Non-Cochrane · aetiology · PM38742908
Periodontitis and the risk of oral cancer: a meta-analysis of case-control studies.
Ma Yan, Tuerxun Nijiati, Maimaitili Gulibaha · Acta odontologica Scandinavica · 2024 · PubMed · doi:10.2340/aos.v83.40478
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
11
current version
GRADE rated
1
No studies
0
Included studies
16
linked below
No studies 0 · 0%Ungraded 10 · 90.9%Very low 0 · 0%Low 1 · 9.1%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Any population (PECO framework: P = any population) | 16 case-control studies; abstract reports 6,032 OC patients and 7,432 healthy controls, whereas the body text reports 12,584 cases and 19,273 controls (internal discrepancy) (n=16 studies) |
| Intervention | Exposure to a history of periodontitis or oral cancer (PECO: E) | Periodontitis; also tooth loss/missing teeth, clinical attachment loss (CAL), DMFT, periodontal pocket depth (PPD), alveolar bone loss (ABL) |
| Comparison | Not exposed to periodontitis or oral cancer (comparator without exposure) | Individuals without periodontitis / healthy controls |
| Outcomes | Outcome indicators related to oral cancer (OC) | Oral cancer (OC), oral squamous cell carcinoma (OSCC), oral/oropharyngeal (OOSCC), oropharyngeal and pharyngeal cancer |
| Study designs | Observational studies (case-control and cohort) reporting HR/OR/RR with 95% CI, or sufficient data to compute them; NOS for quality | Case-control studies (n=16); mean NOS 8.2 (range 5-9); 14 low risk of bias, 2 high risk of bias |
| Timing | Not specified | Not specified |
Search date: Up to September 2023 (databases from inception). Databases: EMBASE; PubMed; Web of Science; Cochrane Library
Questions and results
Periodontitis / periodontal disease (history or clinical diagnosis) vs No periodontitis (individuals without periodontal disease)
Population: Adults in case-control studies of oral cancer; people assessed for periodontitis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Oral cancer (OC) Not specified · Overall (random-effects pooled estimate) Periodontitis is associated with roughly a threefold higher odds of oral cancer (pooled OR 2.94, 95% CI 2.13-4.07; low certainty of evidence), though heterogeneity is moderate (I2=52.4%). Source: Abstract; Results 'The relationship between PD and OC'; Figure 2 (forest plot) · same question in other reviews | OR 2.94 [2.13, 4.07] | 8 studies · 6927 participants | Low |
Number of missing teeth (per additional tooth) vs One fewer missing tooth
Population: Adults in case-control studies of oral cancer
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Oral cancer (OC) Not specified · Missing teeth (per tooth) The number of missing teeth (per tooth) was not significantly associated with oral cancer (OR 0.96, 95% CI 0.92-1.01); ungraded. Source: Results 'The relationship between missing teeth and OC'; Figure 3 (subgroup 'missing per tooth') · same question in other reviews | OR 0.96 [0.92, 1.01] | 2 studies | Ungraded |
Oral cancer (OC) Not specified · Overall (all missing-teeth measures pooled) Pooling across all missing-teeth measures, the overall association with oral cancer was not statistically significant (OR 1.20, 95% CI 0.97-1.48; high heterogeneity, I2=82.8%); ungraded. Source: Results 'The relationship between missing teeth and OC'; Figure 3 (overall diamond) · same question in other reviews | OR 1.20 [0.97, 1.48] | 6 studies | Ungraded |
Oral cancer patients (cases) vs Healthy controls
Population: Adults in case-control studies (oral cancer patients vs healthy controls)
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Periodontal parameters (all measures pooled) in OC cases vs controls Not specified · Overall (all periodontal measures pooled) Pooling all periodontal measures, oral cancer patients had worse periodontal status than controls (SMD 0.95, 95% CI 0.41-1.49; very high heterogeneity, I2=96.8%); ungraded. Note this pools clinically different measures. Source: Results 'Assessing the difference of PD between OC and control groups'; Figure 4 (overall diamond) · same question in other reviews | SMD 0.95 [0.41, 1.49] | 5 studies | Ungraded |
DMFT index in OC cases vs controls Not specified · DMFT (decayed, missing, filled teeth) The DMFT index was significantly higher in oral cancer patients than controls (SMD 0.65, 95% CI 0.12-1.18); ungraded. Source: Abstract; Results 'Assessing the difference of PD between OC and control groups'; Figure 4 (subgroup DMFT) · same question in other reviews | SMD 0.65 [0.12, 1.18] | 2 studies | Ungraded |
Alveolar bone loss (ABL) in OC cases vs controls Not specified · ABL (alveolar bone loss) Alveolar bone loss did not differ significantly between oral cancer patients and controls (SMD 0.18, 95% CI -2.34 to 2.69; extreme heterogeneity); ungraded. Source: Results 'Assessing the difference of PD between OC and control groups'; Figure 4 (subgroup ABL) · same question in other reviews | SMD 0.18 [-2.34, 2.69] | 2 studies | Ungraded |
Oral cancer risk Missing teeth >15 Population: People with and without more than 15 missing teeth More than 15 missing teeth was associated with higher odds of oral cancer. Source: Figure 3; Results: The relationship between missing teeth and OC (I²=83.3%) · same question in other reviews | OR 1.91 [1.01, 3.62] | 5 studies | Ungraded |
Periodontal pocket depth (PPD) in OC cases vs controls Not specified · PPD (periodontal pocket depth) Periodontal pocket depth did not differ significantly between oral cancer patients and controls (SMD 1.64, 95% CI -0.20 to 3.47; very high heterogeneity); ungraded. Source: Results 'Assessing the difference of PD between OC and control groups'; Figure 4 (subgroup PPD) · same question in other reviews | SMD 1.64 [-0.20, 3.47] | 2 studies | Ungraded |
Mean number of missing teeth in OC cases vs controls Not specified · Missing teeth (mean count) The mean number of missing teeth did not differ significantly between oral cancer patients and controls (SMD 0.59, 95% CI -0.04 to 1.22); ungraded. Source: Results 'Assessing the difference of PD between OC and control groups'; Figure 4 (subgroup missing teeth) · same question in other reviews | SMD 0.59 [-0.04, 1.22] | 3 studies | Ungraded |
Clinical attachment loss (CAL) in OC cases vs controls Not specified · CAL (clinical attachment loss) Clinical attachment loss was significantly greater in oral cancer patients than controls (SMD 1.94, 95% CI 0.22-3.66), though heterogeneity was very high (I2=96.7%); ungraded. Source: Abstract; Results 'Assessing the difference of PD between OC and control groups'; Figure 4 (subgroup CAL) · same question in other reviews | SMD 1.94 [0.22, 3.66] | 2 studies | Ungraded |
Comparison
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Oral cancer (OC) Sensitivity analysis: excluding Moraes et al. [34] | OR 2.63 [1.92, 3.62] | 7 studies | Ungraded |
Included primary studies 16
Open as a trial list| Study | Also included by | Outcomes it informs here | Trial PICO | Results |
|---|---|---|---|---|
| Bundgaard 1995 Case-control study of squamous cell cancer of the oral cavity in Denmark DOI:10.1007/bf00051681 | this review only | not stated | not extracted yet | not extracted yet |
| Chang 2007 Investigating the association between oral hygiene and head and neck cancer DOI:10.1016/j.oraloncology.2013.07.004 | this review only | not stated | not extracted yet | not extracted yet |
| Chen 2021 Effect of Periodontitis and Scaling and Root Planing on Risk of Pharyngeal Cancer: A Nested Case-Control Study. PMID:33375028 | this review only | not stated | not extracted yet | not extracted yet |
| De Rezende 2008 Oral health changes in with oral and oropharyngeal cancer. PMID:18852988 | this review only | not stated | not extracted yet | not extracted yet |
| Garrote 2001 Risk factors for cancer of the oral cavity and oro-pharynx in Cuba. PMID:11437401 | this review only | not stated | not extracted yet | not extracted yet |
| Guha 2007 Oral Health and Risk of Squamous Cell Carcinoma of the Head and Neck and Esophagus: Results of Two Multicentric Case-Control Studies DOI:10.1093/aje/kwm193 | this review only | not stated | not extracted yet | not extracted yet |
| Komlos 2021 Periodontitis as a risk for oral cancer: a case-control study. PMID:34911520 | this review only | not stated | not extracted yet | not extracted yet |
| Laprise 2016 Periodontal diseases and risk of oral cancer in Southern India: Results from the HeNCe Life study DOI:10.1002/ijc.30201 | this review only | not stated | not extracted yet | not extracted yet |
| Moergel 2013 Chronic periodontitis and its possible association with oral squamous cell carcinoma - a retrospective case control study. PMID:24321243 | this review only | not stated | not extracted yet | not extracted yet |
| Moraes 2016 Association between Chronic Periodontitis and Oral/Oropharyngeal Cancer DOI:10.1590/0103-6440201600754 | this review only | not stated | not extracted yet | not extracted yet |
| Narayan 2014 Dental Caries and Periodontal Disease Status in Patients with Oral Squamous Cell Carcinoma: A Screening Study in Urban and Semiurban… PMID:26225008 | this review only | not stated | not extracted yet | not extracted yet |
| Rosenquist 2005 Oral status, oral infections and some lifestyle factors as risk factors for oral and oropharyngeal squamous cell carcinoma. A… DOI:10.1080/00016480510012273 | this review only | not stated | not extracted yet | not extracted yet |
| Shin 2019 Association of Periodontitis with Oral Cancer: A Case-Control Study DOI:10.1177/0022034519827565 | this review only | not stated | not extracted yet | not extracted yet |
| Tezal 2007 Chronic Periodontitis and the Risk of Tongue Cancer DOI:10.1001/archotol.133.5.450 | this review only | not stated | not extracted yet | not extracted yet |
| Tezal 2009 Chronic Periodontitis and the Incidence of Head and Neck Squamous Cell Carcinoma DOI:10.1158/1055-9965.epi-09-0334 | this review only | not stated | not extracted yet | not extracted yet |
| Zheng 1990 Dentition, oral hygiene, and risk of oral cancer: a case-control study in Beijing, People's Republic of China DOI:10.1007/bf00117475 | this review only | not stated | not extracted yet | not extracted yet |