Apical Periodontitis and Cardiovascular Disease in Adults: A Systematic Review with Meta-Analysis
Background: A potential relationship between oral health and cardiovascular diseases has been proposed. However, uncertainty remains as to whether there is sufficient data to support this association. This review aims to appraise the relationship between apical periodontitis and cardiovascular disea...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
IMR Press
2022-03-01
|
| Series: | Reviews in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/RCM/23/3/10.31083/j.rcm2303100 |
| _version_ | 1811271564270764032 |
|---|---|
| author | Rita Noites Manuel Teixeira Ivan Cavero-Redondo Celia Alvarez-Bueno Fernando Ribeiro |
| author_facet | Rita Noites Manuel Teixeira Ivan Cavero-Redondo Celia Alvarez-Bueno Fernando Ribeiro |
| author_sort | Rita Noites |
| collection | DOAJ |
| description | Background: A potential relationship between oral health and cardiovascular diseases has been proposed. However, uncertainty remains as to whether there is sufficient data to support this association. This review aims to appraise the relationship between apical periodontitis and cardiovascular disease based on data from observational studies. Methods: The databases Medline (via PubMed) and EMBASE (via Scopus) were searched up to August 2020 for observational studies (case-control, cross-sectional, and cohort) assessing the association of apical periodontitis with cardiovascular disease among adults. Pooled relative risk/odds ratio and 95% confidence interval (CI) were estimated using a random-effects model. Sensitivity analyses and random-effects meta-regressions were performed. Results: The initial search yielded 2537 documents, of which 15 were eligible for inclusion, including 8 cross-sectional studies, 5 case-control studies, and 2 cohort studies. The majority of studies enrolled both men and women, with mean age ranging from 41 to 66 years. In cross-sectional studies, the presence of apical periodontitis was significantly associated with cardiovascular disease with a combined odds ratio of 1.53 (95% CI: 1.02–2.29, p = 0.039; I2 = 75.0%; p < 0.001). In the case-control studies, the combined odds ratio did not show a significant association of apical periodontitis with cardiovascular disease (OR = 1.24; 95% CI: 0.67–2.29, p = 0.494; I2 = 82.1%; p < 0.001). The pooled risk ratio from the 2 cohort studies showed (RR = 1.27; 95% CI: 0.71–2.27, p = 0.413; I2 = 69.1%; p = 0.072) also showed no significant association between apical periodontitis and cardiovascular disease. These results should be interpreted with caution due to the high heterogeneity. Conclusions: Data derived from cross-sectional studies suggest a weak association between apical periodontitis and cardiovascular disease. As the results were not consistent across study designs, further research is recommended, namely longitudinal studies with long-term follow-up. Registration: PROSPERO database (CRD42020204379). |
| first_indexed | 2024-04-12T22:23:17Z |
| format | Article |
| id | doaj.art-c72d61c4d8f144108d9960fa10f2de71 |
| institution | Directory Open Access Journal |
| issn | 1530-6550 |
| language | English |
| last_indexed | 2024-04-12T22:23:17Z |
| publishDate | 2022-03-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj.art-c72d61c4d8f144108d9960fa10f2de712022-12-22T03:14:17ZengIMR PressReviews in Cardiovascular Medicine1530-65502022-03-0123310010.31083/j.rcm2303100S1530-6550(22)00424-0Apical Periodontitis and Cardiovascular Disease in Adults: A Systematic Review with Meta-AnalysisRita Noites0Manuel Teixeira1Ivan Cavero-Redondo2Celia Alvarez-Bueno3Fernando Ribeiro4Universidade Católica Portuguesa, Faculty of Dental Medicine, Center for Interdisciplinary Research in Health l, 3510-105 Viseu, PortugalInstitute of Biomedicine—iBiMED, School of Health Sciences, University of Aveiro, 3810-085 Aveiro, PortugalUniversidad de Castilla-La Mancha, Health and Social Research Center, 02006 Cuenca, SpainUniversidad de Castilla-La Mancha, Health and Social Research Center, 02006 Cuenca, SpainInstitute of Biomedicine—iBiMED, School of Health Sciences, University of Aveiro, 3810-085 Aveiro, PortugalBackground: A potential relationship between oral health and cardiovascular diseases has been proposed. However, uncertainty remains as to whether there is sufficient data to support this association. This review aims to appraise the relationship between apical periodontitis and cardiovascular disease based on data from observational studies. Methods: The databases Medline (via PubMed) and EMBASE (via Scopus) were searched up to August 2020 for observational studies (case-control, cross-sectional, and cohort) assessing the association of apical periodontitis with cardiovascular disease among adults. Pooled relative risk/odds ratio and 95% confidence interval (CI) were estimated using a random-effects model. Sensitivity analyses and random-effects meta-regressions were performed. Results: The initial search yielded 2537 documents, of which 15 were eligible for inclusion, including 8 cross-sectional studies, 5 case-control studies, and 2 cohort studies. The majority of studies enrolled both men and women, with mean age ranging from 41 to 66 years. In cross-sectional studies, the presence of apical periodontitis was significantly associated with cardiovascular disease with a combined odds ratio of 1.53 (95% CI: 1.02–2.29, p = 0.039; I2 = 75.0%; p < 0.001). In the case-control studies, the combined odds ratio did not show a significant association of apical periodontitis with cardiovascular disease (OR = 1.24; 95% CI: 0.67–2.29, p = 0.494; I2 = 82.1%; p < 0.001). The pooled risk ratio from the 2 cohort studies showed (RR = 1.27; 95% CI: 0.71–2.27, p = 0.413; I2 = 69.1%; p = 0.072) also showed no significant association between apical periodontitis and cardiovascular disease. These results should be interpreted with caution due to the high heterogeneity. Conclusions: Data derived from cross-sectional studies suggest a weak association between apical periodontitis and cardiovascular disease. As the results were not consistent across study designs, further research is recommended, namely longitudinal studies with long-term follow-up. Registration: PROSPERO database (CRD42020204379).https://www.imrpress.com/journal/RCM/23/3/10.31083/j.rcm2303100endodontic infectionapical periodontitisnecrotic teethcardiovascular disease |
| spellingShingle | Rita Noites Manuel Teixeira Ivan Cavero-Redondo Celia Alvarez-Bueno Fernando Ribeiro Apical Periodontitis and Cardiovascular Disease in Adults: A Systematic Review with Meta-Analysis Reviews in Cardiovascular Medicine endodontic infection apical periodontitis necrotic teeth cardiovascular disease |
| title | Apical Periodontitis and Cardiovascular Disease in Adults: A Systematic Review with Meta-Analysis |
| title_full | Apical Periodontitis and Cardiovascular Disease in Adults: A Systematic Review with Meta-Analysis |
| title_fullStr | Apical Periodontitis and Cardiovascular Disease in Adults: A Systematic Review with Meta-Analysis |
| title_full_unstemmed | Apical Periodontitis and Cardiovascular Disease in Adults: A Systematic Review with Meta-Analysis |
| title_short | Apical Periodontitis and Cardiovascular Disease in Adults: A Systematic Review with Meta-Analysis |
| title_sort | apical periodontitis and cardiovascular disease in adults a systematic review with meta analysis |
| topic | endodontic infection apical periodontitis necrotic teeth cardiovascular disease |
| url | https://www.imrpress.com/journal/RCM/23/3/10.31083/j.rcm2303100 |
| work_keys_str_mv | AT ritanoites apicalperiodontitisandcardiovasculardiseaseinadultsasystematicreviewwithmetaanalysis AT manuelteixeira apicalperiodontitisandcardiovasculardiseaseinadultsasystematicreviewwithmetaanalysis AT ivancaveroredondo apicalperiodontitisandcardiovasculardiseaseinadultsasystematicreviewwithmetaanalysis AT celiaalvarezbueno apicalperiodontitisandcardiovasculardiseaseinadultsasystematicreviewwithmetaanalysis AT fernandoribeiro apicalperiodontitisandcardiovasculardiseaseinadultsasystematicreviewwithmetaanalysis |