title: Association between Herpesviruses and Chronic Periodontitis: A Meta-Analysis Based on Case-Control Studies.
abstract: OBJECTIVE
  Numerous 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.
  
  
  METHODS
  A 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.
  
  
  RESULTS
  Ten 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).
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: Department of Preventive Dentistry, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Stomatology, Shanghai, China.
authors.forename: Ce
authors.initials: C
authors.lastname: Zhu
authors.affiliation: Department of Preventive Dentistry, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Stomatology, Shanghai, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Li
authors.affiliation: Dental Public Health, Faculty of Dentistry, University of Hong Kong, Hong Kong, China.
authors.forename: May Chun Mei
authors.initials: MC
authors.lastname: Wong
authors.affiliation: Department of Preventive Dentistry, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Stomatology, Shanghai, China.
authors.forename: Xi-Ping
authors.initials: XP
authors.lastname: Feng
authors.affiliation: Department of Preventive Dentistry, Ninth People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai Key Laboratory of Stomatology, Shanghai, China.
authors.forename: Hai-Xia
authors.initials: HX
authors.lastname: Lu
authors.affiliation: Department of Preventive Dentistry, Shanghai Municipal Hospital for Oral Health, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Xu
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D055113:Chronic Periodontitis / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D003587:Cytomegalovirus / Q000472:pathogenicity* / Q000502:physiology; D005260:Female; D006566:Herpesviridae Infections / Q000150:complications / Q000175:diagnosis* / Q000821:virology; D004854:Herpesvirus 4, Human / Q000472:pathogenicity* / Q000502:physiology; D016199:Herpesvirus 7, Human / Q000472:pathogenicity / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D018139:Simplexvirus / Q000472:pathogenicity / Q000502:physiology