Dental Research
Intro: Cardiovascular disease (CVD) claims 18 million lives each year. Periodontitis, affecting up to 50% of the population, is associated with an elevated risk of CVD, including atherosclerosis, hypertension, endocarditis, and heart attacks etc. The severity of periodontitis correlates with an increased risk of CVD. One contributing factor is Porphyromonas gingivalis (Pg), an oral pathogenic bacterium, can disrupt lipid levels and damage endothelial cells, further increasing the risk.
Aim: To determine the prevalence of Pg in surgical samples of adults with CVD needing surgical intervention compared to healthy vessel samples.
Methods: We followed PRISMA guidelines for the systematic search. After full text selection and data extraction the proportion of patients with prevalence of Pg in CV samples was calculated using random-effects meta-analyses. Multiple subgroup analyses were performed.
Results: Twenty-five articles were included and subgrouped according to the study population presenting healthy periodontium, periodontitis or edentulousness. The articles detailing periodontitis in patients were further subgrouped by surgeries at various CV sites: heart, coronary artery, aorta, and carotid artery. The control group consisted of samples taken from healthy vessels. Our results show that Pg was found in CV lesions of patients with healthy periodontium in 11% (0.01-0.53) with 0% heterogenity (I2 ) and in periodontitis in 23% (0.13-0.36) with I2 80%, which could be explained by the diversity of the sample size, the location of the CV lesion and the different sensitivity of the PCR techniques used in the studies. In edentulous subgroups, there were too few articles for statistical analysis. In the coronary artery subgroup of patients with periodontitis the prevalence of Pg was 40% (0.23-0.60), the highest among the vessels. Followed by the aorta and the carotid artery with 18% (0.01-0.81) and 14% (0.02-0.56), respectively. The test for subgroup differences suggests a significant subgroup effect (p<0.001). Heart sample number was not enough for statistics.
Conclusion: Pg can be found in CV samples, suggesting a role in the pathogenesis of CVD. Coronary arteries are more susceptible to Pg compared to other investigated arteries. These results highlight the importance of oral hygiene and health in preventing life-threatening conditions.
Funding: N/A