Periodontitis as a risk factor for cardiovascular disease development: systematic review

Abstract

Relevance. The high prevalence of inflammatory periodontal diseases (IPD) and periodontitis, in particular, is a relevant issue since the latter progression leads to alveolar bone destruction and loss of periodontal attachment and is considered one of the principal causes of tooth loss in the adult population. The adverse impact of periodontal pathogens doesn't only extend to the oral organs and tissues, but it also affects general health. There is evidence of a possible relationship between IPD and cardiovascular diseases (CVD). Periodontal pathogens are found in the myocardium, pericardial fluid, heart valves and vascular intima.Purpose. The study aimed to systematically review the impact of periodontitis on the risk of cardiovascular disease development.Material and methods. The study systematically reviewed scientific articles and original studies from international and national databases using the PRISMA (The Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist for systematic reviews and meta-analyses.Results. The study detected 1857 articles according to the inclusion criteria. After the duplicate removal, the number of articles decreased to 685. Of these, 137 articles were selected for screening, which contained data from randomized controlled clinical trials, longitudinal studies, cohort studies and case-control studies. Ninety-eight articles were excluded for the lack of clinical diagnoses or clear diagnostic criteria for the studies and the lack of sample representativeness. The experts assessed 39 articles, of which seven were removed due to a high risk of bias. Finally, 32 studies were included in the systematic review.Conclusion. Thus, the review confirms the hypothesis that there is a relationship between IPD and CVD, such as ACVD, myocardial infarction, peripheral vascular disease, and hypertension. The theory of the pathogenic influence of systemic inflammation caused by the spread of periodontal pathogens in the bloodstream is the key option for grounding this relationship.