Invasive dental treatment and acute vascular events: A systematic review and meta-analysis

Acute infection/inflammation increases the risk of acute vascular events (AVEs). Invasive dental treatments (IDTs) trigger short-term acute inflammation.

The aim of this work is to critically appraise the evidence linking IDTs and AVEs.

Six bibliographical databases were searched up to 31 August 2021. A systematic review following PRISMA guidelines was performed.

Intervention and observational studies reporting any AVEs following IDT were included.

Two reviewers independently extracted data and rated the quality of studies. Data were pooled using fixed-effect, inverse variance weights analysis.

Risk of bias was assessed by the Newcastle-Ottawa Quality Assessment Scale for observational studies and the Cochrane Handbook-Rob 2.0 for randomized controlled trials.

In 3 out of 16 clinical studies, a total of 533,175 participants, 124,344 myocardial infarctions, and 327,804 ischaemic strokes were reported. Meta-analysis confirmed that IDT did not increase incidence ratios (IR) for combined vascular events either at 1-4 weeks (IR of 1.02, 95% CIs: 0.92 to 1.13) and at 5-8 weeks (IR of 1.04, 95% CIs: 0.97 to1.10) after treatment.

A high level of heterogeneity (study designs and time point assessments) was found.

Patients who received IDT exhibited no substantial increase in vascular risk over 8 weeks post treatment.