Efficacy of periodontal treatment modalities in Down syndrome patients: a systematic review and meta-analysis

Q3 Dentistry

Evidence-based dentistry Pub Date : 2024-08-25 DOI:10.1038/s41432-024-01055-x

Zakaria Yehia, Angelika Silbereisen, Despina Koletsi, Mahla Arabzadehtousi, Georgios Tsilingaridis, Nagihan Bostanci

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Abstract

The systematic review aimed to review the existing evidence, to identify and appraise the effectiveness of periodontal prevention and treatment modalities in individuals diagnosed with Down syndrome (DS) and to determine the estimates of the effects of implemented periodontal prevention and treatment strategies compared to chromosomally normal (CN) individuals. The systematic review was conducted and reported in conformity with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The study protocol was registered in the Open Science Framework. Electronic and manual searches, in accordance with PICO framework and delineated inclusion/exclusion criteria, were conducted in multiple databases. The initial search identified 11,704 studies. After removing duplicates, 9,048 remained. Title and abstract screening narrowed these to 281 for full-text review. Ultimately, 16 studies met the inclusion criteria, with 4 eligible for quantitative data synthesis. Results of the meta-analysis indicated that professional tooth cleaning in combination with oral hygiene reinforcement was less effective in the reduction of PPD in patients with DS compared to those without DS (Mean difference (MD): 0.23; 95% Confidence Interval (CI): 0.14 to 0.32; p < 0.001). These findings suggest that conventional periodontal treatment is less effective in managing periodontitis in patients with DS. Thus, tailored periodontal care strategies that address the specific needs of individuals with DS should be implemented to improve treatment outcomes for this population The presence of moderate to high risk of bias in the included studies underscores the need for rigorously designed research that minimizes bias through effective blinding, randomization, control of confounding factors, and inclusion of diverse treatment outcomes to further investigate these associations. Based on the best available evidence, professional tooth cleaning combined with oral hygiene instructions appears to be less effective in reducing pocket depths in individuals with DS compared to those without DS. https://doi.org/10.17605/OSF.IO/UXTCG

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唐氏综合征患者牙周治疗方法的疗效：系统回顾和荟萃分析。

目的该系统综述旨在审查现有证据，确定和评估牙周病预防和治疗方法对确诊为唐氏综合征（DS）患者的有效性，并确定与染色体正常（CN）患者相比，已实施的牙周病预防和治疗策略的效果估计值：系统综述的开展和报告符合 PRISMA（系统综述和元分析首选报告项目）指南。研究方案已在开放科学框架中注册。根据 PICO 框架和界定的纳入/排除标准，在多个数据库中进行了电子和人工检索：初步检索发现了 11 704 项研究。去除重复的研究后，还剩下 9048 项。通过标题和摘要筛选，将这些研究缩减到 281 项，以便进行全文审阅。最终，16 项研究符合纳入标准，其中 4 项符合定量数据综合的条件。荟萃分析的结果表明，与无 DS 的患者相比，专业洁牙结合口腔卫生强化措施在减少 DS 患者 PPD 方面的效果较差（平均差 (MD)：0.23；95% 置信区间 (CI)：0.14 至 0.32；P 讨论）：这些研究结果表明，传统的牙周治疗在控制 DS 患者的牙周炎方面效果较差。所纳入的研究存在中度至高度偏倚风险，这突出表明需要进行严格的研究设计，通过有效的盲法、随机化、混杂因素控制和纳入不同的治疗结果来进一步研究这些关联，从而最大限度地减少偏倚：https://doi.org/10.17605/OSF.IO/UXTCG。

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来源期刊

Evidence-based dentistry Dentistry-Dentistry (all)

CiteScore

2.50

自引率

0.00%

发文量

期刊介绍： Evidence-Based Dentistry delivers the best available evidence on the latest developments in oral health. We evaluate the evidence and provide guidance concerning the value of the author''s conclusions. We keep dentistry up to date with new approaches, exploring a wide range of the latest developments through an accessible expert commentary. Original papers and relevant publications are condensed into digestible summaries, drawing attention to the current methods and findings. We are a central resource for the most cutting edge and relevant issues concerning the evidence-based approach in dentistry today. Evidence-Based Dentistry is published by Springer Nature on behalf of the British Dental Association.