Periodontitis and Mediterranean fever: a systematic review and metaanalysis

Periodontitis is a severe oral health condition that damages the supporting bone and soft tissues surrounding the teeth. In recent years, it has become evident that periodontitis could increase systemic inflammatory markers. Some studies showed a potential link between periodontitis and autoinflammatory diseases, including Familial Mediterranean fever (FMF), which is a hereditary autoinflammatory condition. The current study aimed to comprehensively evaluate the association between FMF and periodontitis by analyzing clinical periodontal parameters-Plaque Index (PI), Gingival Index (GI), and Clinical Attachment Loss (CAL)-through a meta-analysis.

A thorough search was conducted across different databases, including PubMed, Scopus, Web of Science, and Google Scholar, covering publications up to July 2024. Eleven studies were included, consisting of one cohort and ten case controls. Following established methods, we performed data extraction and quality assessment of the selected publications. We conducted a meta-analysis to gather the effect sizes obtained from the eligible publications.

The meta-analysis highlighted a statistically significant increase in PI among FMF patients compared to controls, with a pooled mean difference of 0.1833 (95% CI: 0.0012, 0.3655; p=0.0485), indicating higher plaque accumulation in FMF patients. On the other hand, CAL exhibited a non-significant mean difference of -0.0933 (95% CI: -0.2928 to 0.1062; p = 0.3596), and the GI similarly did not reach statistical significance, presenting a mean difference of 0.3223 (95% CI: -0.0713 to 0.7158; p = 0.1085).

Our investigation underscores a potential association between FMF and periodontitis, as seen by elevated levels of PI in FMF patients. These results suggest that FMF patients experience higher levels of periodontal inflammation, emphasizing the importance of periodontal care in this population.