Association between periodontitis and pulse wave velocity: a systematic review and meta-analysis

Objectives Severe periodontitis has been associated with endothelial dysfunction and arterial stiffness. The present study aimed to provide a critical appraisal and a meta-analysis of the literature investigating pulse wave velocity (PWV) in patients with and without severe periodontitis and to asse...

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Published in:Clinical oral investigations Vol. 25; no. 2; pp. 393 - 405
Main Authors: Darnaud, Christelle, Courtet, Alexandre, Schmitt, Audrey, Boutouyrie, Pierre, Bouchard, Philippe, Carra, Maria Clotilde
Format: Journal Article
Language:English
Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.02.2021
Springer Nature B.V
Subjects:
Ankle
Carotid Arteries
Cross-Sectional Studies
Dentistry
Gum disease
Humans
Medicine
Meta-analysis
Periodontitis
Pulse Wave Analysis
Review
Risk Factors
Vascular Stiffness
Velocity
Endothelial dysfunction
Pulse wave velocity
Periodontitis
Arterial stiffness
Oral health
ISSN:1432-6981, 1436-3771, 1436-3771
Online Access:Get full text
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Summary:Objectives Severe periodontitis has been associated with endothelial dysfunction and arterial stiffness. The present study aimed to provide a critical appraisal and a meta-analysis of the literature investigating pulse wave velocity (PWV) in patients with and without severe periodontitis and to assess whether treatments influence PWV. Materials and methods English literature was searched on multiple databases up to April 2020 by two independent reviewers. Studies comparing PWV between patients with and without severe periodontitis or assessing the impact of periodontal treatments on PWV were searched and retrieved. Pool data analyses with random effect models were performed. The risk of bias was assessed using Newcastle–Ottawa Scale and RoB2 tools. Results Seventeen studies were selected. Of these, 10 were used for the meta-analysis. Twelve were cross-sectional studies and 5 interventional studies, including 3176 patients, of whom 1894 had severe periodontitis and 1282 were considered as the controls (without severe periodontitis). Based on carotid–femoral PWV measurement, patients with severe periodontitis ( n  = 309) have a significantly higher PVW than patients with non-severe periodontitis ( n  = 213), with a mean difference of 0.84 m/s (95% CI 0.50–1.18; p  < 0.0001; I 2  = 5%). Similarly, carotid–radial or brachial–ankle PWV values were significantly higher in patients with severe periodontitis. Results concerning the effect of non-surgical periodontal therapy were not conclusive. Overall, 9 studies (53%) were classified at a low risk of bias. Conclusions The present study demonstrates that patients with severe periodontitis have higher PWV compared to patients with non-severe periodontitis. Clinical significance Severe periodontitis is associated with arterial stiffness, supporting the mutual involvement of dentists and physicians.
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ISSN:1432-6981
1436-3771
1436-3771
DOI:10.1007/s00784-020-03718-2