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Is There a Causal Link Between Periodontitis and Cardiovascular Disease? A Concise Review of Recent Findings

There is substantial evidence in support of an association between periodontitis and cardiovascular disease. The most important open question related to this association is causality. This article revisits the question of causality by reviewing intervention studies and systematic reviews and meta an...

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Autores principales: Febbraio, Maria, Roy, Christopher Bryant, Levin, Liran
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275186/
https://www.ncbi.nlm.nih.gov/pubmed/34565546
http://dx.doi.org/10.1016/j.identj.2021.07.006
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author Febbraio, Maria
Roy, Christopher Bryant
Levin, Liran
author_facet Febbraio, Maria
Roy, Christopher Bryant
Levin, Liran
author_sort Febbraio, Maria
collection PubMed
description There is substantial evidence in support of an association between periodontitis and cardiovascular disease. The most important open question related to this association is causality. This article revisits the question of causality by reviewing intervention studies and systematic reviews and meta analyses published in the last 3 years. Where are we now in answering this question? Whilst systematic reviews and epidemiological studies continue to support an association between the diseases, intervention studies fall short in determining causality. There is a dearth of good-quality, blinded randomised control trials with cardiovascular disease outcomes. Most studies use surrogate markers/biomarkers for endpoints, and this is problematic as they may not be reflective of cardiovascular disease status. This review further highlights another issue with surrogate markers/biomarkers: the potential for collider bias. Ethical considerations surrounding nontreatment have led to calls for a well-annotated database containing in-depth dental health data. Finally, a relatively new and important risk factor for cardiovascular disease, clonal haematopoiesis of indeterminate potential, is discussed. Clonal haematopoiesis of indeterminate potential increases cardiovascular risk by more than 40%, and inflammation is a contributing factor. The impact of periodontal disease on this emerging risk factor has yet to be explored. Although the question of causality in the association between periodontal disease and cardiovascular disease remains unanswered, the importance of good oral health in maintaining good heart health is reiterated.
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spelling pubmed-92751862022-08-02 Is There a Causal Link Between Periodontitis and Cardiovascular Disease? A Concise Review of Recent Findings Febbraio, Maria Roy, Christopher Bryant Levin, Liran Int Dent J Concise Clinical Review There is substantial evidence in support of an association between periodontitis and cardiovascular disease. The most important open question related to this association is causality. This article revisits the question of causality by reviewing intervention studies and systematic reviews and meta analyses published in the last 3 years. Where are we now in answering this question? Whilst systematic reviews and epidemiological studies continue to support an association between the diseases, intervention studies fall short in determining causality. There is a dearth of good-quality, blinded randomised control trials with cardiovascular disease outcomes. Most studies use surrogate markers/biomarkers for endpoints, and this is problematic as they may not be reflective of cardiovascular disease status. This review further highlights another issue with surrogate markers/biomarkers: the potential for collider bias. Ethical considerations surrounding nontreatment have led to calls for a well-annotated database containing in-depth dental health data. Finally, a relatively new and important risk factor for cardiovascular disease, clonal haematopoiesis of indeterminate potential, is discussed. Clonal haematopoiesis of indeterminate potential increases cardiovascular risk by more than 40%, and inflammation is a contributing factor. The impact of periodontal disease on this emerging risk factor has yet to be explored. Although the question of causality in the association between periodontal disease and cardiovascular disease remains unanswered, the importance of good oral health in maintaining good heart health is reiterated. Elsevier 2021-09-24 /pmc/articles/PMC9275186/ /pubmed/34565546 http://dx.doi.org/10.1016/j.identj.2021.07.006 Text en © 2021 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Concise Clinical Review
Febbraio, Maria
Roy, Christopher Bryant
Levin, Liran
Is There a Causal Link Between Periodontitis and Cardiovascular Disease? A Concise Review of Recent Findings
title Is There a Causal Link Between Periodontitis and Cardiovascular Disease? A Concise Review of Recent Findings
title_full Is There a Causal Link Between Periodontitis and Cardiovascular Disease? A Concise Review of Recent Findings
title_fullStr Is There a Causal Link Between Periodontitis and Cardiovascular Disease? A Concise Review of Recent Findings
title_full_unstemmed Is There a Causal Link Between Periodontitis and Cardiovascular Disease? A Concise Review of Recent Findings
title_short Is There a Causal Link Between Periodontitis and Cardiovascular Disease? A Concise Review of Recent Findings
title_sort is there a causal link between periodontitis and cardiovascular disease? a concise review of recent findings
topic Concise Clinical Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275186/
https://www.ncbi.nlm.nih.gov/pubmed/34565546
http://dx.doi.org/10.1016/j.identj.2021.07.006
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