Department of Stomatology, Renmin Hospital of Wuhan University, Wuhan, China.
School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
J Periodontal Res. 2022 Aug;57(4):690-697. doi: 10.1111/jre.13006. Epub 2022 Jun 14.
Periodontal disease is a major threat to oral health and would further contribute to systemic diseases without timely control. We aimed to evaluate the relation between periodontal disease, periodontal treatment and carotid intima-media thickness (CIMT) based on available epidemiological and clinical evidence. PubMed and Scopus were searched for relevant studies through May 2021. Observational studies reporting risk estimates with 95% confidence intervals (95% CIs) for the association between periodontal disease (including periodontitis and gingivitis) and risk of increased CIMT (defined as CIMT value that exceeded the cut-off value of clinical and prognostic significance), as well as interventional studies providing mean values with standard deviations of CIMT before and after periodontal intervention, were included. Random-effect models for meta-analysis were used to calculate the summary effect estimates with 95% CIs. A total of 406 citations were retrieved from electronic databases and 45 full-text articles were screened, leaving 11 articles using ultrasound to measure CIMT with 8744 participants included. Pooled results of seven cross-sectional studies involving 8558 participants indicated that compared to those without periodontitis, patients with periodontitis and those with severe periodontitis had an odds ratio of 1.42 (95% CI: 1.16, 1.75) and 1.70 (95% CI: 1.24, 2.33) for increased CIMT, respectively. Although publication bias was detected in these results, odds ratios corrected by the trim-and-fill method were still statistically significant. Results of four non-randomized controlled trials with 186 patients suggested that periodontal intervention may help reduce CIMT in patients with periodontal disease in the short term. Periodontitis, especially severe periodontitis, was significantly associated with the risk of increased CIMT. Periodontal intervention might help slow the progression of carotid intima-media thickening in patients with periodontal disease in the short term.
牙周病是口腔健康的主要威胁，如果不及时控制，还会进一步导致全身性疾病。我们旨在根据现有流行病学和临床证据评估牙周病、牙周治疗与颈动脉内膜中层厚度（CIMT）之间的关系。通过 2021 年 5 月在 PubMed 和 Scopus 上检索相关研究。纳入报告牙周病（包括牙周炎和牙龈炎）与 CIMT 增加风险之间关联的风险估计值（95%置信区间[95%CI]）的观察性研究，以及提供牙周干预前后 CIMT 平均值和标准差的干预性研究。使用随机效应模型进行荟萃分析，计算 95%CI 的汇总效应估计值。从电子数据库中检索到 406 条引用，筛选出 45 篇全文文章，最终纳入 11 篇使用超声测量 CIMT 的文章，共 8744 名参与者。涉及 8558 名参与者的七项横断面研究的汇总结果表明，与无牙周炎者相比，牙周炎患者和重度牙周炎患者发生 CIMT 增加的比值比分别为 1.42（95%CI：1.16，1.75）和 1.70（95%CI：1.24，2.33）。尽管这些结果存在发表偏倚，但经填充和修剪法校正后的比值比仍具有统计学意义。四项非随机对照试验（共 186 名患者）的结果表明，牙周干预可能有助于在短期内降低牙周病患者的 CIMT。牙周炎，尤其是重度牙周炎，与 CIMT 增加的风险显著相关。牙周干预可能有助于在短期内减缓牙周病患者颈动脉内膜中层增厚的进展。
