Periodontitis and Oral Health-Related Quality of Life: A Systematic Review and Meta-Analysis.

AIM: To investigate the association between periodontitis and oral health-related quality of life (OHRQoL) in adults, and to compare OHRQoL across different severities of the disease. MATERIALS AND METHODS: Searches were conducted in five electronic databases up to December 2023. Observational studies that provided a clear definition of periodontitis and used validated measures of OHRQoL were included. Meta-analyses were performed both overall and based on factors that could explain heterogeneity between studies. RESULTS: Sixty studies comprising 14,851 individuals were included in the review. Meta-analyses showed that periodontitis was associated with impaired OHRQoL: any OHRQoL instruments (n = 33 studies; SMD: 0.75, 95% CI: 0.53-0.93), solely using the OHIP-14 (n = 26 studies; MD: 5.14, 95% CI: 3.64-6.64), and risk assessment (n = 9 studies; adjusted RR: 1.42, 95% CI: 1.12-1.78). Stages III-IV periodontitis had a greater impact than Stages I-II periodontitis. Subgroup and meta-regression analyses indicated smaller effect size estimates for individuals with comorbidities. CONCLUSIONS: Periodontitis negatively impacts OHRQoL, with a positive score-response relationship found between periodontitis severity and poorer OHRQoL. However, the magnitude of this association appears to be diminished in individuals with comorbidities.

Xerostomia impacts oral health-related quality of life in individuals with end-stage renal disease / Xerostomia impacta a qualidade de vida relacionada à saúde bucal de indivíduos em estágio final de doença renal crônica

ABSTRACT Objective: This two-centre cross-sectional study aimed to evaluate whether xerostomia occurrence is associated with oral health-related quality of life (OHRQoL) in patients with end-stage renal disease (ESRD) after the adjustment for potential confounders. Methods: Oral examinations were performed by calibrated examiners for untreated dental caries, periodontitis and tooth loss in 180 adults with ESRD. The presence of xerostomia was determined using the global question "How often does your mouth feel dry?". OHRQoL was evaluated by the simplified version of the Oral Health Impact Profile (OHIP14) questionnaire. Multivariate zero-inflated negative binomial regression analysis was used to calculate the incidence rate ratios (IRR) for the nonzero scores and odds ratios (OR) of having no impact in OHIP14 scores according to the presence of exposure. Results: In the adjusted model, xerostomia (IRR = 1.57; 95% CI: 1.12 to 2.20) was associated with poorer OHRQoL. The adjusted domain-specific analysis revealed that xerostomia occurrence significantly impacted the psychological disability and social disability, and the chance of having no impact was lower for the psychological discomfort domain (OR = 0.84; 95% CI: 0.12 to 0.98). Conclusion: Xerostomia exert an impact on OHRQoL in patients with ESRD, mainly in the psychological and social disabilities constructs.

RESUMO Objetivo: Este estudo transversal realizado em dois centros teve como objetivo avaliar se a ocorrência de xerostomia está associada à qualidade de vida relacionada à saúde bucal (QVRSB) em pacientes com doença renal crônica em estágio final (DRCEF) após o ajuste para potenciais fatores de confusão. Métodos: Exames bucais foram realizados por examinadores calibrados para cárie dentária não tratada, periodontite e perda dentária em 180 adultos com DRCEF. A presença de xerostomia foi determinada por meio da pergunta global "Com que frequência você fica com a boca seca?". A QVRSB foi avaliada pela versão simplificada do questionário Oral Health Impact Profile (OHIP-14). A análise multivariada de regressão binomial negativa inflacionada por zero foi usada para calcular as taxas de incidência (IRR) para os escores diferentes de zero e os razões de chance (OR) de não haver impacto nos escores do OHIP-14 de acordo com a presença dA exposição. Resultados: No modelo ajustado, a xerostomia (IRR = 1,57; IC 95%: 1,12 a 2,20) foi associada a pior QVRSB. A análise específica por domínio revelou que a ocorrência de xerostomia impactou significativamente a incapacidade psicológica e a incapacidade social, e a chance de não haver impacto foi menor para o domínio desconforto psicológico (OR = 0,84; IC95%: 0,12 a 0,98). Conclusão: A xerostomia exerce impacto sobre a QVRSB em pacientes com DRCEF, principalmente nos construtos de deficiência psicológica e social.

C-reactive protein levels are associated with periodontitis and periodontal inflamed surface area in adults with end-stage renal disease.

BACKGROUND: Several studies have shown the relationship between periodontal disease and chronic kidney disease, but there is little evidence to assess the impact of the amount of inflamed periodontal tissue on the levels of systemic inflammatory markers. So the aim of this study is determine the association between high-sensitivity C-reactive protein (hsCRP) and both periodontitis and periodontal inflamed surface area (PISA) in adults with end-stage renal disease (ESRD). METHODS: Cross-sectional study was conducted with 176 adults with ESRD on regular hemodialysis. The participants were submitted to a full-mouth periodontal examination to determine the occurrence of periodontitis and PISA. Regression analysis was performed to test the independent association between periodontal conditions and serum hsCRP levels. RESULTS: A total of 98.9% of the participants had periodontitis, with stages III and IV found in 26.1% and 52.9%, respectively. Mean hsCRP and PISA was 6.57 (SD: 6.03) mg/L and 217.15 (SD: 271.50), respectively. In the adjusted analysis, mean serum hsCRP levels were significantly higher in patients with stage III and IV generalized periodontitis compared with no/localized/generalized stages I-II (7.67 mg/L versus 5.72 mg/L, P = 0.028). After adjustments for confounding variables, individuals with PISA >490.56 mm2 (85th percentile) had a 3.26-fold greater chance of having hsCRP above 5 mg/L than their counterparts (OR = 3.26; 95% CI: 1.25 to 8.49). CONCLUSION: The inflammatory burden imposed by periodontitis can increase serum hsCRP levels in adults with end-stage renal disease.

Periodontitis is associated with oral health-related quality of life in individuals with end-stage renal disease.

AIM: The aim of the present study was to evaluate whether periodontitis is independently associated with oral health-related quality of life (OHRQoL) in individuals with end-stage renal disease (ESRD). MATERIALS AND METHODS: Calibrated examiners assessed 180 adults with ESRD. A full-mouth periodontal examination was performed at six sites on each tooth. Periodontitis was considered a categorical variable (absent, mild/moderate or severe). OHRQoL was assessed using the simplified version of the Oral Health Impact Profile (OHIP14 ) questionnaire. Adjusted multivariate Poisson regression analysis was used with a conceptual hierarchical approach to calculate the rate ratio (RR) of OHIP14 scores for periodontitis according to the severity categories. RESULTS: In the adjusted model, mild/moderate and severe periodontitis were significantly associated with poorer OHRQoL compared to the absence of periodontitis [RR = 1.49 (95% confidence interval: 1.16-1.91) and RR 1.77 (95% CI: 1.36-2.30), respectively]. The adjusted domain-specific analysis revealed that mild/moderate periodontitis significantly impacted the psychological disability domain and severe periodontitis significantly impacted the physical pain, psychological discomfort, physical disability and psychological disability domains. CONCLUSIONS: Periodontitis exerts an influence on OHRQoL in individuals with ESRD, with a more severe condition impacting different domains.