PDF(Pubmed)
Abstract：
OBJECTIVE: There are more than one million children and adolescents living with type 1 diabetes mellitus, and their number is steadily increasing. Diabetes affects oral health through numerous channels, including hyposalivation, immune suppression, and the inflammatory effect of glycation end-products. However, patients with type 1 diabetes must follow a strict sugar free diet that is proven to be carioprotective. Therefore, the aim of this systematic review and meta-analysis is to investigate whether children with type 1 diabetes have a difference in Decayed, Missing, Filled Teeth index (DMFT), salivary function, and periodontal status than children without diabetes, with an emphasis on glycemic control.
METHODS: PubMed, Embase and Cochrane libraries were screened for articles, using predefined search keys without any language or date restrictions. Two independent authors performed the selection procedure, extracted data from the eligible articles, carried out a manual search of the reference lists, and assessed the risk of bias using the Newcastle-Ottawa scale. Meta-analysis was performed in R using the random-effects model. Effect sizes were mean differences; subgroup analysis was performed on glycemic control.
RESULTS: 33 studies satisfied the eligibility criteria. 22 studies did not show a significant difference regarding the DMFT index between the diabetes and non-diabetes groups; six studies found that children living with diabetes had higher DMFT scores, compared to five studies that found significantly lower scores. Meta-analysis found no statistically significant differences in plaque, gingival, and calculus indexes, however it found significant differences in pooled DMFT indexes, and salivary flow rate. Subgroup analysis on glycemic control using DMFT values found significant differences in children with good and poor glycemic control with results of 0.26 (CI95%=-0.50; 1.03) and 1.46 (CI95%=0.57; 2.35), respectively.
CONCLUSIONS: Children with poor glycemic control face higher risk of developing caries compared to good control and non-diabetes children. Regular dental check-ups and strict control of glycemic levels are highly advised for children living with type 1 diabetes, further emphasizing the importance of cooperation between dentists and diabetologists.
METHODS: PubMed, Embase and Cochrane libraries were screened for articles, using predefined search keys without any language or date restrictions. Two independent authors performed the selection procedure, extracted data from the eligible articles, carried out a manual search of the reference lists, and assessed the risk of bias using the Newcastle-Ottawa scale. Meta-analysis was performed in R using the random-effects model. Effect sizes were mean differences; subgroup analysis was performed on glycemic control.
RESULTS: 33 studies satisfied the eligibility criteria. 22 studies did not show a significant difference regarding the DMFT index between the diabetes and non-diabetes groups; six studies found that children living with diabetes had higher DMFT scores, compared to five studies that found significantly lower scores. Meta-analysis found no statistically significant differences in plaque, gingival, and calculus indexes, however it found significant differences in pooled DMFT indexes, and salivary flow rate. Subgroup analysis on glycemic control using DMFT values found significant differences in children with good and poor glycemic control with results of 0.26 (CI95%=-0.50; 1.03) and 1.46 (CI95%=0.57; 2.35), respectively.
CONCLUSIONS: Children with poor glycemic control face higher risk of developing caries compared to good control and non-diabetes children. Regular dental check-ups and strict control of glycemic levels are highly advised for children living with type 1 diabetes, further emphasizing the importance of cooperation between dentists and diabetologists.
摘要：
目标：有超过一百万儿童和青少年患有1型糖尿病，他们的数量正在稳步增加。糖尿病通过多种渠道影响口腔健康，包括唾液分泌不足,免疫抑制，和糖基化终产物的炎症作用。然而,1型糖尿病患者必须遵循严格的无糖饮食，这种饮食被证明是保护龋齿的。因此,本系统评价和荟萃分析的目的是调查1型糖尿病儿童在衰变，失踪，补牙指数(DMFT),唾液功能,和牙周状况比没有糖尿病的儿童，强调血糖控制。
方法：PubMed，Embase和Cochrane图书馆进行了文章筛选，使用预定义的搜索键，没有任何语言或日期限制。两名独立作者进行了选择程序，从符合条件的文章中提取数据，对参考列表进行了手动搜索，并使用纽卡斯尔-渥太华量表评估偏倚风险。使用随机效应模型在R中进行Meta分析。效应大小为平均差异；对血糖控制进行亚组分析。
结果：33项研究符合资格标准。22项研究未显示糖尿病组和非糖尿病组之间的DMFT指数有显著差异；6项研究发现，患有糖尿病的儿童有更高的DMFT评分，与五项发现得分明显较低的研究相比。Meta分析发现斑块无统计学差异,牙龈,和微积分指数，然而，它发现汇集的DMFT指数存在显著差异，和唾液流速。使用DMFT值对血糖控制进行亚组分析发现，血糖控制良好和不良的儿童存在显着差异，结果为0.26（CI95％=-0.50;1.03）和1.46（CI95％=0.57;2.35），分别。
结论：血糖控制不良的儿童患龋齿的风险高于对照组和非糖尿病儿童。对于患有1型糖尿病的儿童，强烈建议定期进行牙科检查并严格控制血糖水平。进一步强调牙医和糖尿病专家之间合作的重要性。
方法：PubMed，Embase和Cochrane图书馆进行了文章筛选，使用预定义的搜索键，没有任何语言或日期限制。两名独立作者进行了选择程序，从符合条件的文章中提取数据，对参考列表进行了手动搜索，并使用纽卡斯尔-渥太华量表评估偏倚风险。使用随机效应模型在R中进行Meta分析。效应大小为平均差异；对血糖控制进行亚组分析。
结果：33项研究符合资格标准。22项研究未显示糖尿病组和非糖尿病组之间的DMFT指数有显著差异；6项研究发现，患有糖尿病的儿童有更高的DMFT评分，与五项发现得分明显较低的研究相比。Meta分析发现斑块无统计学差异,牙龈,和微积分指数，然而，它发现汇集的DMFT指数存在显著差异，和唾液流速。使用DMFT值对血糖控制进行亚组分析发现，血糖控制良好和不良的儿童存在显着差异，结果为0.26（CI95％=-0.50;1.03）和1.46（CI95％=0.57;2.35），分别。
结论：血糖控制不良的儿童患龋齿的风险高于对照组和非糖尿病儿童。对于患有1型糖尿病的儿童，强烈建议定期进行牙科检查并严格控制血糖水平。进一步强调牙医和糖尿病专家之间合作的重要性。
