Abstract
ObjectiveNumerous studies have investigated the associations between herpesviruses and chronic periodontitis; however, the results remain controversial. To derive a more precise estimation, a meta-analysis on all available studies was performed to identify the association between herpesviruses and chronic periodontitis.MethodsA computerized literature search was conducted in December 2014 to identify eligible case-control studies from the PUBMED and EMBASE databases according to inclusion and exclusion criteria. Data were extracted and pooled odds ratios (OR) with 95% confidence intervals (CI) were used to assess the association between herpesviruses and risk of chronic periodontitis. A fixed or random effects model was determined based on a heterogeneity test. Sensitivity analysis was conducted to investigate stability and reliability. Publication bias was investigated using the Begg rank correlation test and Egger's funnel plot.ResultsTen eligible studies were included to investigate the association between Epstein–Barr virus (EBV) and chronic periodontitis. The results showed that EBV has a significant association with chronic periodontitis compared with periodontally healthy group (OR = 5.74, 95% CI = 2.53–13.00, P<0.001). The association between human cytomegalovirus (HCMV) and chronic periodontitis was analyzed in 10 studies. The pooled result showed that HCMV also has a significant association with chronic periodontitis (OR = 3.59, 95% CI = 1.41–9.16, P = 0.007). Similar results were found in the sensitivity analyses. No significant publication bias was observed. Two eligible studies were included to investigate the association between herpes simplex virus (HSV) and chronic periodontitis risk. The association between HSV and chronic periodontitis was inconclusive (OR = 2.81 95% CI = 0.95–8.27, P = 0.06). Only one included study investigated the association between human herpesvirus 7 (HHV-7) and chronic periodontitis risk (OR = 1.00, 95% CI = 0.21–4.86).ConclusionThe findings of this meta-analysis suggest that two members of the herpesvirus family, EBV and HCMV, are significantly associated with chronic periodontitis. There is insufficient evidence to support associations between HSV, HHV-7 and chronic periodontitis.
Highlights
Periodontitis is a complex disease that is among the most prevalent microbial diseases and chronic inflammatory diseases worldwide [1]
The results showed that Epstein–Barr virus (EBV) has a significant association with chronic periodontitis compared with periodontally healthy group (OR = 5.74, 95% confidence intervals (CI) = 2.53–13.00, P
The pooled result showed that human cytomegalovirus (HCMV) has a significant association with chronic periodontitis (OR = 3.59, 95% CI = 1.41–9.16, P = 0.007)
Summary
Periodontitis is a complex disease that is among the most prevalent microbial diseases and chronic inflammatory diseases worldwide [1]. Several studies have reported the absence of these specific bacterial species in patients with periodontal disease, and no significant difference has been found in the prevalence of bacteria between healthy and diseased periodontal tissues [3,4]. It is becoming increasingly clear that some major clinical characteristics of periodontitis, such as, site specificity, self-limited progression and recurrence, are difficult to be explained by the theory of bacterial infection [5]. In view of this issue and the fact that most evidence for the bacterial etiology of periodontitis is indirect, some scholars have suggested that the pure bacterial cause for periodontitis had been overemphasized [6]
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