Periodontitis and cardiovascular diseases: Consensus report.

Mariano Sanz, Alvaro Marco Del Castillo, Søren Jepsen, Jose R Gonzalez-Juanatey, Francesco D'Aiuto, Philippe Bouchard, Iain Chapple, Thomas Dietrich, Israel Gotsman, Filippo Graziani, David Herrera, Bruno Loos, Phoebus Madianos, Jean-Baptiste Michel, Pablo Perel, Burkert Pieske, Lior Shapira, Michael Shechter, Maurizio Tonetti, Charalambos Vlachopoulos, Gernot Wimmer

Journal: Journal of clinical periodontology 2020;47(3):268-288

PMID: 32011025

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Abstract

BACKGROUND

In Europe cardiovascular disease (CVD) is responsible for 3.9 million deaths (45% of deaths), being ischaemic heart disease, stroke, hypertension (leading to heart failure) the major cause of these CVD related deaths. Periodontitis is also a chronic non-communicable disease (NCD) with a high prevalence, being severe periodontitis, affecting 11.2% of the world's population, the sixth most common human disease.

MATERIAL AND METHODS

There is now a significant body of evidence to support independent associations between severe periodontitis and several NCDs, in particular CVD. In 2012 a joint workshop was held between the European Federation of Periodontology (EFP) and the American Academy of Periodontology to review the literature relating periodontitis and systemic diseases, including CVD. In the last five years important new scientific information has emerged providing important emerging evidence to support these associations RESULTS AND CONCLUSIONS: The present review reports the proceedings of the workshop jointly organised by the EFP and the World Heart Federation (WHF), which has updated the existing epidemiological evidence for significant associations between periodontitis and CVD, the mechanistic links and the impact of periodontal therapy on cardiovascular and surrogate outcomes. This review has also focused on the potential risk and complications of periodontal therapy in patients on anti thrombotic therapy and has made recommendations for dentists, physicians and for patients visiting both the dental and medical practices.

Address: Department of Dental Clinical Specialties, ETEP Research Group, Faculty of Odontology, University Complutense of Madrid, Madrid, Spain.; Cardiology Department, Hospital Universitario Ramon y Cajal, Madrid, Spain.; Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Bonn, Germany.; Cardiology Department, University Hospital, IDIS, CIBERCV, Univerity of Santiago de Compostela, Santiago de Compostela, Spain.; Department of Periodontology, Eastman Dental Institute and Hospital, University College London, London, UK.; U.F.R. d'odontologie, Université Paris Diderot, Hôpital Rothschild AP-HP, Paris, France.; School of Dentistry, Institute of Clinical Sciences, College of Medical & Dental Sciences, The University of Birmingham, Birmingham, UK.; Heart Institute, Hadassah University Hospital, Jerusalem, Israel.; Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.; ACTA University, Amsterdam, The Netherlands.; Department of Periodontology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece.; Inserm Unit 1148, Laboratory for Translational CV Science, X. Bichat Hospital, Paris, France.; World Heart Federation, Geneva, Switzerland.; Centre for Global Chronic Conditions, London School of Hygiene & Tropical Medicine, London, UK.; Department of Internal Medicin & Cardiology, Charité Universitätsmedizin Berlin, Berlin, Germany.; DZHK (German Center for Cardiovascular Research) Partnersite Berlin, German Heart Institut Berlin, Berlin, Germany.; Department of Periodontology, Hebrew University - Hadassah Faculty of Dental Medicine, Jerusalem, Israel.; Leviev Heart Center, Chaim Sheba Medical Center, tel Hashomer and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel.; Department of Periodontology, Prince Philip Dental Hospital, The University of Hong Kong, Hong Kong, Hong Kong.; 1st Department of Cardiology, National and Kapodistrian University of Athens, Athens, Greece.; Department of Prosthetic Dentistry, School of Dental Medicine, Karl-Franzens University Graz, Graz, Austria.

DOI: 10.1111/jcpe.13189

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MeSH Terms: Cardiovascular Diseases, Consensus, Europe, Humans, Periodontal Diseases, Periodontics, Periodontitis