Systemic benefits of periodontal therapy in patients with obesity and periodontitis: a systematic review.
Cláudia Callegaro de MenezesDavi da Silva BarbiratoMariana Fampa FogacciErika Calvano KüchlerJoão Régis Ivar CarneiroLucianne Cople Maia FariaMaria Cynésia Medeiros de BarrosPublished in: Brazilian oral research (2024)
This systematic review aimed to answer the focused question: "What are the benefits of subgingival periodontal therapy on blood hematological and biochemical index, biomarkers of inflammation and oxidative stress, quality of life, and periodontal pathogen counts in patients with obesity and periodontitis?". A systematic literature search was performed in six databases: PubMed, Embase, LILACS, Web of Science, Cochrane and SCOPUS and other sources, and a manual search was conducted as well. Inclusion criteria were randomized and non-randomized clinical trials, and before-and-after studies on patients with obesity subjected to periodontal therapy. The results were synthesized qualitatively. Risk of bias within studies was assessed using RoB 2 and ROBINS-I tools. The certainty of evidence was evaluated following the GRADE approach. Three randomized controlled trials and 15 before-and-after studies were included. Randomized controlled trials were considered to have a low risk of bias, as compared to before-and-after studies assessed as having low, serious, and critical risks of bias. Non-surgical periodontal therapy plus azithromycin, chlorhexidine, and cetylpyridinium chloride reduced blood pressure and decreased serum levels of HbA1c, hsCRP, IL-1β, and TNF-α. Salivary resistin level also decreased in patients with obesity and periodontitis after therapy and chlorhexidine mouth rinse. Before-and-after data suggest an improvement in total cholesterol, LDL, triglycerides, insulin resistance, C3, GCF levels of TNF-α, chemerin, vaspin, omentin-1, visfatin, 8-OHdG, and periodontal pathogen counts after therapy.
Keyphrases
- insulin resistance
- systematic review
- metabolic syndrome
- oxidative stress
- type diabetes
- blood pressure
- weight loss
- randomized controlled trial
- high fat diet induced
- weight gain
- high fat diet
- adipose tissue
- rheumatoid arthritis
- body mass index
- skeletal muscle
- big data
- electronic health record
- polycystic ovary syndrome
- double blind
- stem cells
- risk assessment
- cell therapy
- clinical trial
- blood glucose
- placebo controlled
- replacement therapy
- low density lipoprotein
- human health
- dna damage
- phase ii
- glycemic control
- smoking cessation