META-ANALYSIS OF PERIODONTAL INTERVENTIONS IN REDUCING SYSTEMIC INFLAMMATION: EVALUATING THE CARDIOVASCULAR BENEFITS OF MANAGING PERIODONTAL DISEASE

Abstract

Background: Periodontal disease, a chronic inflammatory condition affecting the supporting structures of teeth, has systemic implications, particularly for cardiovascular health. Systemic inflammation arising from periodontal infections is thought to contribute to cardiovascular disease (CVD) by elevating inflammatory markers such as C-reactive protein (CRP) and interleukin-6 (IL-6), which impair vascular function. Managing periodontal disease through effective interventions may reduce systemic inflammation, offering a potential strategy for mitigating cardiovascular risks and improving overall cardiovascular health.

Objective: To evaluate the efficacy of periodontal interventions in reducing systemic inflammation and improving cardiovascular outcomes, thereby assessing their potential as a preventive approach to cardiovascular disease.

Methods: A systematic search of PubMed, Scopus, and Google Scholar databases was conducted for studies published up to June 2024. Following PRISMA guidelines, randomized controlled trials and observational studies investigating the effects of periodontal interventions on cardiovascular outcomes were included. Primary outcomes assessed were reductions in systemic inflammatory markers (CRP, IL-6) and cardiovascular-related mortality. Data were synthesized using a random-effects model to calculate pooled effect sizes with 95% confidence intervals (CIs). Heterogeneity was evaluated using the I² statistic, and subgroup analyses explored variations across treatment modalities and patient populations.

Results: Twelve studies involving 1,091 participants across diverse populations were included. Periodontal interventions were associated with significant reductions in systemic inflammatory markers, with a pooled effect size of 0.5 (95% CI: 0.30–0.70, I² = 35%). Cardiovascular mortality was moderately reduced, with a pooled effect size of 0.4 (95% CI: 0.20–0.60, I² = 20%). Subgroup analyses revealed that comprehensive periodontal treatments demonstrated greater reductions in inflammatory markers compared to standard care. Sensitivity analyses confirmed the robustness of these findings, with minimal publication bias detected.

Conclusion: This meta-analysis supports the hypothesis that periodontal interventions reduce systemic inflammation and may provide cardioprotective benefits, particularly in at-risk populations. These findings underscore the importance of integrating periodontal care into cardiovascular risk reduction strategies. Further randomized controlled trials are warranted to clarify underlying mechanisms and optimize treatment protocols for maximizing cardiovascular benefits.