Periodontal therapy as adjunctive treatment for gastric Helicobacter pylori infection

doi:10.1002/14651858.CD009477.pub2

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	Periodontal therapy as adjunctive treatment for gastric Helicobacter pylori infection
	Ren, Q; Yan, X; Zhou, YN; Li, WX; Yan, X (reprint author), Lanzhou Univ, Hosp 1, 1 Donggang West Rd, Lanzhou 730000, Gansu, Peoples R China.
刊名	COCHRANE DATABASE OF SYSTEMATIC REVIEWS
	2016
期号	2
ISSN号	1469-493X
DOI	10.1002/14651858.CD009477.pub2
文献子类	Review
英文摘要	Background Helicobacter pylori is estimated to affect about half the world's population and is considered as the main cause of chronic gastritis and peptic ulcer disease. Eradication of H. pylori infection accelerates ulcer healing and prevents relapse, reducing incidence of H. pylori-related gastric diseases. Numerous studies have provided evidence that the oral cavity could be a potential reservoir for H. pylori. The presence of oral H. pylori might affect the efficiency of eradication therapy and act as a causal force for its recurrence. Conversely, other investigators have indicated that the colonization and growth of H. pylori differs between the oral cavity and the stomach. Considering the open debate on the topic, it's necessary to clarify whether periodontal therapy is an effective adjunctive treatment for gastric H. pylori infection. Objectives To assess the effects of periodontal therapy plus eradication therapy versus eradication therapy alone for gastric H. pylori infection. The secondary objective is to compare the non-recurrence rate at long-term follow up in different treatment groups. Search methods We identified randomized controlled trials (RCTs) by searching the Cochrane Central Register of Controlled Trials (CENTRAL) (2015, Issue 8), MEDLINE (1946 to August 2015), EMBASE (1980 to August 2015), and the Chinese Biomedical Database (1978 to August 2015). We also searched both ClinicalTrials.gov and the WHO ICTRP portal in October 2015. We handsearched the reference lists of included studies to identify relevant trials. Selection criteria RCTs comparing periodontal therapy plus eradication treatment with eradication treatment alone, regardless of language of publication. Data collection and analysis Two reviewers selected the trials that met the inclusion criteria and extracted the details of each study independently. The data were pooled using both fixed-effect and random-effects models and results calculated as odds ratios (OR) with their 95% confidence intervals (CIs) based on an intention-to-treat analysis. However, because there was little difference in the results from these two models, we only reported the results from the fixed-effect model. Main results We included seven small RCTs involving 691 participants aged 17 to 78 years in our meta analyses. The primary result showed that periodontal therapy combined with H. pylori eradication treatment increased the eradication rate of gastric H. pylori compared with eradication treatment alone (OR 2.15; 95% CI 1.47 to 3.14; P < 0.0001) in people with H. pylori infection. In addition, periodontal therapy also had benefits on long-term gastric H. pylori eradication. After eradication of H. pylori, the non-recurrence rate of gastric H. pylori infection increased in participants treated with periodontal therapy compared with those who received eradication therapy alone (OR 3.60; 95% CI 2.11 to 6.15; P < 0.00001). According to the GRADE approach, the overall quality of the evidence was 'moderate' for eradication rate of gastric H. pylori and 'low' for non-recurrence rate of gastric H. pylori. Authors' conclusions Overall, periodontal therapy could increase the efficiency of H. pylori eradication and the non-recurrence rate of gastric H. pylori. In view of the limited number and quality of included studies, it will be necessary to conduct more well-designed, multicenter, and large-scale RCTs to determine the effects of periodontal therapy in eradicating gastric H. pylori and suppressing the recurrence of this bacterium in the stomach.
学科主题	General & Internal Medicine
出版地	HOBOKEN
项目编号	First Hospital of Lanzhou University, China ; Evidence-Based Medicine Center of Lanzhou University, China
语种	英语
WOS记录号	WOS:000373285000051
资助机构	LZU
内容类型	期刊论文
源URL	[http://ir.lzu.edu.cn/handle/262010/178544]
专题	第一临床医学院_期刊论文
通讯作者	Yan, X (reprint author), Lanzhou Univ, Hosp 1, 1 Donggang West Rd, Lanzhou 730000, Gansu, Peoples R China.
推荐引用方式 GB/T 7714	Ren, Q,Yan, X,Zhou, YN,et al. Periodontal therapy as adjunctive treatment for gastric Helicobacter pylori infection[J]. COCHRANE DATABASE OF SYSTEMATIC REVIEWS,2016(2).
APA	Ren, Q,Yan, X,Zhou, YN,Li, WX,&Yan, X .(2016).Periodontal therapy as adjunctive treatment for gastric Helicobacter pylori infection.COCHRANE DATABASE OF SYSTEMATIC REVIEWS(2).
MLA	Ren, Q,et al."Periodontal therapy as adjunctive treatment for gastric Helicobacter pylori infection".COCHRANE DATABASE OF SYSTEMATIC REVIEWS .2(2016).