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Does treating periodontitis improve the atherosclerotic profile? A systematic review

Beautiful woman smile. Dental health care clinic.This summary is based on the article published in the Journal of Clinical Periodontology: Treatment of periodontitis improves the atherosclerotic profile: a systematic review and meta-analysis (January 2014)

Wijnand J. Teeuw, Dagmar E. Slot, Hendri Susanto, Victor E. A. Gerdes, Frank Abbas, Francesco D’Aiuto, John J. P. Kastelein and Bruno G. Loos

 

Courtesy of Wiley Publishing, access the full-text article for the next three months here

Context

  • A large number of studies have reported on the relationship between periodontitis and cardiovascular disease (CVD). (1, 2)
  • Periodontitis is a common chronic multifactorial infectious disease of the supporting structures of the teeth (root cementum, periodontal ligament and alveolar bone) and a major cause of tooth loss.
  • Several causal mechanisms have been proposed whereby bacterial pathogens, antigens, endotoxins, and/or inflammatory cytokines from periodontal lesions in the oral cavity contribute to the process of atherogenesis as well as to thromboembolic events and thereby increase the risk for CVD. (3, 1)
  • Treatment of periodontitis includes mechanical removal of supra- and subgingival bacterial plaque deposits and intensive oral hygiene instructions. Regularly, periodontal surgery is needed to reduce or eliminate residual periodontitis lesions.

Purpose of the Review

The authors hypothesized that if periodontitis is somehow causally related to the common atherosclerotic form of CVD, then periodontal treatment (PT) should affect parameters for CVD.

The review was conducted to study the robustness of observations that treatment of periodontitis improves the atherosclerotic profile.

Key Findings

The review demonstrated that periodontal treatment improves endothelial function and reduces biomarkers of atherosclerotic disease, especially in those already suffering from CVD and/or diabetes.

References

  1. Friedewald, V. E., Kornman, K. S., Beck, J. D., Genco, R., Goldfine, A., Libby, P., Offenbacher, S., Ridker, P. M., Van Dyke, T. E. & Roberts, W. C. (2009) The American Journal of Cardiology and Journal of Periodontology Editors’ Consensus: periodontitis and atherosclerotic cardiovascular disease. American Journal of Cardiology 104, 59–68.
  2. Dietrich, T., Sharma, P., Walter, C., Weston, P. & Beck, J. (2013). The epidemiological evidence behind the association between periodontitis and incident atherosclerotic cardiovascular disease. Journal of Clinical Periodontology 40 (Suppl. 14), S70–S84.
  3. Humphrey, L. L., Fu, R., Buckley, D. I., Freeman, M. & Helfand, M. (2008) Periodontal disease and coronary heart disease incidence: a systematic review and meta-analysis. Journal of General Internal Medicine 23, 2079–2086.

 

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