Periodontitis and respiratory diseases: A systematic review with meta-analysis

Objective To conduct a systematic review and meta-analysis to evaluate the recent scientific literature addressing the association between periodontitis and asthma, chronic obstructive pulmonary disease (COPD), and pneumonia. Materials and Methods The search for studies was carried out using MEDLINE/PubMed, EMBASE, Lilacs, Web of Science, Scopus, and SciELO databases, including the gray literature (ProQuest). Reference lists of selected articles were also searched. Studies having varying epidemiological designs assessing the association between periodontitis and respiratory diseases in human subjects were eligible for inclusion. Three independent reviewers performed the selection of articles and data extraction. Fixed and random effects meta-analysis were performed for the calculation of the association measurements (Odds Ratio-OR) and 95% confidence intervals (95% CI). Results A total of 3,234 records were identified in the database search, with only 13 studies meeting the eligibility criteria and 10 studies contributed data for meta-analysis. Using a random effects models periodontitis was associated with asthma: ORadjusted: 3.54 (95% CI: 2.47-5.07), I-2 = 0%; with COPD: OR adjusted: 1.78 (95% CI: 1.04-3.05), I-2 = 37.9%; and with pneumonia: OR adjusted: 3.21 (95% CI: 1.997-5.17), I-2 = 0%. Conclusions The main findings of this systematic review validated an association between periodontitis and asthma, COPD and pneumonia.