The Association of Periodontitis With Cardiovascular Disease Parameters: A Synthesis of Systematic Reviews.

Abstract

<h4>Focused question</h4>What is the association of periodontal disease (PerioD) and cardiovascular diseases (CVD/CVE) as reported in existing systematic reviews (SRs)?<h4>Methods</h4>MEDLINE-PubMed and Cochrane-CENTRAL databases were searched. Papers that primarily evaluate cardiovascular parameters of CVD and CVE in PerioD patients compared to non-PerioD individuals were included. Data and conclusions as presented in the selected papers were extracted and the potential risk of bias was estimated. A descriptive analysis of the meta-analyses of the selected studies was conducted. A citation analysis was performed, the Bradford Hill criteria were assessed and the acquired evidence was graded.<h4>Results</h4>Independent screening of 446 reviews resulted in 19 eligible SRs. These were categorised into 13 reviews evaluating CVD and eight evaluating CVE. In total 27 meta-analyses were obtained, the majority (78%) of reported risk ratios and odds ratios are estimated to show a negligible magnitude of the association of PerioD and CVD. For CVE, 46% of the values of the association are considered to be of small magnitude as emerging from 23 meta-analyses. For factors such as gender, age, PerioD severity, smoking status and geographic region, the statistical significance and magnitude of the association varied. Given the results, a definitive confirmation of causality according to the Bradford Hill criteria was not attainable. With moderate certainty, a predominantly negligible to small magnitude of the association of PerioD and CVD/CVE was identified.<h4>Conclusion</h4>Based on data collected from existing SRs, the association between PerioD and CVD/CVE was generally observed to be of negligible to small magnitude. Additionally, the data does not confirm potential causality.