AbstractObjectiveThe systematic review aimed to review the existing evidence, to identify and appraise the effectiveness of periodontal prevention and treatment modalities in individuals diagnosed with Down syndrome (DS) and to determine the estimates of the effects of implemented periodontal prevention and treatment strategies compared to chromosomally normal (CN) individuals.MethodologyThe systematic review was conducted and reported in conformity with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines.

摘要目的系统评价旨在回顾现有证据，确定和评估诊断为唐氏综合征（DS）的个体的牙周预防和治疗方式的有效性，并确定与染色体正常（CN）个体相比，实施的牙周预防和治疗策略的效果估计。方法学系统评价按照PRISMA（系统评价和荟萃分析的首选报告项目）指南进行和报告。

The study protocol was registered in the Open Science Framework. Electronic and manual searches, in accordance with PICO framework and delineated inclusion/exclusion criteria, were conducted in multiple databases.ResultsThe initial search identified 11,704 studies. After removing duplicates, 9,048 remained.

该研究方案已在开放科学框架中注册。根据PICO框架和划定的纳入/排除标准，在多个数据库中进行了电子和手动搜索。。删除重复项后，剩下9048个。

Title and abstract screening narrowed these to 281 for full-text review. Ultimately, 16 studies met the inclusion criteria, with 4 eligible for quantitative data synthesis. Results of the meta-analysis indicated that professional tooth cleaning in combination with oral hygiene reinforcement was less effective in the reduction of PPD in patients with DS compared to those without DS (Mean difference (MD): 0.23; 95% Confidence Interval (CI): 0.14 to 0.32; p < 0.001).DiscussionThese findings suggest that conventional periodontal treatment is less effective in managing periodontitis in patients with DS.

标题和摘要筛选将全文审查的范围缩小到281个。最终，有16项研究符合纳入标准，其中4项符合定量数据合成的条件。荟萃分析结果表明，与没有DS的患者相比，专业牙齿清洁联合口腔卫生强化对DS患者PPD的减少效果较差（平均差异（MD）：0.23；95%置信区间（CI）：0.14至0.32；p<0.001）。讨论这些发现表明，常规牙周治疗对DS患者的牙周炎治疗效果较差。

Thus, tailored periodontal care strategies that address the specific needs of individuals with DS should be implemented to improve treatment outcomes for this population The presence of moderate to high risk of bias in the included studies underscores the need for rigorously designed research that minimizes bias through effective bl.

因此，应实施针对DS患者特定需求的量身定制牙周护理策略，以改善该人群的治疗效果。纳入研究中存在中度至高度偏倚风险，这强调需要严格设计的研究，通过有效的bl将偏倚降至最低。

Key points

关键点

Based on the best available evidence, professional tooth cleaning combined with oral hygiene instructions appears to be less effective in reducing probing pocket depths in individuals with Down syndrome (DS) compared to those without DS.

根据现有的最佳证据，与没有唐氏综合症（DS）的人相比，专业的牙齿清洁结合口腔卫生指导似乎在减少唐氏综合症（DS）患者的探测袋深度方面效果不佳。

The current evidence highlights the vulnerability of the DS population to periodontal diseases and emphasizes the need for increased awareness, enhanced monitoring, preventive measures, and personalized treatment planning.

目前的证据突出了DS人群对牙周疾病的脆弱性，并强调需要提高认识，加强监测，预防措施和个性化治疗计划。

This systematic review provides new insights into the effectiveness of previously implemented interventions, which may encourage the development of new oral health strategies beneficial not only to individuals with DS but also to those with other abnormalities and intellectual impairments.

这项系统评价为以前实施的干预措施的有效性提供了新的见解，这可能会鼓励制定新的口腔健康策略，不仅对DS患者有益，而且对其他异常和智力障碍患者有益。

IntroductionDown syndrome (DS) comprises one of the most frequently existing neurodevelopmental birth defects, constituting a chromosomal deviation that is correlating with trisomy of chromosome 21 and with a frequency of 1 per 700–1200 nascencies a year1,2. Depending on the type of genetic manifestation, the neurodevelopmental aberration is divided into three types of which primary nondisjunction trisomy 21 measures up to approximately 95 percent of the deviation3,4.

引言唐氏综合征（DS）包括最常见的神经发育出生缺陷之一，构成与21号染色体三体性相关的染色体变异，每年每700-1200个新生1,2个。根据遗传表现的类型，神经发育异常分为三种类型，其中原发性非分离三体性21测量高达约95%的偏差3,4。

Mosaicism and translocations, ordinarily of Robertsonian type, accounts for the remaining 5 percent of the aberration5,6.Individuals with DS display phenotypical, physiological, neurological and orofacial manifestations that deviate, alter in severity and considerably impacts the influenced individuals well-being7.

镶嵌和易位通常是罗伯逊类型，占畸变的剩余5%，6。患有DS的个体表现出表型，生理，神经和口面部表现，这些表现偏离，严重程度改变，并对受影响的个体产生重大影响7。

The clinical manifestation of periodontal disease in these patients is advanced, generalized, and demonstrates a haste progression with an increased disease prevalence of up to 100 percent below the age of 30 years8,9. Nevertheless, the progression and severity of periodontal diseases have been demonstrated to be of slower character in terms of alveolar bone loss progression in radiographs over a seven-year period in comparison with previously delineated findings10,11.

这些患者牙周病的临床表现是晚期，全身性的，并且表现出快速进展，疾病患病率在30岁以下高达100%8,9。然而，与之前描述的结果相比，牙周疾病的进展和严重程度已被证明在七年的X线片中牙槽骨丢失进展较慢10,11。

Even though individuals with DS exhibits a severe clinical manifestation of periodontal tissue breakdown, the seriousness goes beyond the breakdown of the periodontal tissues solely caused by confined oral hygiene measures. Greater propensities to inflammatory diseases and infections, notably periodontal infections, may be correlated with immunological aberrations11,12,13.

尽管患有DS的个体表现出牙周组织破坏的严重临床表现，但其严重性超出了仅由有限的口腔卫生措施引起的牙周组织破坏。更大的炎症性疾病和感染倾向，特别是牙周感染，可能与免疫异常有关11,12,13。

Increased concentrations of Type 1 T helper (Th) 1 and Th2 and Th17-interrelated cytokines have been shown in the gingival crevicular fluid (GCF) in comparison .

相比之下，龈沟液（GCF）中显示出1型辅助性T细胞（Th）1和Th2和Th17相关细胞因子的浓度增加。

Data availability

数据可用性

The authors confirm that the data supporting the findings within this study are available within this article.

作者证实，本文中提供了支持本研究结果的数据。

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Download referencesFundingOpen access funding provided by Karolinska Institute.Author informationAuthors and AffiliationsDivision of Periodontology and Oral Health, Department of Dental Medicine, Karolinska Institutet, Stockholm, SwedenZakaria Yehia, Angelika Silbereisen, Mahla Arabzadehtousi & Nagihan BostanciDepartment of Orthodontics, Folktandvården Stockholms län AB, Folktandvården Eastmaninstitutet, Stockholm, SwedenZakaria YehiaClinic of Orthodontics and Pediatric Dentistry, Center of Dental Medicine, University of Zurich, Zurich, SwitzerlandDespina KoletsiMeta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USADespina KoletsiDivision of Orthodontics and Pediatric Dentistry, Department of Dental Medicine, Karolinska Institutet, Stockholm, SwedenGeorgios TsilingaridisCentre of Pediatric Oral Health, Stockholm, SwedenGeorgios TsilingaridisAuthorsZakaria YehiaView author publicationsYou can also search for this author in.

下载由卡罗琳学院提供的参考基金开放获取资金。作者信息作者和附属机构斯德哥尔摩卡罗林斯卡研究所牙科医学系牙周病学和口腔健康系，斯维登扎卡里亚Yehia，Angelika Silbereisen，Mahla Arabzadehtousi＆Nagihan BostanciDepartment of Ortodontics，Folktandvården Stockholms län AB，Folktandvården Eastmaninstitutet，斯德哥尔摩，斯维登扎卡里亚Yehia口腔正畸和儿科牙科诊所，苏黎世大学牙科医学中心，苏黎世，瑞士科莱西梅塔研究创新中心在斯坦福大学（METRICS）、斯坦福大学（Stanford University）、加利福尼亚州斯坦福市（Stanford），USAspedina KoletsiDivision of Orthontics and Pediatric Dentistry，Department of Dental Medicine，Karolinska Institutet，Stockholm，SwedenGeorgios TsilingaridisCentre of Pediatric Oral Health，Stockholm，SwedenGeorgios TsilingaridisAuthorsZakaria YehiaView Author Publications，您也可以在中搜索这位作者。

PubMed Google ScholarAngelika SilbereisenView author publicationsYou can also search for this author in

PubMed Google ScholarAngelika SilbereisenView作者出版物您也可以在

PubMed Google ScholarDespina KoletsiView author publicationsYou can also search for this author in

PubMed Google ScholarDespina KoletsiView作者出版物您也可以在

PubMed Google ScholarMahla ArabzadehtousiView author publicationsYou can also search for this author in

PubMed Google ScholarMahla ArabzadehtousiView作者出版物您也可以在

PubMed Google ScholarGeorgios TsilingaridisView author publicationsYou can also search for this author in

PubMed Google Scholargios TsilingaridisView作者出版物您也可以在

PubMed Google ScholarNagihan BostanciView author publicationsYou can also search for this author in

PubMed Google ScholarNagihan BostanciView作者出版物您也可以在

PubMed Google ScholarContributionsZY reviewed the existing literature evidence base. ZY, NB, AS, GT and DK constructed the search strategy. The designed search strategy was approved and validated by all authors. ZY conducted and completed the article selection in accordance with delineated inclusion and exclusion criteria.

PubMed Google ScholarContributionsZY回顾了现有的文献证据基础。ZY，NB，AS，GT和DK构建了搜索策略。设计的搜索策略得到了所有作者的批准和验证。ZY根据划定的纳入和排除标准进行并完成了文章选择。

DK re-assessed the article selection. ZY conducted the extraction of data. DK, GT, NB re-examined and validated the data. ZY conducted the quality assessments and risk of bias of included studies. DK, GT, NB validated the quality assessments. DK conducted the meta-analysis. ZY, NB, AS and DK analyzed all results.

DK重新评估了文章选择。ZY进行了数据提取。DK，GT，NB重新检查并验证了数据。ZY进行了纳入研究的质量评估和偏倚风险。DK、GT、NB验证了质量评估。DK进行了荟萃分析。ZY，NB，AS和DK分析了所有结果。

ZY wrote the first draft of the article and prepared the tables and figures excluding the meta-analysis. DK prepared the meta-analysis figures, tables and wrote the meta-analysis text. All authors reviewed and approved the final version of the manuscript.Corresponding authorCorrespondence to.

ZY撰写了文章的初稿，并准备了不包括荟萃分析的表格和数字。DK准备了荟萃分析图表，并撰写了荟萃分析文本。所有作者都审查并批准了稿件的最终版本。对应作者对应。

Nagihan Bostanci.Ethics declarations

Nagihan Bostanci。道德宣言

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Reprints and permissionsAbout this articleCite this articleYehia, Z., Silbereisen, A., Koletsi, D. et al. Efficacy of periodontal treatment modalities in Down syndrome patients: a systematic review and meta-analysis.

转载和许可本文引用本文Yehia，Z.，Silbereisen，A.，Koletsi，D。等人。唐氏综合症患者牙周治疗方式的疗效：系统评价和荟萃分析。

Evid Based Dent (2024). https://doi.org/10.1038/s41432-024-01055-xDownload citationReceived: 21 March 2024Accepted: 01 July 2024Published: 25 August 2024DOI: https://doi.org/10.1038/s41432-024-01055-xShare this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

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