title: Association between overweight/obesity and periodontal disease in children and adolescents: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To provide a systematic review and meta-analyses investigating the association between overweight/obesity as defined by Body Mass Index (BMI) and periodontal disease in terms of clinical periodontal outcomes.
  
  
  METHODS
  A systematic search of the literature was conducted by two authors (SR and SD) independently in the Cochrane Library, PubMed, Web of Science (ISI), Scopus, Scielo, Lilacs and System for Information on Grey Literature in Europe (SIGLE) for full articles published until September 2015. Studies analysing the association between overweight/obesity as defined by Body Mass Index (BMI) and periodontal disease in children and/or adolescents (age ≤18 years) were included. The Gwets AC1 inter-rater reliability coefficient for screening data was calculated using Agreestat 2011.1. Meta-analyses were carried out by using RStudio version 0.97.551-©2009-2012 RStudio, Inc. software.
  
  
  RESULTS
  A total of 769 titles and abstracts were screened and 12 articles met the inclusion criteria for the systematic review while only 7 were selected for meta-analyses. The Gwets AC1 inter-rater reliability coefficient for screening data was excellent (0.98; CI 0.98-0.99). A positive association between overweight/obesity and a number of periodontal diseases was seen. For the association between prevalent periodontal disease and obesity in children, the overall fixed-effects OR and 95% CI was 1.46 (1.20-1.77) with a χ2statistic for heterogeneity (Q) of 33.4 with 6 degrees of freedom (P < 0.005).
  
  
  CONCLUSIONS
  The available evidence suggests a significantly positive association between periodontal disease and obesity in children. Paediatric dentists should be aware of periodontal alterations as a potential hazard associated with obesity.
authors.affiliation: Department of Paediatric Dentistry and Special Care, PAECOMEDIS Research Cluster, Ghent University, UZ Ghent, 1P8, De Pintelaan 185, 9000, Ghent, Belgium. luc.martens@ugent.be.
authors.forename: L
authors.initials: L
authors.lastname: Martens
authors.affiliation: Department of Paediatric Dentistry and Special Care, PAECOMEDIS Research Cluster, Ghent University, UZ Ghent, 1P8, De Pintelaan 185, 9000, Ghent, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: De Smet
authors.affiliation: Department of Paediatric Dentistry and Special Care, PAECOMEDIS Research Cluster, Ghent University, UZ Ghent, 1P8, De Pintelaan 185, 9000, Ghent, Belgium.
authors.forename: M Y P M
authors.initials: MY
authors.lastname: Yusof
authors.affiliation: Department of Paediatric Dentistry and Special Care, PAECOMEDIS Research Cluster, Ghent University, UZ Ghent, 1P8, De Pintelaan 185, 9000, Ghent, Belgium.
authors.forename: S
authors.initials: S
authors.lastname: Rajasekharan
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D002648:Child; D015897:Comorbidity; D006801:Humans; D050177:Overweight / Q000150:complications* / Q000453:epidemiology; D063766:Pediatric Obesity / Q000150:complications* / Q000453:epidemiology; D010510:Periodontal Diseases / Q000150:complications* / Q000453:epidemiology
keywords: BMI; Gingivitis; Obesity; Overweight; Periodontal disease; Periodontitis