Periodontal therapy and treatment of hypertension-alternative to the pharmacological approach. A systematic review and meta-analysis

Sharma, Shilpi; Sridhar, Swathi; McIntosh, Alasdair; Messow, Claudia‐Martina; Aguilera, Eva; Pinto, Rita Del; Pietropaoli, Davide; Górska, Renata; Siedliński, Mateusz; Maffia, Pasquale; Tomaszewski, Maciej; Guzik, Tomasz J.; D’Aiuto, Francesco; Cześnikiewicz-Guzik, Marta

doi:10.1016/j.phrs.2021.105511

Cited by 32 publications

(35 citation statements)

References 53 publications

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“…Endothelial function measured by flow-mediated dilatation also improved after periodontal treatment both in patients without ASCVD and in patients after AMI [55,56]. Moreover, intensive periodontal treatment (non-surgical periodontal therapy with supra and subgingival instrumentation) caused a significantly larger decrease in systolic and diastolic blood pressure, compared to conventional treatment (supragingival debridement only) [57]. Periodontal diseases might affect prognosis after coronary events, and also in primary prevention, arterial hypertension and its consequences [58,59].…”

Section: Periodontal Diseasementioning

confidence: 97%

Infections as Novel Risk Factors of Atherosclerotic Cardiovascular Diseases: Pathophysiological Links and Therapeutic Implications

Szwed

Zawadka

Eyileten

et al. 2021

JCM

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Atherosclerotic cardiovascular diseases (ASCVD) are the major cause of mortality worldwide. Despite the continuous progress in ASCVD therapy, the residual risk persists beyond the management of traditional risk factors. Several infections including Helicobacter pylori infection, periodontal disease, and viral infections are associated with the increased risk of ASCVD, both directly by damage to the heart muscle and vasculature, and indirectly by triggering a systemic proinflammatory state. Hence, beyond the optimal management of the traditional ASCVD risk factors, infections should be considered as an important non-classical risk factor to enable early diagnosis and appropriate treatment. Here, we summarized the currently available evidence regarding the role of inflammation in ASCVD and the association between the particular infections and pathogens (Helicobacter pylori, periodontal disease, pneumonia, Cytomegalovirus, Human immunodeficiency virus, Herpes simplex virus, and severe acute respiratory syndrome coronavirus 2) on the development and progression of ASCVD. We also speculated about the potential therapeutic implications of the anti-inflammatory and anti-infective drugs on ASCVD outcomes, including drugs routinely administered in patients with ASCVD (statins, P2Y12 receptor inhibitors, and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers) and novel strategies aiming at residual risk reduction (colchicine, anti-cytokine drugs, and methotrexate). Considering the emerging association between infections and ASCVD, it is crucial to determine the possible advantages of infection prevention and treatment in patients with ASCVD.

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Section: Periodontal Diseasementioning

confidence: 97%

Infections as Novel Risk Factors of Atherosclerotic Cardiovascular Diseases: Pathophysiological Links and Therapeutic Implications

Szwed

Zawadka

Eyileten

et al. 2021

JCM

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“…Some studies found that intervention of periodontitis could help in controlling hypertension [31]. Hence, good oral hygiene not only improves oral health but also controls hypertension and hence reduces the risk of stroke and other cardiovascular diseases.…”

Section: Hypertensionmentioning

confidence: 99%

Common Medical and Dental Problems of Older Adults: A Narrative Review

et al. 2021

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The advancement of medicine has reduced the rate of mortality and older adult population is increasing. Among the 7,700,000,000 world population in 2019, 1 in 11 people were at the age of 65 or more. The population is expected to increase to 1 in 6 people by 2050. Older adults have degenerative changes that become more severe with age. This study used the World Health Organization’s websites and PubMed and Google Scholar databases to review current global oral and systemic health issues. Studies generally reported that many older adults have no regular dental checkup. Common oral diseases such as dental caries particularly root caries and periodontal disease are highly prevalent among them. These oral diseases are often interrelated with their systemic problems. A meta-analysis reported diabetes increases the incidence and progression of periodontitis by 86%. A decrease in salivary output is common among older adults having polypharmacy. A review reported the caries risk in older adults increases by 60% with low resting pH and low stimulated salivary flow rate. Many older adults suffer from dementia and depression which complicates the delivery of dental treatment. Proper oral hygiene practice and dental care at supine position are often difficult to be carried out if they have rheumatoid arthritis. With the increasing need of elderly dental care, dentists and other dental personnel should understand interlaced oral and general health in order to provide a successful dental care plan for older adults. The aim of this study is to give an overview of the common medical conditions and dental problems and their impacts on older adults.

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“…Since then, numerous studies have concluded a positive association between periodontal diseases and CVD independently of their common risk factors (smoking, age, diabetes) [75,[78][79][80][81]. Moreover, periodontal treatment has been shown to have beneficial effects on cardiovascular biochemical parameters such as endothelial function and C-Reactive Protein (CRP) levels [82][83][84][85]. The mechanisms linking periodontitis and CVD are both direct, via bacterial invasion, and indirect, via inflammation.…”

Section: Cardiovascular Diseasesmentioning

confidence: 99%

Oral Microbiota: A Major Player in the Diagnosis of Systemic Diseases

et al. 2021

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The oral cavity is host to a complex and diverse microbiota community which plays an important role in health and disease. Major oral infections, i.e., caries and periodontal diseases, are both responsible for and induced by oral microbiota dysbiosis. This dysbiosis is known to have an impact on other chronic systemic diseases, whether triggering or aggravating them, making the oral microbiota a novel target in diagnosing, following, and treating systemic diseases. In this review, we summarize the major roles that oral microbiota can play in systemic disease development and aggravation and also how novel tools can help investigate this complex ecosystem. Finally, we describe new therapeutic approaches based on oral bacterial recolonization or host modulation therapies. Collaboration in diagnosis and treatment between oral specialists and general health specialists is of key importance in bridging oral and systemic health and disease and improving patients' wellbeing.

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Periodontal therapy and treatment of hypertension-alternative to the pharmacological approach. A systematic review and meta-analysis

Cited by 32 publications

References 53 publications

Infections as Novel Risk Factors of Atherosclerotic Cardiovascular Diseases: Pathophysiological Links and Therapeutic Implications

Infections as Novel Risk Factors of Atherosclerotic Cardiovascular Diseases: Pathophysiological Links and Therapeutic Implications

Common Medical and Dental Problems of Older Adults: A Narrative Review

Oral Microbiota: A Major Player in the Diagnosis of Systemic Diseases

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