肥満と小児の第1および第2永久臼歯の萌出との関連：系統的レビュー

Association of obesity with the eruption of first and second permanent molars in children: a systematic review.

抄録

背景:

永久歯の萌出時期、特に第一大臼歯と第二大臼歯の萌出時期は、咬合、う蝕リスク、予防および矯正歯科的介入の時期に影響を及ぼすため、非常に重要である。

BACKGROUND: Eruption timing of permanent teeth, particularly first and second molars, is of great importance due to its influence on occlusion, caries risk and timing of preventive and orthodontic intervention.

目的:

16歳未満の小児における肥満と第1および第2永久臼歯の萌出時期との相関を評価するエビデンスを、標準体重の小児と比較して評価すること。

AIM: To evaluate the evidence assessing the correlation between obesity and eruption time of first and second permanent molars in children under 16 years of age as compared to normal-weight children. A secondary aim was to assess the total number of erupted teeth in both groups.

方法:

PubMed、MEDLINE、EMBASE、Scopus、Web of Scienceを含むデータベースの系統的検索を行った。体格指数（BMI）、調整BMI、zスコアが歯の萌出に及ぼす影響を評価した研究を対象とした。米国国立衛生研究所（National Institute of Health）の「観察コホート研究および横断研究の質評価ツール（Quality Assessment Tool for Observational Cohort and Cross-sectional Studies）」を用いて対象論文の質を評価した。メタ解析には、95％信頼区間（CI）を用いたランダム効果モデルを考慮した。

METHODS: A systematic search of databases including PubMed, MEDLINE, EMBASE, Scopus and Web of Science was conducted. Studies that assessed the effect of body mass index (BMI), adjusted BMI or z scores on dental eruption were included. National Institute of Health 'Quality Assessment Tool for Observational Cohort and Cross-sectional Studies' was used to assess the quality of included papers. A random-effects model with its 95% confidence intervals (CIs) was considered for meta-analysis.

結果:

重複除去を行った上で、合計381報の論文をスクリーニングした。全文を読んだ論文は26報で、そのうち19報が除外された。1件は縦断的研究、6件は横断的研究であった。6つの研究で、歯牙萌出と肥満との正の関連が認められた。2つの研究が探索的メタ解析に含まれ、その結果、肥満の12歳児は他の12歳児よりも萌出歯が1本多い可能性が高く、その平均差（MD）は（0.99、95％CI 0.628-1.352）であった。

RESULTS: A total of 381 papers were screened following duplicate removal. Twenty-six papers were read in full text, of which 19 were excluded. Seven studies were included in this review; one was longitudinal, and six were cross-sectional in design. A positive association of dental eruption with obesity was noted in six studies. Two studies were included in the explorative meta-analysis, the results of which indicated that obese, 12-year-olds are likely to have one more erupted tooth than their counterparts with a mean difference (MD) of (0.99, 95% CI 0.628-1.352).

結論:

第1および第2乳臼歯の萌出時期を含め、肥満と歯の萌出との間には正の相関があるようである。バイアスの主なリスクは、組み入れられた研究の横断的性質と潜在的交絡因子の管理不足から生じる。この関連を明らかにするためには、さらなる質の高いエビデンスが必要である。PROSPERO登録（CRD42017084368）。

CONCLUSION: There appears to be a positive correlation between obesity and dental eruption including the eruption timing of first and second permanent molars. Main risk of bias arises from the cross-sectional nature of included studies and lack of control of potential confounders. Further high-quality evidence is required to elucidate this association. Registration PROSPERO (CRD42017084368).

登録:

プロスペロー（CRD42017084368）。

REGISTRATION: PROSPERO (CRD42017084368).