Abstract
Periodontitis is a complex multifactorial disease whose etiology is not yet, well defined, and recently increasing attention has been focused on the genetic risk factors of periodontal disease. The purpose of this study was to analyze published literature on the association between genetic polymorphisms and periodontal disease by a systematic review method. A comprehensive medical literature database, including Medline, EMBASE, BIOSIS Previews, and Japana Centra Revuo Medicina, was searched to retrieve primary research papers on the relationship between genetic polymorphisms and periodontal diseases, and the papers included retrospective studies that compared the prevalence of genetic polymorphisms between periodontitis patients and healthy controls. The exclusion criteria were papers on the genes of microorganisms and on periimplantitis. Studies with subjects less than 10 were also excluded. There were 44 papers that met our selection criteria, and they were reviewed. Seven papers were on Fcγreceptors, 14 on interleukin-1 (IL-1), 8 on tumor necrosis factors (TNFs), and the rest were on other genetic polymorphisms. Most of the studies were fairly well documented in regard to the reproducibility of study methods and the definition of patients/controls, but many studies failed to describe examiner masking in regard to clinical status. All 7 papers on the genotype of Fcγreceptors reported evidence supporting a relationship to periodontitis. Two of 6 papers reported a positive association between IL-1 allele polymorphisms and adult periodontitis, and 1 of 3 papers reported a positive association between IL-1 polymorphisms and early-onset periodontitis. None of the 8 papers on TNFs demonstrated a significant correlation between polymorphisms and periodontitis. Due to the lack of the consistency of the definition of periodontal diseases and because of the great heterogeneity of each population studied, a cumulative meta-analysis of predictor measures for periodontal disease was impassible. The evidence from the articles reviewed indicated significant associations between periodontitis and some specific genetic polymorphisms, but some reports showed bidirectional results. Further rigorous studies based on well-defined disease and control criteria will be required to contribute to the prevention and management of periodontitis. J Jpn Soc Periodontol, 45: 150-462, 2003.
