Periodontal disease and carotid atherosclerosis: A meta-analysis of 17,330 participants

Background and objectives: The association between periodontal disease and carotid atherosclerosis has been evaluated primarily in single-center studies, and whether periodontal disease is an independent risk factor of carotid atherosclerosis remains uncertain. This meta-analysis aimed to evaluate the association between periodontal disease and carotid atherosclerosis. Methods: We searched PubMed and Embase for relevant observational studies up to February 20, 2015. Two authors independently extracted data from included studies, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated for overall and subgroup meta-analyses. Statistical heterogeneity was assessed by the chi-squared test (P < 0.1 for statistical significance) and quantified by the I-2 statistic. Data analysis was conducted using the Comprehensive Meta-Analysis (CMA) software. Results: Fifteen observational studies involving 17,330 participants were included in the meta-analysis. The overall pooled result showed that periodontal disease was associated with carotid atherosclerosis (OR: 1.27, 95% CI: 1.14-1.41; P < 0.001) but statistical heterogeneity was substantial (I-2 = 78.90%). Subgroup analysis of adjusted smoking and diabetes mellitus showed borderline significance (OR: 1.08; 95% CI: 1.00-1.18; P = 0.05). Sensitivity and cumulative analyses both indicated that our results were robust. Conclusions: Findings of ourmeta-analysis indicated that the presence of periodontal disease was associated with carotid atherosclerosis; however, further large-scale, well-conducted clinical studies are needed to explore the precise risk of developing carotid atherosclerosis in patients with periodontal disease. (C) 2015 Elsevier Ireland Ltd. All rights reserved.