Two-Way Relationship Between Helicobacter Pylori Infection and Periodontitis: Results from A Systematic Review and Meta-Analysis

Abstract

Aim: Helicobacter pylori (H. pylori) infection and periodontitis have considerable worldwide prevalence once they both present systemic alterations with a possible association between them. Therefore, we have performed this meta-analysis to assess the possible association between H. pylori infection and periodontitis. Material and Methods: A systematic search in the literature was performed for studies published before December 2, 2019 in diverse scientific and educational databases. The data was extracted by two investigators and the statistical analysis was performed by Review Manager statistical program with heterogeneity and Odds Ratio (OR) with 95% of Confidence Intervals (CI) calculations as well as a sensitive analysis to assess the accuracy of the results. The value of P<0.05 was considered as significant. In addition, we performed the analysis of the quality of included studies as well as the evaluation for risk of bias. Results: In overall analysis, H. pylori infection was associated with the risk of periodontitis development (OR = 1.72, CI: 1.47, 2.02, P<0.00001) and the periodontitis was considered as a risk factor for H. pylori infection (OR = 3.21, CI: 2.31, 4.47, P<0.00001). Moreover, the evaluation of dental plaque from patients with periodontitis reveled increased risk of H. pylori infection (OR = 3.46, CI: 2.39, 5.01, P<0.00001). Conclusions: This current systematic review and meta-analysis composed by 12 studies in 7,059 participants showed that H. pylori infection increased significantly the risk of the development of periodontitis and the periodontitis may be a risk for this bacterial infection.

Association of Chronic Periodontitis with Helicobacter pylori Infection in Stomach or Mouth: A Systematic Review and Meta-Analysis

“…42 A two-way association between these two disease entities has been suggested. 29 The present meta-analysis provided evidence for an association between the presence of H. pylori in the subgingival plaque and chronic periodontal disease, as H. pylori was detected at a higher rate in the subgingival plaque of patients with periodontitis compared with healthy controls. This finding is consistent with a recent meta-analysis, which concluded that periodontitis is associated with oral H. pylori infection due to the presence of the bacterium in saliva and plaque in general.…”

“…At the same time, an association has been established between periodontitis and H. pylori infection, suggesting that the oral cavity is a potential reservoir of H. pylori. 28,29 In interventional studies, successful eradication of gastric H. pylori resulted in improved periodontal disease. 30,31 As the studies published so far have been focused on the supragingival plaque or patients with periodontal diseases in general (including gingivitis), the present systematic review and meta-analysis aimed to investigate the association of H. pylori infection in the stomach and/or in specific oral cavity areas (subgingival plaque, and gingival crevicular fluid) with chronic periodontitis.…”