Devi Oinam Monica, Gupta Jyoti, Chahal Gurparkash Singh, Jain Ashish
Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India.
J Indian Soc Periodontol. 2023 May-Jun;27(3):238-250. doi: 10.4103/jisp.jisp_576_21. Epub 2023 May 1.
Venous thromboembolism (VTE) is a rising major health problem comprising pulmonary embolism (PE) and deep vein thrombosis. It is of concern due to premature mortality, increased morbidity, and associated healthcare costs and hospitalization. Periodontitis can increase the risk of VTE by way of systemic inflammation induced by infection that can contribute to hypercoagulability and platelet aggregation. This systematic review aims to synthesize all the evidence concerning periodontal infection as a risk factor for thromboembolic disease.
A search for articles published from 1967 till December 2020 was conducted in the PubMed (MEDLINE), Scopus, and EMBASE data bases.
Five hundred and five articles were retrieved after running search strategies in PubMed, Scopus, and EMBASE search databases. Based on the inclusion criteria, three clinical studies, two case series, and ten case reports were included for qualitative analysis. The presence of periodontal disease was reported to influence the occurrence of venous thromboembolic disease with a statistical significance of <0.010. Case series and case reports of septic PE due to periodontal disease showed complete resolution of lung lesions and subsiding of symptoms after dental treatment and antimicrobial therapy.
The results of this systematic review suggested for an association between periodontal disease and the incidence of thromboembolic disease. As most of the included/available studies are case series and case reports, the strength of evidence is weak. Evidence generated from well-designed longitudinal controlled clinical trials may be helpful to further assess the strength of the association.
静脉血栓栓塞症（VTE）是一个日益严重的主要健康问题，包括肺栓塞（PE）和深静脉血栓形成。由于其导致过早死亡、发病率增加以及相关的医疗保健成本和住院治疗，令人担忧。牙周炎可通过感染引起的全身炎症增加VTE风险，这种炎症可导致血液高凝性和血小板聚集。本系统评价旨在综合所有关于牙周感染作为血栓栓塞性疾病危险因素的证据。
在PubMed（MEDLINE）、Scopus和EMBASE数据库中检索1967年至2020年12月发表的文章。
在PubMed、Scopus和EMBASE检索数据库中运行检索策略后，共检索到505篇文章。根据纳入标准，纳入三项临床研究、两项病例系列和十项病例报告进行定性分析。据报道，牙周疾病的存在会影响静脉血栓栓塞性疾病的发生，统计学意义<0.010。牙周疾病导致的感染性PE的病例系列和病例报告显示，牙科治疗和抗菌治疗后肺部病变完全消退，症状缓解。
本系统评价结果提示牙周疾病与血栓栓塞性疾病的发病率之间存在关联。由于纳入的/可获得的大多数研究是病例系列和病例报告，证据强度较弱。精心设计的纵向对照临床试验产生的证据可能有助于进一步评估这种关联的强度。
