Is there evidence that periodontal diseases are risk factors for coronary arterial disease?—Scoping review

Abstract

Aim: To determine the scientific evidence regarding the condition of periodontal diseases (PDs) as risk factors of coronary artery diseases. Materials and methods:A scoping review was performed through the selection of articles from online databases (Medline via PubMed, LILACS, and Cochrane CENTRAL), using a search algorithm and eligibility criteria for data extraction and data synthesis of included papers. Four hundred forty-one studies from online databases and 1364 from reference lists were initially identified, and 34 articles were selected for inclusion. Articles had to be published between 2015 and 2020 and had to associate PDs to coronary arterial diseases. All studies comprised a sample of 446443 participants. Favorable opinions totaled 70.59%, and the cross-sectional observational study design was more frequently found (32.35%). Biochemical outcomes were showed more frequently, such as inflammatory biomarkers (58.82%). Despite a large advantage for favorable opinions, a statistically significant result was not found when extracted data were combined with studies opinions. Conclusion:The evidence was classified as level II-3, hence, still distant from the best ranks and can therefore be considered as unclear. Moreover, studies with the higher potential to generate evidence showed a high risk of bias.

Oral Health of Patients Undergoing Percutaneous Coronary Intervention—A Possible Link between Periodontal Disease and In-Stent Restenosis

“…The link between periodontal disease and angiographically verified coronary disease has been well established in stable coronary artery disease and acute coronary syndromes [ 20 , 21 , 22 , 23 ]. Nonetheless, it is still a matter of debate whether PD is an independent risk factor for CAD or whether the association is based on an abundance of shared risk factors, including, amongst others: age, gender, smoking, diabetes mellitus, hypertension, obesity, low socioeconomic status, and stress [ 24 ]. In our age- and gender-matched case-control study, we were not only able to provide further evidence for a strong association between PD and CAD, but we also showed that this association is independent of diabetes mellitus (one of the most prominent shared risk factors for both CAD and PD).…”

“…Finally, it is important to note that as with PD and atherosclerosis, PD and in-stent restenosis also have been associated with common underlying medical conditions, such as age, gender, diabetes mellitus, chronic kidney disease, and multivessel coronary disease. [ 3 , 24 ] Thus, the question of causality, whether PD is an independent risk factor of in-stent restenosis or the association is based on common risk factors, is a possible debate as with PD and atherosclerosis [ 24 ].…”