Tooth Loss is a Risk Factor for Cardiovascular Disease Mortality: A Systematic Review with Meta-analyses

IF 3.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of endodontics Pub Date : 2024-10-01 DOI:10.1016/j.joen.2024.06.012

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引用次数: 0

Abstract

Introduction

The current evidence linking tooth loss and cardiovascular disease mortality is inconclusive. Thus, the aim of this systematic review was to explore the association between tooth loss and cardiovascular disease (CVD) mortality.

Methods

A comprehensive literature search of databases and gray literature included: Web of Science, Scopus, PubMed, Cochrane Central Register of Controlled Trials, Google Scholar, various digital repositories. The included studies reported on CVD mortality and tooth loss. The Newcastle-Ottawa scale was used to assess the quality of included studies. Random-effects meta-analysis method, sub-group analysis (based on the tooth loss categories (edentulous and fewer than 10 teeth present), meta-regression (based on the number. of confounders), publication bias, and sensitivity analysis were performed.

Results

Twelve articles met the eligibility criteria with an overall “Good” quality. A significant association between tooth loss (edentulous or less than 10 teeth present) and CVD mortality was found in the primary meta-analysis, which compiled data from 12 studies. The estimated hazard ratio was 1.66 (95% CI: 1.32–2.09), and there was high heterogeneity (I² = 82.42). Subgroup analysis revealed that the edentulous subgroup showed a higher risk with no significant heterogeneity, while the subgroup with fewer than 10 teeth showed a higher risk with substantial heterogeneity. Meta-regression analysis did not reveal any significant impact (P = .626) on whether variations in the number of confounders across studies would substantially affect the overall findings. No publication bias was detected and the sensitivity analysis based on the critical confounders also confirmed that tooth loss as a risk factor for CVD mortality (hazard ratio = 1.52, 95% CI: 1.28–1.80), (I² 51.82%).

Conclusion

The present systematic review reported that being edentulous or having lesser than 10 teeth is a predictive indicator of CVD mortality.

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牙齿脱落是心血管疾病死亡的风险因素：系统回顾与元分析》。

介绍：目前有关牙齿脱落与心血管疾病死亡率之间关系的证据尚无定论。因此，本系统综述旨在探讨牙齿脱落与心血管疾病（CVD）死亡率之间的关系：方法：对数据库和灰色文献进行了全面的文献检索：方法：对数据库和灰色文献进行了全面的文献检索，包括：Web of Science、Scopus、PubMed、CENTRAL、Google Scholar 和各种数字资料库。纳入的研究报告了心血管疾病死亡率和牙齿脱落情况。采用纽卡斯尔-渥太华量表评估纳入研究的质量。进行了随机效应荟萃分析法、亚组分析（基于缺牙类别（无牙和少于 10 颗牙齿））、元回归（基于混杂因素的数量）、发表偏倚和敏感性分析：结果：12 篇文章符合资格标准，总体质量为 "良好"。在对 12 项研究数据进行的主要荟萃分析中发现，牙齿缺失（无牙齿或牙齿少于 10 颗）与心血管疾病死亡率之间存在明显联系。估计危险比 (HR) 为 1.66（95% CI：1.32-2.09），异质性较高（I2 = 82.42）。亚组分析显示，无牙齿亚组的风险较高，但无明显异质性，而牙齿少于 10 颗的亚组的风险较高，但有很大异质性。元回归分析表明，不同研究中混杂因素数量的变化是否会对总体研究结果产生重大影响（p = 0.626）。没有发现发表偏倚，基于关键混杂因素的敏感性分析也证实，牙齿缺失是心血管疾病死亡的一个风险因素（HR = 1.52，95% CI：1.28- 1.80），（I2 51.82%）：本系统综述报告指出，无牙或牙齿少于 10 颗是心血管疾病死亡率的预测指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of endodontics 医学-牙科与口腔外科

CiteScore

8.80

自引率

9.50%

发文量

224

审稿时长

42 days

期刊介绍： The Journal of Endodontics, the official journal of the American Association of Endodontists, publishes scientific articles, case reports and comparison studies evaluating materials and methods of pulp conservation and endodontic treatment. Endodontists and general dentists can learn about new concepts in root canal treatment and the latest advances in techniques and instrumentation in the one journal that helps them keep pace with rapid changes in this field.