title: Association between depression and periodontitis: a systematic review and meta-analysis.
abstract: OBJECTIVE
  The aim of this systematic review and meta-analysis was to assess the scientific evidence on the association between depression and periodontitis.
  
  
  METHODS
  An electronic search was conducted in three databases until October 2015 (PROSPERO-CRD42014006451). Hand searches and grey literature were also included. Search retrieved 423 potentially studies. Two independent reviewers selected the studies, extracted data and assessed risk bias through a modified version of Newcastle-Ottawa scale. Meta-analysis was performed for the presence/absence of periodontitis (dichotomic). Summary effect measures and odds ratio (OR) 95% CI were calculated.
  
  
  RESULTS
  After selecting the studies, 15 were included in the systematic review (eight cross-sectional, six case-control and one cohort study). Six studies reported that depression was associated with periodontitis, whereas nine studies did not. The majority of studies had low risk of bias by methodological quality assessment. Meta-analysis of seven cross-sectional studies showed no significant association between depression and periodontitis (OR = 1.03, 95% CI = 0.75-1.41).
  
  
  CONCLUSIONS
  Findings from the present systematic review showed a great heterogeneity among the studies and the summary effect measure of the meta-analysis cannot affirm an association between depression and periodontitis. Future studies with different designs in distinct populations should be conducted to investigate this association.
authors.affiliation: Department of Dental Clinics, Oral Pathology, and Oral Surgery, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Milena Moreira
authors.initials: MM
authors.lastname: Araújo
authors.affiliation: Department of Pediatric Dentistry and Orthodontics, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Carolina Castro
authors.initials: CC
authors.lastname: Martins
authors.affiliation: Department of Dental Clinics, Oral Pathology, and Oral Surgery, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Lidiane Cristina Machado
authors.initials: LC
authors.lastname: Costa
authors.affiliation: Department of Dental Clinics, Oral Pathology, and Oral Surgery, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Luís Otávio Miranda
authors.initials: LO
authors.lastname: Cota
authors.affiliation: Department of Dental Clinics, Oral Pathology, and Oral Surgery, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Rodrigo Lamounier Araújo Melo
authors.initials: RL
authors.lastname: Faria
authors.affiliation: Department of Dental Clinics, Oral Pathology, and Oral Surgery, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Fabiano Araújo
authors.initials: FA
authors.lastname: Cunha
authors.affiliation: Department of Dental Clinics, Oral Pathology, and Oral Surgery, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors.forename: Fernando Oliveira
authors.initials: FO
authors.lastname: Costa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003863:Depression; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D010518:Periodontitis; D055815:Young Adult
keywords: aggressive periodontitis; chronic periodontitis; depressive disorders.periodontal disease; periodontitis