Association between Periodontitis and Carotid Artery Calcification: A Systematic Review and Meta-Analysis

Abstract

Recent studies have supported the relationship between periodontitis and carotid artery calcification (CAC), but still uncertain. This systematic review is aimed at evaluating the association between periodontitis and CAC. The search was conducted in four electronic databases: PubMed, EMBASE, Web of Science, and The Cochrane Library, supplemented by checking references of included articles and related review articles. Eligibility assessment and data extraction were conducted independently. The quality assessment and publication bias analysis were performed. The association between periodontitis and CAC was presented in odd ratio (OR) with 95% confidence interval (CI). Additional outcomes included the percentage of alveolar bone loss in CAC versus non-CAC. Twelve studies were included, and 10 were performed quantity analysis. Periodontitis with secure definition ( OR = 2.02 , 95 % CI = 1.18 − 3.45 ) and insecure definition ( OR = 10.78 , 95 % CI = 4.41 − 26.34 ) was associated with CAC. And a higher average percentage of alveolar bone loss ( weighted mean difference = 10.84 % ; 95 % CI = 6.40 − 15.48 ) was also observed in CAC patients compared to non-CAC patients. No significant publication bias was found. The results of this systematic review and meta-analysis revealed a significant relationship between periodontitis and CAC.

Unravelling the link between periodontitis and abdominal aortic calcification in the US adult population: a cross-sectional study based on the NHANES 2013–2014

“…16 The results from a meta-analysis that included 12 studies also revealed a significant relationship between periodontitis and carotid artery calcification. 15 Similar to our findings, a cohort study in Chinese populations suggested that periodontitis was also positively associated with aortic calcification, and this association was more pronounced in men and in participants younger than 65 years. 13 The exact mechanism of the link between periodontitis and AAC remains unclear and needs to be further explored.…”

“…A Chinese cohort study showed that periodontitis increased the risk of aortic calcification and was more pronounced in men and younger participants than in women and older participants 13. In addition, a cross-sectional study and meta-analysis suggested that periodontitis was associated with carotid calcification,14 15 and there was radiographic evidence suggesting the possible involvement of intracranial carotid calcification 16. However, other cohort studies reported inconsistent conclusions 17 18.…”

Association between Periodontitis and Aortic Calcification: A Cohort Study

“…In the first systematic review and meta-analysis there was a positive association between periodontitis and carotid artery calcification. 30 Similar findings have been obtained in clinical and animal studies. 31,32 In our prospective cohort study conducted in a non-selected population of 6059 individuals, periodontitis was associated with the occurrence of AC (HR and 95% CI: 1.18 (1.02-1.36), P = .025).…”

“…IL-1β induces the secretion of RANKL (receptor activator of NF-κB ligand) and activates osteoclasts, 38 causing a series of inflammatory responses and producing the inflammatory marker CRP, 29 allowing the recoding of vascular smooth muscle cells (VSMCs) towards an osteoblast-like phenotype, and VSMCs secrete bone-associated matrix proteins, 39,40 which cause vascular wall calcification and vascular lesions. 30,41 However, the inflammatory markers mentioned above were not measured and these mechanisms could not be verified in this study. More studies are needed to confirm these hypotheses.…”

Unexpected Relationships: Periodontal Diseases: Atherosclerosis–Plaque Destabilization? From the Teeth to a Coronary Event

“…An interesting meta-analysis of 20 studies by Wang et al summarized the relationship between PD and the risk of carotid artery calcification. The risk of carotid artery calcification was significantly higher by 102% in patients with PD (OR = 2.02; 95% CI: 1.18–3.45) [ 104 ]. It is also worth mentioning that the study by Rodean et al showed that the occurrence of PD was associated with a higher risk of the presence of high-risk atherosclerotic plaques in the coronary arteries [ 105 ].…”