Cardiovascular and anti-inflammatory effects of periodontal therapy: A systematic review and meta-analysis of...

Emerging evidence has demonstrated a bidirectional relationship between periodontal disease and cardiovascular outcomes, with periodontal inflammation contributing to systemic vascular dysfunction. Herein, we aimed to assess the available evidence on whether periodontal therapy improves cardiovascular and inflammatory outcomes in patients with periodontitis through the systematic modulation of blood pressure and C-reactive protein levels.

Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and the population, intervention, comparison, outcomes, and study design (PICOS) question, electronic databases were screened from inception to January 2025 for randomized controlled trials addressing the impact of periodontal interventions on systolic and diastolic blood pressure and C-reactive protein outcomes in patients with periodontitis. Studies were selected, and data were extracted by two independent reviewers. Random-effects models were applied to perform meta-analyses, and the Cochrane Risk of Bias 2 (RoB2) tool was used to assess study quality.

Twelve randomized controlled trials were included in the qualitative and quantitative syntheses. The meta-analysis demonstrated that periodontal therapy significantly reduced systolic (mean difference, -4.64 mmHg; 95% CI, -5.99 to -3.30) and diastolic blood pressure (mean difference, -1.84 mmHg; 95% CI, -2.65 to -1.02). Concurrent anti-inflammatory effects were evident through significant reductions in C-reactive protein levels (mean difference, -0.58 mg/L; 95% CI -0.83 to -0.33).

Periodontal therapy shows potential cardiovascular and anti-inflammatory benefits through reductions in blood pressure and C-reactive protein levels, although evidence certainty was moderate to low, and high-quality trials powered for blood pressure endpoints are warranted to strengthen this evidence.

Periodontal disease has been linked to heart and blood vessel problems via inflammation, which affects the entire body. This study analyzed randomized controlled trials to determine whether treating gum disease could help to reduce cardiovascular risk by lowering blood pressure and inflammatory markers. Our analysis showed that periodontal therapy led to meaningful reductions in both systolic and diastolic blood pressure, with improvements similar to those observed with blood pressure medications, while also reducing C-reactive protein levels, indicating less systemic inflammation. These findings suggest that treating gum disease may provide important benefits for heart health and should be considered part of overall cardiovascular disease prevention strategies. However, more standardized investigations are needed to strengthen these conclusions and to help healthcare providers better understand how dental treatment fits into comprehensive heart disease prevention.