Treatment of periodontitis improves the atherosclerotic profile: a systematic review and meta‐analysis. (29th October 2013)

• Record Type: Journal Article
• Authors: Teeuw, Wijnand J.; Slot, Dagmar E.; Susanto, Hendri; Gerdes, Victor E. A.; Abbas, Frank; D'Aiuto, Francesco; Kastelein, John J. P.; Loos, Bruno G.
• Is Part Of: Journal of clinical periodontology. Volume 41:Number 1(2014:Jan.)
• Page Start: 70
• Page End: 79
• Publication Date: 2013-10-29
• Subjects: Periodontics -- Periodicals; 617.6
• DOI: 10.1111/jcpe.12171
• Languages: English
• ISSNs: 0303-6979

Abstract

<abstract abstract-type="main" id="jcpe12171-abs-0001"> <title>Abstract</title> <sec id="jcpe12171-sec-0001" sec-type="section"> <title>Aim</title> <p>Systematic review and meta‐analyses to study the robustness of observations that treatment of periodontitis improves the atherosclerotic profile.</p> </sec> <sec id="jcpe12171-sec-0002" sec-type="section"> <title>Material and Methods</title> <p>Literature was searched in Medline‐PubMed, Cochrane CENTRAL and EMBASE, based on controlled periodontal intervention trials, including also a non‐intervention group. Data were extracted and meta‐analyses were performed.</p> </sec> <sec id="jcpe12171-sec-0003" sec-type="section"> <title>Results</title> <p>From 3928 screened studies, 25 trials met the eligibility criteria. These trials enrolled 1748 periodontitis patients. Seven trials enrolled periodontitis patients that were otherwise healthy, 18 trials recruited periodontal patients with various co‐morbidities, such as CVD or diabetes. None of the trials used hard clinical endpoints of CVD. However, improvement of endothelial function has been consistently reported. Meta‐analyses demonstrated significant weighted mean difference (WMD) for hsCRP (−0.50 mg/l, 95% CI:−0.78; −0.22), IL‐6 (−0.48 ng/l, 95% CI: −0.90; −0.06), TNF‐α (−0.75 pg/ml, 95% CI: −1.34; −0.17), fibrinogen (−0.47 g/l, 95% CI: −0.76; −0.17), total cholesterol (−0.11 mmol/l, 95% CI: −0.21; −0.01) and HDL‐C (0.04 mmol/l, 95% CI: 0.03; 0.06) favouring periodontal intervention. Importantly, periodontitis patients with co‐morbidity benefitted most from periodontal therapy; significant WMD were observed for levels of hsCRP (−0.71 mg/l, 95% CI: −1.05; −0.36), IL‐6 (−0.87 ng/l, 95% CI: −0.97; −0.78), triglycerides (−0.24 mmol/l, 95% CI: −0.26; −0.22), total cholesterol (−0.15 mmol/l, 95% CI: −0.29; −0.01), HDL‐C (0.05 mmol/l, 95% CI: 0.03; 0.06) and HbA<sub>1c</sub> (−0.43%, 95% CI: −0.60; −0.25).</p> </sec> <sec id="jcpe12171-sec-0004" sec-type="section"> <title>Conclusions</title> <p>This systematic review and meta‐analyses demonstrate that periodontal treatment improves endothelial function and reduces biomarkers of atherosclerotic disease, especially in those already suffering from CVD and/or diabetes.</p> </sec> </abstract>