Associations Between Periodontal Disease and Risk for Atherosclerosis, Cardiovascular Disease, and Stroke. A Systematic Review

Background: Recent studies implicate exposure to systemic conditions involving chronic inflammation, including chronic periodontitis, in the etiology of atherosclerosis

Rationale: A systematic review of the literature was conducted to assess the association between chronic inflammatory periodontal disease and atherosclerosis.

Focused Question:Does periodontal disease influence the initiation/ progression of atherosclerosis and, therefore, cardiovascular disease (CVD), stroke, and peripheral vascular disease (PVD)?

Search Protocol: MEDLINE, pre-MEDLINE, MEDLINE Daily Update, and the Cochrane Controlled Trials Register were searched to identify human studies that related variables associated with atherosclerosis to periodontal disease. Searches were made for papers published from 1966 through March 2002.

Inclusion criteria: Published randomized controlled clinical trials (RCTs), longitudinal, cohort, and case-control studies were included. Study participants included those with atherosclerosis, myocardial infarction (MI), stroke, or PVD. Oral conditions included periodontal disease.

Exclusion criteria: Only studies on humans were included. Data Collection and Analysis: Because the studies used different oral assessment measures, it was not possible to perform a metaanalysis of the data reported. Weighted mean differences, relative risks, or odds ratios were compared for cohort studies.

Ann Periodontol 2003;8:38-53.