Oral manifestations in patients with familial adenomatous polyposis: A systematic review and meta-analysis

J Gastroenterol Hepatol. 2016 Mar;31(3):527-40. doi: 10.1111/jgh.13149.


Background and aim: The oral manifestations of familial adenomatous polyposis (FAP) have been reported in the recent literature. Therefore, there has been growing interest in the characterization of the dento-osseous anomalies because they may precede colorectal cancer and may be used as a diagnostic marker. This systematic review and meta-analysis was performed to evaluate the published evidence for what are the oral manifestations of FAP and their frequency in affected individuals.

Methods: The search was performed at Cochrane Library, EMBASE, LILACS, PubMed, Scopus, and Web of Science for articles published up to March 2015. A grey literature search was conducted through Google Scholar. Reference lists of the included articles and additional studies identified by expert were screened for potential relevant studies. The methodology of selected studies was evaluated using the risk of bias checklist of the Agency for Healthcare Research and Quality.

Results: Twenty observational studies totalizing 1635 individuals affected by FAP met the inclusion criteria. Osseous, dental, and oral mucosa alterations were observed in FAP patients. The meta-analysis showed the frequency of osseous jaw lesions, and the dental anomalies were 65.35% and 30.48%, respectively, and two studies suggested that oral mucosa vascular density is a phenotypic manifestation in patients with FAP. Most of the studies were evaluated as moderate risk of bias.

Conclusion: The most frequent oral manifestation on FAP patients is osseous jaw alterations. In the future, well-designed studies are necessary to classify osseous and dental anomalies in order to demonstrate the true prevalence of each alteration separately.

Keywords: familial adenomatous polyposis; oral manifestations; systematic review.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Adenomatous Polyposis Coli / epidemiology
  • Adenomatous Polyposis Coli / genetics
  • Adenomatous Polyposis Coli / pathology*
  • Blood Vessels / abnormalities
  • Blood Vessels / pathology
  • Databases, Factual
  • Female
  • Humans
  • Jaw / pathology
  • Male
  • Mouth Mucosa / blood supply
  • Mouth Mucosa / pathology
  • Observational Studies as Topic
  • Prevalence
  • Risk
  • Tooth Abnormalities / epidemiology
  • Tooth Abnormalities / pathology