Association Between Migraine and Periodontitis: A Systematic Review and Meta-Analysis

偏头痛与牙周炎的关联:系统评价和荟萃分析

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Abstract

BACKGROUND: Migraine is a global public health burden, with characteristics of stabbing pain, hypersensitivity and vegetative symptoms, affecting one billion people with multiple risk factors and potential pathophysiological mechanisms, including neuroinflammation. Periodontitis is a multifactorial disease that affects the dental supporting tissues (gingiva, periodontal ligament, root cementum, and alveolar bone), which in advanced stages can cause tooth loss. This pathology can have systemic implications, and its association with migraine offers a promising area of research to understand and treat both conditions. The aim of this study was to review the scientific evidence that links both pathologies. MATERIAL AND METHODS: A systematic review and meta-analysis was carried out using four databases (PubMed, Web of Science, Scopus, and Embase). A total of 197 articles were retrieved; after applying the selection criteria, a total of 8 articles were included in the review and 6 in the meta-analysis, which were combined using the Random Forest model. RESULTS: An OR of 1.8 with a 95% confidence interval = 1.4-2.32 was estimated. The meta-analysis showed a significant OR by Z-test = 4.55 (p < 0.001). Regarding publication bias, an intercept was obtained using Egger's regression method equivalent to 2.83 with a 95% confidence interval = 1.31-4.36 (p = 0.007). After qualitative analysis, we found risk factors (such as smoking and stress) and comorbidities (obesity, diabetes, hormonal disorders, among others) that could be involved in this association. CONCLUSIONS: Through this meta-analysis, we have seen how there is a statistically significant relationship between periodontitis and migraine.

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