Associação entre periodontite e qualidade de vida relacionada à saúde bucal: revisão sistemática e metanálise

Abstract

Assessing the perception of individuals in relation to their oral health allows for a multidimensional and, therefore, more comprehensive analysis of the impact of different oral diseases and conditions, such as periodontitis, on quality of life. The aim of this study is to systematically review the association between periodontitis and oral health-related quality of life (OHRQoL) in adult individuals. Electronic searches were performed in PubMed, Embase, Web of Science and Scopus databases up to September 2020. Additional studies were identified through grey literature and by manual search. Only observational studies with clinical periodontal examination, definition of periodontitis and a validated instrument for measuring OHRQoL were included. The NewCastle-Ottawa scale was used to assess the risk of bias. Meta-analyses of standardized mean differences (SMD) and mean differences (MD) were performed. Sixty studies comprising a total of 29,924 individuals were included in the review and 37 studies were included in the meta-analyses. The meta-analyses (OHIP-14/49 and OIDP, SMD 1.24, 95%CI: 0.45 to 2.04; GOHAI-ADD and OHQoL-UK, SMD -0.71, 95% CI: -1.12- to -0.29) as well as the pooled estimates with OHIP-14 ([log] OR 1.84, 95% CI: 1.42 to 2.38) showed that periodontitis is associated with impaired OHRQoL. Individuals with periodontitis were 84% more likely to report a negative impact on OHRQoL. The subgroup results (OHIP-14, MD 4.42, 95% CI: 3.00 to 5.84) showed that the study design, composition of the sample, economic classification of the country, parameters used to define periodontitis and type of comparison group influenced the combined estimates. The comparison group seemed to explain approximately 20% of the heterogeneity among studies. A dose-response gradient was found between greater periodontal disease severity and poorer OHRQoL. Our findings suggest that periodontitis is associated with impaired of OHRQoL. Additional high-quality studies are recommended to further explore this association.