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Effect of Periodontal Treatment on Serum C‐Reactive Protein Levels: A Systematic Review and Meta‐Analysis
Author(s) -
Ioannidou Effie,
Malekzadeh Tannaz,
DongariBagtzoglou Anna
Publication year - 2006
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1902/jop.2006.050443
Subject(s) - medicine , meta analysis , systemic inflammation , randomized controlled trial , c reactive protein , relative risk , periodontitis , cohort study , cohort , adverse effect , medline , inflammation , confidence interval , political science , law
Background: Systemic inflammation is increasingly being recognized as a risk factor for adverse cardiovascular events. Evidence is accumulating that associates periodontal disease with a higher risk for atherosclerotic plaque formation. A positive association between circulating C‐reactive protein (CRP) levels and periodontal disease may be responsible for these observations. We undertook a systematic review and conducted a meta‐analysis of the available evidence to examine the effect of periodontal treatment on systemic CRP levels and to assess the quality of the available evidence. Methods: We conducted a systematic search of the English‐language literature on the effect of periodontal treatment on CRP levels, as assessed by high‐sensitivity assays, at least 2 months after periodontal treatment. The search was conducted in MEDLINE between 1966 and July 2005 and the Cochrane Central Register of Controlled Trials. We performed a meta‐analysis using the DerSimonian and Laird random‐effects model. Results: The literature search yielded 814 citations of which 10 met the inclusion criteria. The meta‐analysis of the randomized controlled trials (RCTs) showed that the difference in serum CRP levels is not significantly different between the two arms. Similarly, results from the single‐cohort studies showed that the difference on serum CRP levels was not significantly different before and after treatment. Conclusions: There is now a large body of evidence to indicate that systemic inflammation is present in patients with periodontal disease. Thus, information from RCTs and single‐cohort studies does not support the hypothesis that periodontal treatment can reduce systemic CRP levels.