Blaizot · International dental journal 2009 · systematic review and meta-analysis of observational studies · n=29 studies

Periodontal diseases and cardiovascular events: meta-analysis of observational studies.

Cited 289 times in the scientific literature.

Level 3 - non-randomized controlled study

Systematic review and meta-analysis of observational studies (cohort, case-control, and cross-sectional)

PubMed 19774803 · record verified 2026-08-28

What was done

The authors performed a systematic review and meta-analysis following MOOSE guidelines to assess the relationship between periodontitis and cardiovascular disease (CVD). Seven databases were searched for observational studies (cohort, cross-sectional, and case-control) published between 1989 and 2007. Eligible studies assessed confirmed CVD endpoints (diagnosed coronary artery disease, angina pectoris, acute myocardial infarction, or cardiac mortality). Characteristics were extracted by independent researchers using a standardized protocol.

What was found

From 215 epidemiological studies identified, 47 were observational and 29 were included in the meta-analyses: - From 22 case-control and cross-sectional studies, periodontal disease was associated with increased odds of CVD (pooled OR = 2.35, 95% CI [1.87, 2.96], p < 0.0001). - From 7 cohort studies, periodontal disease was associated with a 34% higher risk of developing CVD compared to those without periodontal disease (pooled RR = 1.34, 95% CI [1.27, 1.42], p < 0.0001).

Why it matters

This meta-analysis quantifies a consistent observational association between periodontal disease and elevated cardiovascular risk across both retrospective and prospective designs.

Limits

The analysis relies entirely on observational studies, which cannot establish causality or exclude residual confounding. Total participant sample size and statistical heterogeneity metrics are not reported in the abstract. Interventional data showing whether periodontitis treatment reduces CVD events were not evaluated.

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