Effect of non-surgical periodontal therapy on risk markers of cardiovascular disease: a systematic review and meta-analysis

BMC Oral Health. 2024 Jun 14;24(1):692. doi: 10.1186/s12903-024-04433-0.

Abstract

Background: Cardiovascular disease (CVD) is the leading cause of mortality in the world. Patients with periodontitis have a higher risk of CVD, although a causal relationship between these conditions remains unclear. Non-surgical periodontal therapy (NSPT) is able to control inflammation at local and systemic levels. This study aimed to analyze the effect of NSPT on CVD risk markers.

Methods: Four electronic databases were searched from their inception to April 1, 2023, to identify and select articles without any language restrictions. Eleven CVD-related markers (e.g., C-reactive protein [CRP], Interleukin-6 [IL-6]) were selected. Meta-analyses were performed using random and fixed effect models. The differences were expressed as weighted mean differences (WMD) and 95% confidence interval (95% CI).

Results: From 1353 studies, twenty-one randomized controlled clinical trials were included in the meta-analysis. Results showed a significant decrease in CRP, IL-6, and systolic blood pressure (SBP) after NSPT.

Conclusion: Moderate certainty evidence shows that NSPT has a positive effect on the reduction of IL-6 and SBP in patients with periodontitis, while low certainty evidence shows that NSPT is effective for reduction of CRP. Moderate certainty evidence showed that NSPT did not show a positive effect on low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC) and triglycerides (TG), and low certainty evidence showed that NSPT did not show a positive effect on Interleukin-1β (IL-1β), tumor necrosis factor-alpha (TNF-α), diastolic blood pressure (DBP), and flow-mediated dilatation (FMD).

Protocol registration: The protocol was registered in the PROSPERO (International Prospective Register of Systematic Reviews), number CRD42022377565.

Keywords: Cardiovascular disease; Meta-analysis; Non-surgical periodontal therapy; Periodontitis.

Publication types

  • Systematic Review
  • Meta-Analysis

MeSH terms

  • Biomarkers* / blood
  • Blood Pressure
  • C-Reactive Protein* / analysis
  • Cardiovascular Diseases* / prevention & control
  • Heart Disease Risk Factors
  • Humans
  • Interleukin-6* / blood
  • Periodontitis / complications
  • Periodontitis / therapy
  • Randomized Controlled Trials as Topic
  • Risk Factors

Substances

  • C-Reactive Protein
  • Biomarkers
  • Interleukin-6