Current knowledge on correlations between highly prevalent dental conditions and chronic diseases: an umbrella review [Dataset]

Introduction: There are existing studies investigating relationships between chronic systemic and dental conditions, but it remains unclear how such knowledge can be used in clinical practice. The present report provides an overview on existing systematic reviews, identifying and evaluating the most frequently reported dental-chronic disease correlations and common risk factors. Methods: A systematic review on existing systematic reviews published between 1995 and 2017 was conducted (umbrella review) and indexed into four databases. The focus was set on the three most prevalent dental conditions and ten chronic systemic diseases with the highest burden of disease in Germany. Two independent reviewers assessed all articles for eligibility, methodological quality using the AMSTAR criteria, and extracted data from the included studies. Results: 32 out of the initially identified 1,249 systematic reviews were included for qualitative synthesis. The dental conditions with most frequently observed correlations to chronic systemic diseases was periodontitis. The chronic systemic disease with most frequently observed correlations with a dental condition was diabetes mellitus type 2. Most dental-chronic disease correlations were found between periodontitis and diabetes mellitus type 2 and periodontitis and cardiovascular disease. Frequently reported common risk factors included smoking, age, sex and overweight. Using the AMSTAR criteria, 2 studies were assessed as low quality, 26 studies moderate and 4 studies high quality. Conclusion: The quality of included systematic reviews was heterogenous. The most frequently reported correlations were found for periodontitis with diabetes mellitus type 2 and for cardiovascular disease with diabetes mellitus type 2. Yet the strength of evidence for these and other disease correlations remains limited. The evidence to assess the causality of these disease correlations remains unclear. Future research should therefore focus on the causality of disease links in order to provide more decisive evidence with respect to the design of intersectoral care processes.

引言：现有研究已围绕慢性全身性疾病与口腔疾病的关联展开探索，但目前仍未明确该类研究成果如何应用于临床实践。本报告对现有系统综述（systematic review）进行梳理汇总，旨在识别并评估报道频次最高的口腔-慢性疾病关联及常见危险因素。方法：本研究针对1995年至2017年间发表的现有系统综述开展伞状综述（umbrella review），并在4个数据库中进行文献检索。研究聚焦于德国患病率最高的3种口腔疾病与疾病负担最重的10种慢性全身性疾病。由2名独立评审员对所有文献进行纳入资格评估，采用AMSTAR量表评价其方法学质量，并从纳入的研究中提取相关数据。结果：初始检索共获得1249篇系统综述，最终纳入32篇开展定性综合分析。与慢性全身性疾病关联报道最多的口腔疾病为牙周炎（periodontitis）；与口腔疾病关联报道最多的慢性全身性疾病为2型糖尿病（diabetes mellitus type 2）。最常被报道的口腔-慢性疾病关联为牙周炎与2型糖尿病，以及牙周炎与心血管疾病（cardiovascular disease）。常见的共同危险因素包括吸烟、年龄、性别与超重。采用AMSTAR量表评价后，2项研究被评为低质量，26项为中等质量，4项为高质量。结论：纳入研究的系统综述质量参差不齐。最常被报道的疾病关联为牙周炎与2型糖尿病，以及心血管疾病与2型糖尿病。但上述及其他疾病关联的证据强度仍较为有限，评估此类疾病关联因果关系的相关证据尚不明确。因此，未来研究应聚焦于疾病关联的因果关系探索，以期为跨部门照护流程的设计提供更具决定性的循证依据。