Periodontal condition of patients with Thalassemia Major: A systematic review and meta-analysis.

• Patients with Thalassemia Major (TM) had increased gingival inflammation scores compared to systemically healthy controls. • Patients with TM require adequate oral hygiene instructions and motivation. • Conduction of well-designed observational studies including statement of checklist for transparent reporting is needed. The aim of this systematic review was to evaluate the existing evidence on the association between Thalassemia major (TM) and periodontal condition. MEDLINE via OVID, EMBASE, and The Cochrane Database (including the Central Register of Controlled Trials (CENTER)), were searched up to September 2018 to identify observational studies eligible for systematic review and meta-analyses. Newcastle-Ottawa Scale (NOS) was used for quality assessment. The initial search resulted in 172 articles, and of these, 16 articles were included and a qualitative synthesis was carried out. Based on the quantitative data from 14 studies, significant differences were found in gingival index (GI) (p < 0.001), bleeding on probing (p = 0.02) as well as plaque index (PI) (p < 0.01) measures between TM and systemically healthy controls. Additional analyses (young vs. adult) for GI and PI revealed that such significant differences were only observed in adults, even though overall analysis showed no subgroup effect. The majority of the studies qualified as "intermediate quality". Patients with TM had significantly higher gingival inflammation scores compared to controls. Therefore, routine comprehensive periodontal screening in TM is recommended in order to prevent occurrence of periodontal diseases and eventually reduce the complexity of the oral health care. Also, conduction of further well-designed observational studies is recommended to contribute to this topic. [ABSTRACT FROM AUTHOR]