Periodontitis severity relationship with metabolic syndrome: A systematic review with meta-analysis

The objective of this study was to investigate the association between periodontitis severity and metabolic syndrome (MetS) through systematic review, registered in PROSPERO: CRD42021232120. Selected articles were independently chosen by three reviewers from six databases, including using article reference lists, up until March 2022. Eligible studies were observational, without language limitation, and in subjects aged at least 18 years. The methodological quality of selected studies was assessed using the Newcastle-Ottawa Scale. Random effects models calculated summary measurements (odds ratio-OR, 95% confidence interval, 95%CI). The I² test evaluated the statistical heterogeneity of the data. Sensitivity, subgroup, and meta-regression analyses were performed. For the reliability of evidence, the Grading of Recommendations, Assessment, Development, and Evaluations tool was used. A total of 2133 records were identified, and 14 studies were included comprising 24,567 participants. The summary odds ratio showed a positive association between individuals with moderate (OR_adjusted = 1.26; 95%CI = 2.10–5.37; I² = 45.85%), and severe periodontitis (OR_adjusted = 1.50; 95%CI:1.28–1.71; I² = 56.46%), and MetS. Subgroup and meta-regression analyses showed that study effect size was influenced by year of publication, study design, and MetS diagnostic criteria, contributing to inter-study variability. The findings showed that moderate and severe levels of periodontitis are associated with MetS, suggesting a possible dose–response effect.     

Periodontal regeneration in aggressive periodontitis patients: A systematic review of the literature

The aim of the present study was to systematically review the existing literature on periodontal regenerative procedures in individuals affected by aggressive periodontitis (AgP). An electronic and manual search was performed using an ad hoc prepared search string. All types of study designs were considered acceptable for inclusion. Data about treated patients, baseline clinical parameters, type of surgery, and outcomes were extracted and recorded. A narrative evaluation of the results was performed. After the article‐selection process, a total of 22 full‐texts were included in the qualitative synthesis. Twelve papers were case reports; one was a retrospective study; six were non‐randomized, comparative studies; and three papers were published on two randomized, controlled trials (RCT). Various biomaterials and surgical techniques were described in the included papers. Based on the existing literature, even considering the relatively low level of evidence, periodontal regenerative surgery could be successfully performed in patients affected by AgP. There is a substantial need of high‐quality RCT to support this.     

Association between geographic tongue and psoriasis: A systematic review and meta‐analyses

Geographic tongue (GT) has been described as a predictor of psoriasis. The objective of this study was to analyse the prevalence of GT in psoriatic and non‐psoriatic patients. For this purpose, we conducted a systematic review and meta‐analysis. A literature search was performed on PubMed, Embase, Web of Science and the Cochrane Database of Systematic Reviews. The search and selection process was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) criteria. Only case‐control studies were selected, and the prevalence of GT in both groups was compared. Eleven articles met the inclusion criteria, and the frequency of GT was statistically associated with psoriasis in ten studies. The pooled odds ratio (OR) was 3.53 (95% confidence interval [CI] 2.56‐4.86). There were no significant differences between the presence of GT and the clinical form. However, the Psoriasis Area and Severity Index (PASI) score was statistically higher in patients affected by GT in three of four studies. Psoriatic patients with GT also exhibited less improvement in the PASI score after treatment. One study found an association between GT and a negative impact on patients’ quality of life. Nevertheless, age, gender, toxic habits, psoriasis onset and duration of the disease were not clearly associated. The results support the concept of GT as a manifestation of psoriasis. Future research should focus on the repercussions of GT in psoriatic patients, due to the negative consequences on severity and treatment response.     

Interaction of biologic therapy with apical periodontitis and periodontitis: a systematic review

Biologic medications (BMs) are increasingly used for the management of systemic chronic inflammatory diseases. These diseases are often associated with a higher prevalence of apical periodontitis (AP) and periodontitis (P). The purpose of this systematic review was to ascertain the interactions between AP and/or P and BMs. The review was registered in the PROSPERO database (CRD42017054756). Electronic searches were performed on Pubmed Medline, Scopus and The Web of Science from their inception through to 20 March 2018. The references of the articles selected were checked. The keywords were chosen based on a pilot search, which aimed to find the most frequently prescribed BMs. The included studies were appraised qualitatively using appropriate tools. Thirty‐five articles met the inclusion criteria, comprising 16 non‐randomized clinical studies, 12 in vivo animal studies and 7 case reports. Quality of information was assessed as high in 18 articles, moderate in 16 articles and low in 1 article. BMs in patients suffering from chronic inflammatory diseases seems to inhibit the progression of AP and P, and to enhance the healing response to periodontal and endodontic treatment. A healthier condition of the periodontal tissues seems to be associated with a better response of the patient to BMs therapy.     

The effect of smoking on periodontal bone regeneration: a systematic review and meta-analysis

Background: The effect of smoking on soft tissues after periodontal treatment has been extensively studied. However, little focus has been placed on the impact of smoking on bone regeneration after treatment. The aim of this review is to systematically assess the effect of smoking on bone regeneration after periodontal treatment. Methods: A protocol was established and studies were sourced from five electronic databases. Screening, data abstraction, and quality assessment was conducted by two review authors. Prospective and retrospective clinical studies assessing bone regeneration in smokers and non‐smokers after periodontal therapy were selected. In addition, arms of clinical trials comparing different interventions that reported results separately for smokers and non‐smokers were also included. Primary outcome measures were based on clinical and/or radiographic indicators of bone regeneration after periodontal therapy. The review and meta‐analysis followed many of the recommendations outlined in the preferred reporting items for systematic reviews and meta‐analyses statement. Results: Six of 10 studies included in this review concluded that smoking negatively influenced bone regeneration. A meta‐analysis of a subgroup of three studies demonstrated that smoking resulted in significantly less bone gain (P = 0.03) as measured by a change in the probing bone level after the treatment of intrabony defects with guided tissue regeneration. The meta‐analysis showed a standardized mean difference of ?2.05 (95% confidence interval: ?2.64 to ?1.47) using the random‐effects model. Conclusions: Smoking has a negative effect on bone regeneration after periodontal treatment. Patients should be advised that their smoking habit may result in poorer bone regeneration after periodontal treatment.     

Metronidazole and amoxicillin association in aggressive periodontitis: A systematic review and meta-analysis

The aim of this systematic review and meta-analysis was to evaluate the effects of metronidazole and amoxicillin in combination with mechanical therapy for the treatment of aggressive periodontitis. This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in the International Prospective Record of Systematic Reviews (CRD42018111595). The research was performed using PubMed/MEDLINE, Web of Science, Scopus, and Cochrane Library databases till December 2019 and included randomized clinical trials that analyzed whether the use of systemic metronidazole and amoxicillin improved the treatment response in patients with aggressive periodontitis. Altogether, 137 articles were identified and 4 studies were selected after applying the inclusion and the exclusion criteria. No statistically significant difference was observed in the clinical attachment level between the use of systemic antibiotics combined with scaling and root planning (SRP) and SRP without antibiotics (p = 0.52, mean deviation [MD]: 0.21, 95% confidence interval [CI]: −0.04–0.46). There was a statistically significant difference in the probing depth between the use of systemic antibiotics with SRP and the use of SRP alone (p = 0.02, MD: 0.40, 95% CI: 0.02–0.78). Gain in the clinical attachment level was not significantly higher when systemic antibiotics were used with SRP compared to SRP without antibiotics in the treatment of aggressive periodontitis. However, a statistically significant difference was observed in reduction in the probing depth.     

Oral health of patients with intellectual disabilities: A systematic review

A systematic review of original studies was conducted to determine if differences in oral health exist between adults who have intellectual disabilities (ID) and the general population. Electronic searching identified 27 studies that met the inclusion criteria. These studies were assessed for strength of evidence. People with ID have poorer oral hygiene and higher prevalence and greater severity of periodontal disease. Caries rates in people with ID are the same as or lower than the general population. However, the rates of untreated caries are consistently higher in people with ID. Two subgroups at especially high risk for oral health problems are people with Down syndrome and people unable to cooperate for routine dental care. Evidence supports the need to develop strategies to increase patient acceptance for routine care, additional training for dentists to provide this care, and the development of more effective preventive strategies to minimize the need for this care.     

Autoimmune disorders in oral lichen planus: A systematic review and meta-analysis

Objectives

The association of OLP with other autoimmune processes points to the possibility that OLP-affected patients are actually developing an autoimmune status that predisposes them to autoaggression against different targets. This systematic review and meta-analysis aim to evaluate the current evidence on the prevalence of autoimmune disorders in patients with OLP and their magnitude of association.

Methods

We searched PubMed, Embase, Web of Science, Scopus databases for the studies published before May 2021, with no limitation in regards to their publication date or language. We evaluated the quality of studies, carried out meta-analyses and performed heterogeneity, subgroups, meta-regression, and small-study effects analyses.

Results

Inclusion criteria were met by 153 studies (23,327 patients). Our results indicate the existence of high prevalence and a frequent association between OLP and some autoimmune disorders, especially in regards to thyroid disease (PP = 7.96%, 95% CI = 6.32–9.75; OR = 1.99, 95% CI = 1.60–2.49, p < 0.001) and diabetes mellitus (PP = 9.41%,95% CI = 8.16–10.74; OR = 1.64, 95% CI = 1.34–2.00, p < 0.001).

Conclusions

Our study demonstrates the existence of a comorbidity between autoimmune thyroid diseases as well as between diabetes mellitus and OLP respectively. Quality of evidence should be upgraded on other autoimmune diseases (fibromyalgia, gastrointestinal disorders, rheumatic diseases, Sjogren's syndrome, lupus erythematosus, and dermatological diseases) for which the current data do not allow us to know whether they are really associated with OLP.