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目的系统评价评价牙周炎与绝经后骨质疏松症之间的关系。方法计算机检索PubMed(1966～2010.12)、EMbase(1974～2010.12)、CBM(1978～2010.12)、VIP(1989～2010.12)、CNKI(1979～2010.12)和万方数字化期刊全文数据库(1997～2010.12),并手工检索相关杂志及会议论文集中未发表的文献。由2位研究者按照纳入和排除标准筛选文献、提取资料并评价质量后,采用RevMan 5.0软件进行Meta分析。结果共纳入4个病例对照研究,合计678例患者,其中绝经后骨质疏松症组263例,非骨质疏松症组415例。4个研究的合并分析结果显示,绝经后骨质疏松症组临床附着丧失(clinical attachment loss,CAL)程度重于非骨质疏松症组[WMD=0.60,95%CI(0.23,0.96)]。2个研究的合并分析结果显示,绝经后骨质疏松症组牙龈退缩程度高于非骨质疏松症组[WMD=0.78,95%CI(0.41,1.14)]。2个研究合并分析结果显示,两组患者的菌斑指数、牙龈指数、牙周探诊深度之间差异均无统计学意义[WMD=0.17,95%CI(0.00,0.35);WMD=0.05,95%CI(–0.09,0.19);WMD=–0.08,95%CI(–0.24,0.09)]。1个研究发现绝经后骨质疏松症组患者牙周炎患病率高于非骨质疏松症组(P<0.05),与后者相比,前者更容易罹患牙周炎[OR=2.45,95%CI(1.38,4.34),P<0.01];该研究还认为,骨质疏松症与牙槽嵴高度发生重度丧失之间存在相关性[OR=4.20,95%CI(1.57,11.22),P<0.01]。结论绝经后骨质疏松症患者更易罹患牙周炎或其牙周炎病情容易加重。鉴于本系统评价纳入研究数量太少且病例不多,以及测量指标不全面等影响本Meta分析论证强度及全面性的因素存在,以上结论尚需开展更多高质量研究证实。
Objective To evaluate the relationship between periodontitis and postmenopausal osteoporosis. Methods We searched PubMed (1966-2010.12), EMbase (1974-2010.12), CBM (1978-2010.12), VIP (1989-2010.12), CNKI (1979-2010.12) and Wanfang Digital Periodical Full-text Database (1997-2010.12) And manually retrieve relevant unpublished papers in the Journal and Conference Proceedings. Two researchers screened the literature according to inclusion and exclusion criteria, extracted data and evaluated the quality, and then used RevMan 5.0 software to conduct meta-analysis. Results A total of 4 case-control studies were included, with a total of 678 patients, including 263 cases of postmenopausal osteoporosis and 415 cases of non-osteoporosis. The combined results of 4 studies showed that the clinical attachment loss (CAL) in postmenopausal osteoporosis group was more severe than that in non-osteoporosis group [WMD = 0.60,95% CI (0.23,0.96)]. The pooled analysis of the two studies showed that gingival recession in postmenopausal osteoporosis patients was higher than in non-osteoporosis patients [WMD = 0.78, 95% CI (0.41, 1.14)]. There was no significant difference in plaque index, gingival index and periodontal exploration depth between the two groups [WMD = 0.17, 95% CI (0.00,0.35); WMD = 0.05, 95% CI (-0.09, 0.19); WMD = -0.08, 95% CI (-0.24, 0.09)]. One study found that the prevalence of periodontitis in postmenopausal osteoporosis patients was higher than that in non-osteoporosis patients (P <0.05). Compared with the latter, the former was more susceptible to periodontitis (OR = 2.45, 95% CI (1.38, 4.34), P <0.01]. The study also found that there was a correlation between osteoporosis and severe loss of alveolar height [OR = 4.20,95% CI P <0.01]. Conclusions Patients with postmenopausal osteoporosis are more likely to develop periodontitis or their periodontitis is more likely to worsen. In view of the fact that there are too few and few cases in this systematic review, and the factors such as the incompleteness of the measurement indexes that affect the strength and comprehensiveness of this Meta analysis prove that the above conclusions still need to be confirmed by more high-quality research.