有压力的牙周炎患者与无压力的患者相比,唾液皮质醇水平升高吗?系统回顾和荟萃分析。

Q3 Dentistry
Mohammed S Al-Ak'hali, Essam A Al-Moraissi, Hytham N Fageeh, Hani S Alakhali, Syed W Peeran, Turki A Khurayzi, Abdullah G Imran
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引用次数: 0

摘要

目的和背景:本荟萃分析旨在系统地评估牙周炎和压力与唾液皮质醇水平之间的关系。方法:从2005年1月至2023年8月,检索MEDLINE-PubMed、谷歌Scholar、EMBASE和CENTRAL四个主要数据库进行前瞻性和回顾性临床研究。所遵循的PECO指南如下:人群:牙周病患者;暴露:抑郁、压力或焦虑;比较:无牙周病,无抑郁、压力或焦虑;结果:唾液皮质醇水平。从每项研究中提取以下变量:作者、研究设计、样本量、唾液皮质醇水平(平均值)、牙周参数、压力评估方法和研究结果。偏倚风险采用纽卡斯尔-渥太华量表进行评估。统计分析包括计算标准化平均差异(SMD)及其相应的95%置信区间(CI)。meta分析采用综合meta分析版本2进行。结果:共筛选到101篇文献,经第一轮标题及摘要筛选排除73篇,经全文审查排除17篇。最后,我们考虑了11项临床研究,包括1565名参与者,满足系统评价的纳入标准。第一组纳入8项研究进行meta分析,第二组纳入7项研究进行meta分析。本系统综述纳入的11项研究中,7项为横断面研究,3项为病例对照研究,1项为随机双盲前瞻性研究。荟萃分析结果显示,与无牙周炎患者相比,牙周炎患者的皮质醇水平有统计学意义上的显著升高(SMD = -1.424, CI: -2.107至-0.740,p = 0.001,低质量证据)。此外,在经历压力的牙周炎患者中,皮质醇水平有统计学意义上的显著增加。结论:综述中包括的所有研究表明并证实了唾液皮质醇水平升高与牙周炎与压力之间的正相关。临床意义:本研究结果表明,牙周炎患者的治疗可以根据病情的临床方面和患者的压力水平进行定制。因此,临床医生应重视压力管理作为全面牙周护理的一部分。文章引用方式:Al- Ak'hali MS, Al- moraissi EA, Fageeh HN等。有压力的牙周炎患者与无压力的患者相比,唾液皮质醇水平升高吗?系统回顾和荟萃分析。[J]现代医学学报;2009;26(2):206-216。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Are Salivary Cortisol Levels Elevated in Periodontitis Patients Experiencing Stress Compared to Those without Stress? A Systematic Review and Meta-analysis.

Aim and background: This meta-analysis aims to systematically assess the association between periodontitis and stress in relation to salivary cortisol levels.

Methods: Four major databases, the MEDLINE-PubMed, Google Scholar, EMBASE, and CENTRAL databases, were searched from January 2005 to August 2023 for prospective and retrospective clinical studies. The PECO guidelines followed were as follows: Population: Patients with periodontal disease; Exposure: depression, stress, or anxiety; comparison: No periodontal disease and no depression, stress, or anxiety; outcome: salivary cortisol level. The following variables were extracted from each study: author, study design, sample size, saliva cortisol level (mean), periodontal parameters, method of stress evaluation, and the outcome of the study. The risk of bias was evaluated using the Newcastle-Ottawa Scale. The statistical analysis involved calculating standardized mean differences (SMD) and their corresponding 95% confidence intervals (CI). The meta-analysis was conducted using comprehensive meta-analysis version 2.

Results: A total of 101 articles were identified, of which 73 articles were excluded after the first round of screening of titles and abstracts and 17 articles were excluded after full-text examination. Finally, 11 clinical studies comprising of 1,565 participants that satisfied the inclusion criteria for the systematic review were considered. While eight studies were included for meta-analysis in the first comparison group and seven studies were considered for analysis in the second comparison group. Of the 11 studies included in the present systematic review, seven were cross-sectional studies, three were case-control studies, and one was randomized double-blinded prospective study. The meta-analysis findings indicated a statistically significant increase in cortisol levels among patients with periodontitis compared to those without periodontitis (SMD = -1.424, CI: -2.107 to -0.740, p = 0.001, low-quality evidence). Moreover, a statistically significant increase in cortisol levels was observed in patients with periodontitis who experienced stress.

Conclusion: Overall studies included in the review demonstrate and confirm a positive association between elevated salivary cortisol levels and periodontitis with stress.

Clinical significance: The results of this study suggest that treatment for periodontitis patients could be tailored to consider both the clinical aspects of the condition and the patient's stress levels. Thus, clinicians should pay attention to stress management as part of comprehensive periodontal care. How to cite this article: Al‑Ak'hali MS, Al-Moraissi EA, Fageeh HN, et al. Are Salivary Cortisol Levels Elevated in Periodontitis Patients Experiencing Stress Compared to Those without Stress? A Systematic Review and Meta-analysis. J Contemp Dent Pract 2025;26(2):206-216.

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来源期刊
Journal of Contemporary Dental Practice
Journal of Contemporary Dental Practice Dentistry-Dentistry (all)
CiteScore
1.80
自引率
0.00%
发文量
174
期刊介绍: The Journal of Contemporary Dental Practice (JCDP), is a peer-reviewed, open access MEDLINE indexed journal. The journal’s full text is available online at http://www.thejcdp.com. The journal allows free access (open access) to its contents. Articles with clinical relevance will be given preference for publication. The Journal publishes original research papers, review articles, rare and novel case reports, and clinical techniques. Manuscripts are invited from all specialties of dentistry i.e., conservative dentistry and endodontics, dentofacial orthopedics and orthodontics, oral medicine and radiology, oral pathology, oral surgery, orodental diseases, pediatric dentistry, implantology, periodontics, clinical aspects of public health dentistry, and prosthodontics.
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