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Meta-Analysis
. 2018 Nov 1;23(6):e681-e690.
doi: 10.4317/medoral.22725.

Periodontal treatment on patients with cardiovascular disease: Systematic review and meta-analysis

E Roca-Millan  1 , B González-Navarro, M-M Sabater-Recolons, A Marí-Roig, E Jané-Salas, J López-López
Affiliations
Meta-Analysis

Periodontal treatment on patients with cardiovascular disease: Systematic review and meta-analysis

E Roca-Millan et al. Med Oral Patol Oral Cir Bucal. .

Abstract

Background: Atherosclerotic cardiovascular disease is the main cause of mortality in developed countries. It is a chronic and systemic inflammatory disease with a multifactorial etiology. Periodontal disease is one of the many factors that contribute to its development.

Objective: To analyze the effects of periodontal treatment on cardiovascular risk parameters in patients with atherosclerotic cardiovascular disease.

Methods: A systematic research was conducted in the Pubmed/Medline databases for clinical trials published up to and including the year 2017.

Results: Ten articles were included for analysis. Periodontal treatment reduced C-reactive protein levels (77.8% of clinical trials), tumor necrosis factor-alpha (66.7%), interleukin-6 (100%) and leukocytes (50%). Fibrinogen levels also improved considerably (66.7%). Effects on lipid parameters were more limited, whereby only oxidized low density lipoprotein and very low density lipoprotein cholesterol decreased significantly. Meta-analysis showed a statistically significant decreased in C-reactive protein and leukocytes values when patients were submitted to non-surgical periodontal treatment in contrast to receiving no treatment at all (mean difference 1.199 mg/L, 95% confidence interval: 1.100-1.299, p<0.001; and mean difference 0,79 g/L, 95% confidence interval: 0.717-0.879, p<0.001, respectively).

Conclusions: Periodontal treatment has a beneficial effect on some of the biochemical parameters considered to represent cardiovascular risk. Further randomized clinical trials are necessary, with longer follow-up periods including regular periodic monitoring, in order to determine the extent of the impact of periodontal treatment.

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Conflict of interest statement

Conflict of interest statement: None.

Figures

Figure 1
Figure 1
Flow diagram of selection process for articles: 10 trials were selected for analysis.
Figure 2
Figure 2
(a) Forest plot: studies evaluating CRP values before and after the administration of Oral hygiene instructions + Supragingival scaling + Scaling and root planing in the treatment group Vs. Oral hygiene instructions in the control group. (b) Forest plot: studies evaluating CRP values before and after the administration of Oral hygiene instructions + Supragingival scaling + Scaling and root planing in the treatment group Vs. Non treatment.
Figure 3
Figure 3
(a) Forest plot of studies evaluating leukocytes values before and after the administration of Oral hygiene instructions + Supragingival scaling + Root scaling and planning in the treatment group vs. Oral hygiene instructions in the control group.(b) Forest plot of studies evaluating leukocytes values before and after the administration of Oral hygiene instructions + Supragingival scaling + Root scaling and planning in the treatment group vs. Non treatment.
See this image and copyright information in PMC

References

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