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Updated: Sep 2, 2025
Adjunctive Diode Laser Therapy and Probiotic Lactobacillus Therapy in the Treatment of Periodontitis and Peri-Implant Disease
Published on: May 9, 2022
Treatment of periodontitis and C-reactive protein: A systematic review and meta-analysis of randomized clinical
Shailly Luthra1, Marco Orlandi1, Syed Basit Hussain1
1Periodontology Unit, UCL Eastman Dental Institute, London, UK.
Background:
Systemic inflammation is implicated in the onset and progression of several chronic diseases. Periodontitis is a potential trigger of systemic inflammation.
Purpose:
To comprehensively appraise all the evidence on the effects of the treatment of periodontitis on systemic inflammation assessed by serum C-reactive protein (CRP) levels.
Data Sources:
Six electronic databases were searched up to 10 February 2022 to identify and select articles in English language only.
Study Selection:
Twenty-six randomized controlled clinical trials reporting changes amongst 2579 participants about CRP levels at 6 months or more after treatment.
Data Extraction:
Two reviewers independently extracted data and rated the quality of studies. Meta-analyses were performed using random and fixed effect models.
Risk Of Bias:
Risk of bias (RoB 2.0 tool) and quality of evidence (GRADEpro GDT tool) analyses were completed.
Data Synthesis:
Treatment of periodontitis reduced CRP levels by 0.69 mg/L (95% confidence interval: -0.97 to -0.40) after 6 months, but limited evidence was retrieved from studies with longer follow-ups. Similar findings were observed in participants with other co-morbidities in addition to periodontitis. Greatest reductions were observed in participants with concentrations of CRP >3 mg/L at baseline.
Limitations:
High level of heterogeneity.
Conclusions:
Treatment of periodontitis reduces serum CRP levels (up to 6 months follow-up) to a degree equivalent to that observed after traditional lifestyle or drug interventions. This evidence supports a causal association between periodontitis and systemic inflammation.
