
Topics: Animals; Cytokines; Humans; Periodontitis; Polymorphism, Genetic
PubMed: 35046930
DOI: 10.3389/fimmu.2021.713198 -
Vascular Health and Risk Management 2019This systematic review and meta-analysis investigate the association between periodontitis and stroke. This review followed the methods established by the Preferred... (Meta-Analysis)
Meta-Analysis
This systematic review and meta-analysis investigate the association between periodontitis and stroke. This review followed the methods established by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Searches were conducted in five databases and two sources of grey literature. After the selection of the articles, a risk of bias evaluation was performed. Three meta-analyzes were performed: Assessing the overall association between stroke and periodontitis in case-control studies; Ischemic stroke and periodontitis in case-control studies; The association between stroke and periodontitis in cohort studies. Heterogeneity was assessed using the I index and the odds ratio was also calculated (p < 0.05). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) was applied to evaluate the level of evidence. 2193 potentially relevant studies were identified, with 10 studies included in qualitative and quantitative analysis. All the articles were considered with low risk of bias and a low level of certainty. The results demonstrated a positive association between both disorders and increased risk for stroke among cohort studies (RR 1.88 [1.55, 2.29], p<0.00001, I=0%) and for ischemic stroke events in case-control studies (RR 2.72 [2.00, 3.71], p<0.00001, I= 4%). Periodontitis may represent a risk factor for stroke, especially in ischemic events. However, new studies with a robust design are necessary for a reliable conclusion.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Periodontitis; Prognosis; Risk Assessment; Risk Factors; Stroke; Young Adult
PubMed: 31806984
DOI: 10.2147/VHRM.S204097 -
Journal of Periodontal Research Aug 2020Human cytomegalovirus (HCMV) has been associated with periodontitis and apical periodontitis. The objective of this systematic review was to evaluate the association... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND OBJECTIVE
Human cytomegalovirus (HCMV) has been associated with periodontitis and apical periodontitis. The objective of this systematic review was to evaluate the association between HCMV and periodontitis, and apical periodontitis of endodontic origin.
MATERIAL AND METHODS
A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines and registered in the International prospective register of systematic reviews (PROSPERO). The search for potential studies was performed in MEDLINE via PubMed, Scopus, and SciELO. A quality assessment of the studies, publication bias analysis, and meta-analysis was performed. The results are presented in odds ratio with 95% confidence interval with the corresponding Forest plot. Sensitivity analysis was performed to evaluate the consistency of the results.
RESULTS
Thirty-two studies were included in the quantitative and qualitative analyses. Of these, 26 were in periodontitis patients and 6 in apical periodontitis patients. Forest plot of combined studies revealed significant increased odds for periodontitis when subgingival HCMV was detected (OR 5.31; 95% CI 3.15-8.97). Sensitivity analysis based on quality of the included studies, showed consistent results. In contrast, the odds ratio for apical periodontitis when HCMV was detected from apical lesions was not statistically significant (OR 3.65; 95% CI 0.49-27.10).
CONCLUSIONS
The results from the meta-analysis indicate that HCMV is significantly associated with periodontitis. In contrast, HCMV infection is not associated with apical periodontitis.
Topics: Cytomegalovirus; Cytomegalovirus Infections; Humans; Periapical Periodontitis; Periodontitis
PubMed: 32167179
DOI: 10.1111/jre.12742 -
Clinical Oral Investigations May 2024The purpose of this systemic review and meta-analysis was to explore the association between halitosis and periodontitis in observational studies. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
The purpose of this systemic review and meta-analysis was to explore the association between halitosis and periodontitis in observational studies.
MATERIALS AND METHODS
A systematic search covered PubMed, Web of Science, Embase, Scopus, and Cochrane Library until August 18, 2023. Nine observational studies (585 cases, 1591 controls) were analyzed using Stata 17, with odds ratios (ORs) and 95% confidence intervals (CIs). Subgroup analyses considered halitosis assessment methods.
RESULTS
The review found a positive association between halitosis and periodontitis. Significant differences were observed with organoleptic test (OR = 4.05, 95% CI: 1.76, 9.30, p < 0.01) and volatile sulfur compound readings (OR = 4.52, 95% CI: 1.89, 10.83, p < 0.01).
CONCLUSIONS
A positive association was observed between halitosis and periodontitis, supported by significant differences in both organoleptic and volatile sulfur compound readings. However, conclusive findings are limited by statistical heterogeneity, emphasizing the need for additional research.
CLINICAL RELEVANCE
Understanding the halitosis and periodontitis association is clinically significant, informing potential interventions for improved oral health. Further research is vital to refine understanding and guide effective clinical strategies, acknowledging the limitations in current findings.
Topics: Halitosis; Humans; Periodontitis; Sulfur Compounds; Observational Studies as Topic
PubMed: 38801476
DOI: 10.1007/s00784-024-05732-0