Effects of Periodontal Therapy on Cardiovascular Risk Biomarkers: A Systematic Review

Periodontal and cardiovascular diseases are prevalent chronic conditions sharing common pathogenic pathways involving bacterial translocation and systemic inflammation. This systematic review aimed to assess the impact of non-surgical periodontal therapy (NSPT) on cardiovascular risk biomarkers, including endothelial function, systemic inflammation and thrombosis markers, and lipid and glucose metabolism, in patients with or without comorbidities.

A systematic search was conducted in PubMed, Cochrane Library, and Scopus databases, following preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines and supplemented by manual searches. Eligible studies were published after 2010, written in English, and involved adult patients with moderate to severe periodontitis treated with NSPT. Risk of bias was assessed for all included studies.

Sixteen studies were included. NSPT was associated with a significant reduction in high-sensitivity C-reactive protein (hs-CRP) and proinflammatory cytokines (IL-6, TNF-α), as well as with decreased HbA1c levels, particularly in patients with type 2 diabetes. Improvements in endothelial function were observed, notably a reduction in endothelial microparticles (EMPs), although results across vascular parameters such as flow-mediated dilation (FMD) and PWV were heterogeneous. Effects on lipid profiles were inconsistent and generally modest.

NSPT shows moderate to high clinical relevance by improving key cardiovascular biomarkers especially inflammation and glycaemic control with both healthy and comorbid patients. These findings support the integration of periodontal care into cardiovascular risk mana-gement strategies, though further research is needed to confirm effects on lipid metabolism and vascular function.