DMF scores in patients with diabetes mellitus: A systematic review and meta-analysis of observational studies

OBJECTIVEThe aim of this systematic review(SR) is to comprehensively and critically summarise and synthesise the available scientific evidence from observational studies that use the decayed-missed-filled(DMF) index to determine caries experiences among adult patients with diabetes mellitus (DM) as compared to individuals without DM(non-DM). DATAIndices that present examinations of decayed-filled-surfaces(DFS), decayed-missed-filled-surfaces(DMFS), and decayed-missed-filled-teeth(DMFT) established from observational studies were considered. SOURCESMEDLINE-PubMed and Cochrane Central databases were searched through 1 February 2023 to identify studies that evaluate DMF indices for adult patients with DM compared to non-DM. The reference lists of the selected studies were reviewed to identify additional potentially relevant studies. STUDY SELECTIONAll studies were independently screened by two reviewers. Included papers were critically appraised using pre-designed forms, and the risk of bias was assessed. Data as means and standard deviations were extracted. A descriptive data presentation was used for all studies. If quantitative methods were feasible, then a meta-analysis was performed. It was decided 'a priori' to perform a sub-analysis on type of DM(I or II). The quality of the studies was assessed. RESULTSInitially 932 studies were found, and screening resulted in 13 eligible observational studies. The total number of subjects included in this SR is 21,220. A descriptive analysis of the comparisons demonstrated that eight studies provided data and demonstrated higher DFS (1/2), DMFS (2/3) and DMFT (5/8). This was confirmed by the meta-analysis difference of means(DiffM), which was 3.01([95%CI:1.47,4.54],p=0.0001) for DMFT and 10.30([95% CI:8.50,12.11],p