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Associação entre a síndrome de Sjögren e a doença periodontal : revisão sistemática e meta-análise
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Advisor(s)
Abstract(s)
Introdução: A Síndrome de Sjögren (SS) é uma doença autoimune que afeta todo o corpo, mas possui principal apetência para com as glândulas exócrinas. As glândulas salivares são comumente afetadas pela Síndrome de Sjögren, provocando xerostomia. A doença periodontal aparenta estar associada à xerostomia, mas a sua associação com a Síndrome de Sjögren ainda não está provada.
Objetivo: Determinar a associação entre a doença periodontal com a Síndrome de Sjögren através da avaliação da profundidade de sondagem, hemorragia à sondagem, índice de placa, índice gengival e perda de inserção interproximal.
Métodos: A pesquisa foi realizada com recurso a três bases de dados: PubMed, B-On e Google Scholar. As estatísticas, gráficos das meta-análises, meta-regressões e meta-análises de subgrupo foram realizadas usando o software Open Meta [Analyst] e JASP. As meta-análises foram ajustadas considerando a presença de efeitos randomizados segundo o método de Restricted Maximum Likehood (REML). O grau de discordância de cada resultado meta-analítico foi avaliado através do índice de heterogeneidade (I²). Foi considerado que o valor obtido é estatisticamente suportado quando o p < 0.05.
Resultados: Foi obtido um valor médio meta-analítico de 0.181 de diferença de média da Profundidade de sondagem (PS), de 0.639 de diferença de média da Perda de inserção (PI), de 10.105 de diferença de média da Hemorragia à sondagem (HS), de 0.210 de diferença de média do Índice de placa (IP) e de 0.172 de diferença de média do Índice gengival (IG). As meta-regressões e meta-análises de subgrupo mostraram que algumas variáveis continuas e categóricas têm um efeito significativo no parâmetro periodontal avaliado.
Conclusão: Os pacientes com SS possuem piores valores dos parâmetros periodontais PI e HS, pelo que é essencial o tratamento multidisciplinar desta doença.
Introduction: Sjögren Syndrome is an autoimmune disease that influences the whole body, but it affects mainly exocrine glands. The salivary glands are affected by the Sjögren Syndrome, leading to xerostomia. The periodontal disease seems to be associated to xerostomia, but its association with Sjögren Syndrome is not proven. Objective: Evaluate the association between the periodontal disease with Sjögren Syndrome by evaluating the probing depth, bleeding on probing, plaque index, gingival index, and clinical attachment loss. Methods: The research was conducted using three databases: PubMed, B-On and Google Scholar. The meta-analysis was adjusted considering the presence of randomized effects by the REML (Restricted Maximum Likehood) method. The degree of disagreement of each meta-analytic result was assessed by the heterogeneity index (I²). It was considered that the difference observed was statistically supported when p < 0.05. Results: It was obtained a medium meta-analytic value of 0.181 means difference of probing depth, of 0.639 means difference in clinical attachment loss, of 10.105 means difference in bleeding on probing, of 0.210 of mean difference in plaque index and 0.172 mean difference in gingival index. In the meta-regression and subgroup meta-analysis showed that some continued and categorical variables have a significative effect on the evaluated periodontal parameter. Conclusion: SS patients have worst values periodontal values of clinical attachment loss and bleeding on probing, so it is important to have a multidisciplinary treatment of this disease.
Introduction: Sjögren Syndrome is an autoimmune disease that influences the whole body, but it affects mainly exocrine glands. The salivary glands are affected by the Sjögren Syndrome, leading to xerostomia. The periodontal disease seems to be associated to xerostomia, but its association with Sjögren Syndrome is not proven. Objective: Evaluate the association between the periodontal disease with Sjögren Syndrome by evaluating the probing depth, bleeding on probing, plaque index, gingival index, and clinical attachment loss. Methods: The research was conducted using three databases: PubMed, B-On and Google Scholar. The meta-analysis was adjusted considering the presence of randomized effects by the REML (Restricted Maximum Likehood) method. The degree of disagreement of each meta-analytic result was assessed by the heterogeneity index (I²). It was considered that the difference observed was statistically supported when p < 0.05. Results: It was obtained a medium meta-analytic value of 0.181 means difference of probing depth, of 0.639 means difference in clinical attachment loss, of 10.105 means difference in bleeding on probing, of 0.210 of mean difference in plaque index and 0.172 mean difference in gingival index. In the meta-regression and subgroup meta-analysis showed that some continued and categorical variables have a significative effect on the evaluated periodontal parameter. Conclusion: SS patients have worst values periodontal values of clinical attachment loss and bleeding on probing, so it is important to have a multidisciplinary treatment of this disease.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Síndrome de Sjögren Periodontite Doença periodontal Xerostomia Doença autoimune