Periodontitis and Platelets Status: A Systematic Review With Meta-Analysis and Trial Sequential Analysis

Area of Science:

• Hematology and Immunology
• Periodontology and Oral Health
• Cardiovascular Health

Background:

• Platelets are crucial for hemostasis, thrombosis, and immune responses.
• Platelet function alterations may influence immune reactions to dental biofilm and cardiovascular health.
• The relationship between periodontitis and platelet status/activity requires further investigation.

Purpose of the Study:

• To systematically review observational studies on platelet status and activity in periodontitis patients.
• To compare platelet count (PC) and mean platelet volume (MPV) between individuals with and without periodontitis.

Main Methods:

• Systematic literature search of MEDLINE-PubMed, EMBASE, and Cochrane-CENTRAL up to November 2024.
• Inclusion of observational studies investigating platelet status in periodontitis.
• Meta-analysis and trial sequential analysis for PC and MPV, with quality assessment (Newcastle-Ottawa scale) and evidence grading (GRADE).

Main Results:

• 23 studies with 22 variables on platelet status were included.
• Patients with periodontitis exhibited significantly higher platelet counts (PC) (MD = 23.55 ×10^9/L).
• No statistically significant difference in mean platelet volume (MPV) was observed; conclusive evidence for PC, but more data needed for MPV.

Conclusions:

• Moderate certainty exists for slightly higher PC in periodontitis patients.
• Low certainty for no difference in MPV between groups.
• Insufficient evidence to establish clear differences in other platelet activation biomarkers.