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BioMed Research International 2018Case definitions and criteria of periodontal diseases are not yet consistent worldwide. This can affect the accuracy of any comparison made between two studies. This...
Case definitions and criteria of periodontal diseases are not yet consistent worldwide. This can affect the accuracy of any comparison made between two studies. This study determines which are the most common chronic periodontitis case definitions as well as confounding variables that have been reported worldwide in periodontal literature. A systematic assessment on periodontal disease classification and confounders was conducted using all publications in MEDLINE, EMBASE, SCOPUS, and Google Scholar between 1965 and October 2017. Screening of eligible studies and data extraction were conducted in duplicate and independently by two reviewers. The search protocol produced 4,218 articles. Out of these, 492 potentially relevant articles were selected for review. Only 351 studies fulfilled the selection criteria. Combination of probing depth and clinical attachment loss was the most common chronic periodontitis case definitions used (121, studies, 34.5%). CPI/CPITN was the most common classification used. Age was the most common confounder studied in periodontal research (303 studies, 86.3%), followed by gender (268 studies, 76.4%) and race (138 studies, 39.3%). Albumin and creatinine were the least common variables studied (1 or 2 studies each). Different case definitions affect the prevalence and treatment consequences of periodontitis. We need to standardize periodontitis case definitions worldwide to avoid difficulties in case diagnosis and prognosis. Further studies need to be done to assess the association between periodontitis and several potential confounders.
Topics: Age Factors; Chronic Periodontitis; Female; Humans; Male; Sex Factors
PubMed: 30622957
DOI: 10.1155/2018/4578782 -
Quintessence International (Berlin,... Mar 2016The correlation between periodontal status and systemic conditions, among them pregnancy, is widely described in the scientific literature. The aim of the present... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
The correlation between periodontal status and systemic conditions, among them pregnancy, is widely described in the scientific literature. The aim of the present systematic review of the literature was to evaluate periodontal diseases as an independent risk factor for adverse pregnancy outcomes.
DATA
Case-control studies reporting pregnancy outcomes and periodontal status of the subjects were included. Risk of bias evaluation was performed using a tool developed by the Cochrane Bias Methods Group. After risk of bias evaluation of included studies, a meta-analysis was performed computing the Risk Ratio (RR) for each pregnancy outcome.
SOURCES
Electronic databases (MedLine, Embase, Cochrane Central) were searched after preparation of an appropriate search string.
STUDY SELECTION
The search resulted in 422 entries that were screened. After application of inclusion and exclusion criteria, a total of 22 studies were included in the review accounting for a total of 17,053 subjects. The computed RR for periodontitis was 1.61 for preterm birth evaluated in 16 studies (P < .001), 1.65 for low birthweight evaluated in 10 studies (P < .001), and 3.44 for preterm low birthweight evaluated in four studies.
CONCLUSION
The present systematic review reported a low but existing association between periodontitis and adverse pregnancy outcomes. This assumption is the result of proper corrections of biased methodologies and of heterogeneity of studies. (.
Topics: Female; Humans; Infant, Low Birth Weight; Infant, Newborn; Periodontitis; Pregnancy; Pregnancy Outcome; Premature Birth; Risk Factors
PubMed: 26504910
DOI: 10.3290/j.qi.a34980 -
Journal of Clinical Periodontology Oct 2023To identify (i) the prevalence of meeting the endpoints of 'stable periodontitis' (probing pocket depth [PPD] ≤ 4 mm, bleeding on probing [BoP] < 10%, no BoP... (Meta-Analysis)
Meta-Analysis Review
Prevalence of stable and successfully treated periodontitis subjects and incidence of subsequent tooth loss within supportive periodontal care: A systematic review with meta-analyses.
AIM
To identify (i) the prevalence of meeting the endpoints of 'stable periodontitis' (probing pocket depth [PPD] ≤ 4 mm, bleeding on probing [BoP] < 10%, no BoP at 4 mm sites), 'endpoints of therapy' (no PPD > 4 mm with BoP, no PPD ≥ 6 mm), 'controlled periodontitis' (≤4 sites with PPD ≥ 5 mm), 'PPD < 5 mm' and 'PPD < 6 mm' at the start of supportive periodontal care [SPC]) and (ii) the incidence of tooth loss in relation to not meeting these endpoints within a minimum of 5 years of SPC.
MATERIALS AND METHODS
Systematic electronic and manual searches were conducted to identify studies where subjects, upon completion of active periodontal therapy, entered into SPC. Duplicate screening was performed to find relevant articles. Corresponding authors were contacted to confirm inclusion and retrieve required clinical data for further analyses to assess the prevalence of reaching endpoints and incidence of subsequent tooth loss, if available, within at least 5 years of SPC. Meta-analyses were carried out to evaluate risk ratios for tooth loss in relation to not reaching the various endpoints.
RESULTS
Fifteen studies including 12,884 patients and 323,111 teeth were retrieved. Achievement of endpoints at baseline SPC was rare (1.35%, 11.00% and 34.62%, respectively, for 'stable periodontitis', 'endpoints of therapy' and 'controlled periodontitis'). Less than a third of the 1190 subjects with 5 years of SPC data lost teeth-a total of 3.14% of all teeth were lost. Statistically significant associations with tooth loss, at the subject-level, were found for not achieving 'controlled periodontitis' (relative risk [RR] = 2.57), PPD < 5 mm (RR = 1.59) and PPD < 6 mm (RR = 1.98).
CONCLUSIONS
An overwhelming majority of subjects and teeth do not achieve the proposed endpoints for periodontal stability, yet most periodontal patients preserve most of their teeth during an average of 10-13 years in SPC.
Topics: Humans; Tooth Loss; Incidence; Prevalence; Retrospective Studies; Periodontitis
PubMed: 37402624
DOI: 10.1111/jcpe.13835 -
Journal of Periodontal Research Dec 2023Periodontitis is one of the most common dental diseases with a range of treatment approaches, including pathogenetically reasonable use of various host immune... (Meta-Analysis)
Meta-Analysis Review
Periodontitis is one of the most common dental diseases with a range of treatment approaches, including pathogenetically reasonable use of various host immune modulators. One such approach is the use of omega-3 polyunsaturated fatty acids (PUFAs) in combination with low-dose aspirin. This systematic review and meta-analysis were performed to compare the standard treatment alone and adjunctive use of omega-3 PUFAs in combination with low-dose aspirin with or without standard treatment in patients with periodontitis. A systematic review of the literature was performed using MEDLINE/PubMed, Cochrane Central and Google Scholar databases. Selection criteria included the following: randomized controlled trials in subjects with periodontitis in the age group above 18 years old, with follow-up periods ranging from 6 weeks to 6 months. The meta-analysis was performed using standard methodological procedures according to Cochrane recommendations, including assessment of risk-of-bias and level of evidence (GRADE). Meta-analysis was performed for such clinical outcomes as plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment loss (CAL), bleeding on probing (BOP) and bleeding index (BI) based on data from seven randomized clinical trials conducted between 2010 and 2020. It was shown that adjunctive use of omega-3 PUFAs in combination with low-dose aspirin results in significant clinical improvement in PD, CAL and GI during both short and prolonged follow-up periods. The use of omega-3 PUFAs and low-dose aspirin in periodontitis patients may be promising as an adjunct therapy, however, due to a limited number of patients and significant heterogeneity, further studies need to be conducted.
Topics: Humans; Adolescent; Periodontitis; Aspirin; Fatty Acids, Omega-3; Periodontal Index; Immunologic Factors
PubMed: 37787044
DOI: 10.1111/jre.13191 -
Clinical Oral Investigations Sep 2022To evaluate the role of metabolic syndrome (MetS) components in the association with periodontitis (PE) (#CRD42020218310). (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To evaluate the role of metabolic syndrome (MetS) components in the association with periodontitis (PE) (#CRD42020218310).
MATERIALS AND METHODS
A systematic electronic search was performed in PUBMED, Scielo and Lilacs databases up to April 2022. Cross-sectional, case-control, and cohort studies presenting data on the association between MetS and PE in the adult and elderly populations were included. A random effect meta-analysis was performed to determine association effect estimates. Results interpretation followed the assessment of methodological quality (Joana Briggs Institute tool) together with the certainty of evidence (GRADE approach).
RESULTS
This review included 52 studies, totalling 140,434 participants, and 38 studies were meta-analyzed. Association between PE and MetS was observed (OR from 1.27 to 1.90; PR = 1.19; RR from 1.10 to 1.37) (low and very low certainty of evidence). Hyperglycaemia (OR = 1.18), HDL (OR = 1.16), obesity (OR = 1.08), and hypertension (OR = 1.11) were associated with PE, except triglycerides (low and very low certainty of evidence). There was a dose-response gradient between the number of MetS components and PE, with a gradual increase in the effect magnitude for 1 (OR = 1.14), 2 (OR = 1.52), 3 or more (OR = 1.79), and 4 or 5 components (OR = 2.02) (low to high certainty of evidence).
CONCLUSIONS
MetS was associated with PE, with a dose-response gradient between the number of MetS components and the occurrence of PE, with an increasing effect magnitude according to an increasing number of components.
CLINICAL RELEVANCE
Periodontal examination should be part of a comprehensive propaedeutic approach of MetS patients, particularly those presenting a great number of components.
Topics: Adult; Aged; Case-Control Studies; Cross-Sectional Studies; Humans; Hypertension; Metabolic Syndrome; Periodontitis; Risk Factors
PubMed: 35716205
DOI: 10.1007/s00784-022-04583-x -
Current Vascular Pharmacology 2018Atherosclerosis is a multifactorial inflammatory disease of the cardiovascular system. It has been suggested that periodontitis, an infectious disease of oral cavity...
BACKGROUND
Atherosclerosis is a multifactorial inflammatory disease of the cardiovascular system. It has been suggested that periodontitis, an infectious disease of oral cavity caused by gramnegative anaerobic bacteria, could be linked to atherosclerosis.
OBJECTIVE
The objective of this systematic review was to assess the evidence between the association of periodontitis and atherosclerosis in adults.
METHODS
A systematic literature search was conducted in 7 databases up to January 2017, according to the Preferential Reports for Systematic Review and Meta-analysis (PRISMA) guidelines. Studies in humans with atherosclerosis were considered eligible when considering a group exposed to periodontitis and a control group (absence of periodontitis), in which the primary outcome was the association between the 2 diseases (atherosclerosis and periodontitis). The synthesis of the qualitative studies included was evaluated using previously validated checklist for assessing the risk of bias.
RESULTS
Among the 2138 studies found, 4 observational studies met the eligibility criteria and were included in the qualitative synthesis. All articles were considered adequate, presenting consistent and valid information. The results of the selected studies show the expected effects, being considered as low risk of bias.
CONCLUSION
The available evidence indicates an association between the 2 diseases, with elevated levels of inflammatory markers, mainly C-reactive protein and interleukin 6.
Topics: Adult; Age Factors; Aged; Atherosclerosis; Bacteria; C-Reactive Protein; Diabetes Mellitus; Female; Host-Pathogen Interactions; Humans; Inflammation Mediators; Interleukin-6; Male; Middle Aged; Periodontitis; Prognosis; Risk Factors; Sex Factors; Smoking
PubMed: 28875830
DOI: 10.2174/1570161115666170830141852 -
The Journal of Evidence-based Dental... Jun 2022Coenzyme Q10 gel might be beneficial for periodontitis. However, the results have been controversial. We designed a systematic review and meta-analysis to explore the... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Coenzyme Q10 gel might be beneficial for periodontitis. However, the results have been controversial. We designed a systematic review and meta-analysis to explore the efficacy of coenzyme Q10 in periodontitis patients.
MATERIALS AND METHODS
A systematic review of controlled trials (PROSPERO: CRD42020212424) was performed from 1980 to August 2020 by 2 separate investigators through the following databases: Embase, CENTRAL, PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, and ProQuest. Hand search of reference lists of the included studies was also performed. Of 269 records, eleven trials were included in the meta-analysis using a random-effect model.
RESULTS
Coenzyme Q10 could significantly reduce Plaque Index (SMD, -0.64; CI, -1.03 to -0.26, P = .002; I = 85.7%), Bleeding Index (SMD, -1.05; CI, -1.70 to -0.41, P = .001; I = 89.5%), Pocket Depth (SMD, -0.96; CI, -1.35 to -0.58, P ˂ .001, I = 84.7%), clinical attachment level (SMD, -0.73; CI, -1.23 to -0.22, P = .005; I = 87.8%), and gingival index (SMD, -0.63; CI, -0.97 to -0.28, P = .001; I = 72.8%) in periodontitis. Subgroup analysis showed that coenzyme Q10 had a stronger reduction effect if administered intra-pocket rather than topical. Studies with high risk of bias reported a greater positive effect of coenzyme Q10 compared to studies with unclear risk.
CONCLUSIONS
Our findings encourage administration of coenzyme Q10 gel in periodontitis based on its meaningful effect on Plaque Index, Bleeding Index, gingival index, clinical attachment level and Pocket Depth. Future studies with better qualities are required for a better conclusion.
Topics: Humans; Periodontitis; Ubiquinone
PubMed: 35718433
DOI: 10.1016/j.jebdp.2022.101710 -
Journal of Clinical Periodontology May 2013The aim of this systematic review (SR) was to evaluate the association between periodontitis and chronic kidney disease (CKD) and the effect of periodontal treatment... (Review)
Review
Periodontitis and chronic kidney disease: a systematic review of the association of diseases and the effect of periodontal treatment on estimated glomerular filtration rate.
AIM
The aim of this systematic review (SR) was to evaluate the association between periodontitis and chronic kidney disease (CKD) and the effect of periodontal treatment (PT) on the estimated glomerular filtration rate (eGFR).
METHODS
MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched up to and including September 30, 2012 to observational (S1) and interventional (S2) studies on the association of periodontitis with CKD. Studies were considered eligible for inclusion if they reported the eGFR. Search was conducted by two independent reviewers. The methodological quality of the observational studies was assessed using the Newcastle-Ottawa Scale (NOS) adapted for this review, and the Cochrane's Collaboration risk of bias assessment tool. A random-effects odds-ratio meta-analysis was conducted to estimate the degree of association between periodontitis and CKD.
RESULTS
Search strategy identified 2456 potentially eligible articles, of which four cross-sectional, one retrospective, and three interventional studies were included. Four S1, 80.0% reported some degree of association between periodontitis and CKD. Similarly, such an outcome was supported by pooled estimates (OR: 1.65, 95% Confidence Interval: 1.35, 2.01, p < 0.00001, χ(2) = 1.70, I(2 ) = 0%). All interventional studies found positive outcomes related to treatment.
CONCLUSION
There is quite consistent evidence to support the positive association between periodontitis and CKD, as well as the positive effect of PT on eGFR.
Topics: Bias; Glomerular Filtration Rate; Humans; Periodontitis; Renal Insufficiency, Chronic; Risk Factors; Treatment Outcome
PubMed: 23432795
DOI: 10.1111/jcpe.12067 -
The International Journal of... 2017Previous studies have shown that patients with rheumatoid arthritis (RA) have a higher susceptibility to periodontitis, but the results of individual studies remain... (Meta-Analysis)
Meta-Analysis Review
Previous studies have shown that patients with rheumatoid arthritis (RA) have a higher susceptibility to periodontitis, but the results of individual studies remain controversial. The aim of the present meta-analysis was to comprehensively evaluate the association between RA and periodontitis. A systematic literature search was conducted in PubMed and EMBASE. Data were extracted using standardized forms, and odds ratios (OR) with 95% confidence intervals (CI) were calculated for each study. Pooled data were estimated by fixed- and random-effects models if appropriate. Eight case-control studies were included in the present study. Study size ranged from 104 to 151,569 participants. The prevalence of periodontitis in RA patients ranged from 15.5% to 100%, compared with 10.0% to 82.1% in controls. In group 1 (control) and group 2, the heterogeneity was 38% and 11%, respectively. Using fixed-effects analysis, the overall pooled estimates of the ORs for periodontitis were 4.68 (95% CI: 3.11-7.05) and 1.28 (95% CI: 1.24-1.33) in groups 1 and 2, respectively. This meta-analysis indicates that RA was significantly associated with increased overall risk of periodontitis.
Topics: Arthritis, Rheumatoid; Humans; Periodontitis; Risk Factors
PubMed: 27977821
DOI: 10.11607/prd.2656 -
Clinical and Experimental Dental... Dec 2022To assess the Candida species occurrence rate and concentration in periodontal pockets in chronic periodontitis (CP) by meta-analysis. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
To assess the Candida species occurrence rate and concentration in periodontal pockets in chronic periodontitis (CP) by meta-analysis.
MATERIALS AND METHODS
A search was performed of articles published between January 1, 2010, and October 1, 2020, in English and in Russian, in the electronic databases MEDLINE-PubMed, Google Scholar, The Cochrane Library, ClinicalTrials.gov, Research Gate, eLIBRARY, and Cyberleninka (PROSPEROCRD42021234831). The odds ratio (OR), standardized mean difference (SMD), and 95% confidence interval (CI) were calculated using Review Manager 5.4.1 to compare the risk of CP when Candida spp. were detected in the gingival sulcus or periodontal pocket and to compare Candida spp. density counts in patients with CP and periodontally healthy patients.
RESULTS
Twenty-six studies were included in the systematic review and 11 were included in the meta-analysis. The results showed that Candida spp. may increase the chance of CP development by 1.76 times (OR = 1.76; 95% CI = 1.04-2.99; Z = 2.10; p = .04; I = 61%). More Candida spp. were found in patients with CP than in periodontally healthy patients (SMD = 1.58; 95% CI = 0.15-3.02; p = .03; I = 98%). No data were found relating to the statistically significant influence of Candida glabrata, Candida krusei and Candida tropicalis on CP development.
CONCLUSION
We found that Candida albicans insignificantly increased the risk of CP development but, due to the heterogeneity of the included studies, further research is necessary to determine the exact role of Candida spp. in the development and course of the inflammatory periodontal diseases.
Topics: Humans; Chronic Periodontitis; Candida; Periodontal Pocket; Candida albicans; Gingiva
PubMed: 35903878
DOI: 10.1002/cre2.635