目的:比较龋齿,口腔卫生,牙周状况,磨牙症,错牙合,牙齿脱落,以及自闭症和典型发育个体之间的唾液变化。
方法:提供孤独症谱系障碍(ASD)个体和对照组之间口腔结果临床测量的观察性研究。EMBASE,LILACS,PubMed,PsycINFO,Scopus,WebofScience,谷歌学者,和ProQuest被搜索到2023年6月26日。成对的评审员独立进行研究选择,数据提取,以及方法学质量和证据确定性的评估。进行了标准化平均差异(SMD)和风险比(RR)的荟萃分析。
结果:共有47项研究纳入了6885名自闭症患者。孤独症个体在乳牙中的龋齿经历的严重程度明显更高(SMD0.29,95CI0.02,0.56),牙菌斑的存在(SMD0.59,95CI0.24,0.94),和牙龈炎(SMD0.45,95CI0.02,0.88)。孤独症患者出现牙龈炎的概率较高(RR1.34,95CI1.08,1.66),磨牙症(RR4.23,95CI2.32,7.74),超喷(RR2.16,95CI1.28,3.64),过咬合(RR1.62,95CI1.02,2.59),交叉咬合(RR1.48,95CI1.02,2.13),和开放(RR2.37,95CI1.46,3.85),与神经典型个体相比。大多数估计显示效果很小,证据的确定性很低。
结论:自闭症患者的口腔健康状况比对照组差。
结论:本文报告的研究结果可以帮助制定健康政策,以更好地为自闭症患者服务,包括预防行动和获得专门的牙科护理。
OBJECTIVE: To compare dental caries, oral hygiene, periodontal status, bruxism, malocclusion, tooth loss, and salivary alterations between autistic and typical developing individuals.
METHODS: Observational studies presenting clinical measures of oral outcomes between autism spectrum disorder (ASD) individuals and controls. EMBASE, LILACS, PubMed, PsycINFO, Scopus, Web of Science, Google Scholar, and ProQuest were searched up to June 26, 2023. Pairs of reviewers independently conducted study selection, data extraction, and assessments of methodological quality and certainty of evidence. Meta-analyses of standardized mean differences (SMD) and risk ratio (RR) were performed.
RESULTS: A total of 47 studies comprising 6885 autistic individuals were included in the
review. Autistic individuals had significantly higher severity of dental-caries experience in primary teeth (SMD 0.29, 95%CI 0.02, 0.56), of dental plaque presence (SMD 0.59, 95%CI 0.24, 0.94), and of gingivitis (SMD 0.45, 95%CI 0.02, 0.88). Autistic individuals showed higher probability of occurrence of gingivitis (RR 1.34, 95%CI 1.08, 1.66,), bruxism (RR 4.23, 95%CI 2.32, 7.74), overjet (RR 2.16, 95%CI 1.28, 3.64), overbite (RR 1.62, 95%CI 1.02, 2.59), crossbite (RR 1.48, 95%CI 1.02, 2.13), and openbite (RR 2.37, 95%CI 1.46, 3.85), when compared to neurotypical individuals. Most estimates showed a small effect size with very low certainty of evidence.
CONCLUSIONS: Autistic individuals show worse oral health status than controls.
CONCLUSIONS: The findings reported herein can help to build health policies to better serve autistic individuals including prevention actions and access to specialized dental care.