Related Experiment Video
Updated: May 23, 2025
Adjunctive Diode Laser Therapy and Probiotic Lactobacillus Therapy in the Treatment of Periodontitis and Peri-Implant Disease
Published on: May 9, 2022
Periodontitis and Platelets Status: A Systematic Review With Meta-Analysis and Trial Sequential Analysis
Dimitris Sokos1, Marja L Laine1, Elena A Nicu2
1Department of Periodontology Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Aim:
Circulating platelets are essential in hemostasis, thrombosis, and immune responses. Modifications in platelet function may impact immunological reactions to dental biofilm and cardiovascular health. Understanding changes in platelet status and activity in patients with periodontitis is still a subject of investigation. This study aimed to synthesize evidence from observational studies that investigated platelet status and activity in patients with and without periodontitis.
Methods:
MEDLINE-PubMed, EMBASE, and Cochrane-CENTRAL Library databases were searched up to November 2024. Primary outcomes included platelet count (PC) and mean platelet volume (MPV). Secondary outcomes encompassed any other biomarker relevant to platelet status and activity. Methodological quality was evaluated using the Newcastle-Ottawa scale, and heterogeneity was analyzed. Descriptive analysis of outcomes and meta-analysis, incorporating trial sequential analysis of PC and MPV, were conducted. The body of evidence was graded by utilizing the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).
Results:
3621 unique records were identified, resulting in 23 eligible studies with 22 variables evaluating the platelet status. Fourteen studies exhibited a low risk of bias, and 9 exhibited moderate risk of bias. PC in patients with periodontitis was significantly higher compared to individuals without periodontitis (Mean Difference (MD) = 23.55 ×109/L, 95% CI [7.68; 39.43]). There was no statistically significant difference between the groups for MPV (MD = 0.16 fL, 95% CI [-0.49; 0.82]). Trial sequential analysis indicated a conclusive meta-analysis of PC and highlighted the need for additional data on MPV from future trials.
Conclusions:
The certainty is moderate for slightly higher PC in patients with periodontitis compared to individuals without it and low for no difference in MPV between the two groups. The evidence is not robust to claim a clear difference in other platelet activation biomarkers between the two groups.
Trial Registration:
International Prospective Register of Systematic Reviews (PROSPERO) by number: CRD42023439051.
Related Concept Videos
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
01:22Formation of the Platelet Plug
As the injured blood vessel contracts, endothelial cells undergo contraction, revealing collagen fibers in the basement membrane and underlying connective tissue. Furthermore, the plasma membrane of endothelial cells becomes adhesive, preparing the site for platelet adhesion. Platelets...