Title: 2514 - The Effect of Non-Surgical Periodontal Treatment on Systemic Blood Pressure: A Meta-Analysis
Natalia Oshiro (Presenter)
Federal University of Rio de Janeiro
Maria Cynésia Barros, Federal University of Rio de Janeiro
Mariana Fogacci, Faculdades Integradas Aparício Carvalho
Objectives: This systematic review and meta-analysis aimed to investigate the effect of non-surgical periodontal treatment on systemic arterial blood pressure to answer the question: does non-surgical periodontal treatment reduce blood pressure in patients with chronic periodontitis?
Methods: The systematic search was performed using PubMed, Cochrane Library, Web of Science, BVS Bireme and OpenGrey databases. Methodology was conducted based on Cochrane Handbook for Systematic Reviews of Interventions, and guided by PRISMA statement. Only randomized controlled clinical trials that performed non-surgical periodontal treatment in patients with chronic periodontitis (without metabolic conditions) and checked systolic blood pressure (SBP) and diastolic blood pressure (DBP) were included. Diagnosis of periodontitis were considered when based on probing depth (PD) and clinical attachment level (CAL).
Results: From 2981 articles identified, three met the eligible criteria and were submitted to qualitative (Cochrane Collaboration’s tool for assessing risk of bias) and statistical (meta-analysis) analysis. All domains of the three articles are low risk of bias, except allocation concealment and performance bias. Data were extracted and meta-analyses were performed using statistical software (STATA® 10.0), and reported with a 95% confidence interval and p<0.1. The chi-square test and I-square test for 1-month SBP, 1-month DBP and 3-month DBP showed non-significant heterogeneity. Results were statistically significant and showed a significant reduction in blood pressure in the 3-month DBP group (-2.31;CI:-4.04,-0.58). Results of 3-month SBP, 6-month SBP and 6-month DBP were also statistically significant and showed reduction in blood pressure [(-5.33;CI:-7.16,-3.50);(-11.38;CI:-13.45,-9.31);(-7.91;CI:-10.36,-5.46)respectively], however the heterogeneity test was significant, which makes it more difficult to compare them. The other two groups presented the results: 1-month SBP(-1.72;CI:-3.80,0.36), and 1-month DBP(-0.47;CI:-2.93,1.99), both not significant, but only two studies evaluated 1 month after treatment follow-up.
Conclusions: The main conclusion is that non-surgical periodontal therapy has a significant effect on blood pressure reduction, most remarkable on diastolic blood pressure, three months after the treatment.
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|Kapellas et al., 2014||Hada et al., 2015||Zhou et al., 2017|
|Selection bias||Random sequence generation||Low risk||Low risk||Low risk|
|Allocation concealment||Unclear risk||Low risk||Low risk|
|Performance bias||Blinding of participants and personnel||High risk||High risk||High risk|
|Detection bias||Blinding of outcome assessment||Low risk||Low risk||Low risk|
|Attrition bias||Incomplete outcome data||Low risk||Low risk||Low risk|
|Reporting bias||Selective reporting||Low risk||Low risk||Low risk|
|Other bias||Other sources of bias||Low risk||Low risk||Low risk|
The submitter must disclose the names of the organizations with which any author have a relationship, the nature of the relationship, and the clinical or research area involved. The following is submitted: NONE