Influence of periodontal therapy on C-reactive protein level: a systematic review and meta-analysis

the influence of oral infections, especially periodontal disease, on systemic diseases has been extensively discussed in the literature. because periodontal disease is a persistent infection, it promotes an inflammatory response. c-reactive protein is a marker for inflammatory reactions that is frequently studied, since elevated levels of this protein are related to coronary events. objective: the aim of this study was to investigate the effect of periodontal therapy on reducing the serum levels of c-reactive protein, by means of a systematic review of the literature and meta-analysis. material and methods: a systematic review of the english-language literature was conducted in the pubmed-medline database, using the key words "periodontal disease", "c-reactive protein", "periodontal therapy" and "periodontal treatment", in accordance with the terms for medical subject headings (mesh), to evaluate the effect of periodontal therapy on c-reactive protein levels. a qualitative analysis of studies of randomized clinical trial design was performed using consort, with subsequent meta-analysis. results: the literature search initially retrieved 46 potentially relevant studies available in the databases. from these, in accordance with the inclusion criteria, only 11 were selected, of which only 4 fulfilled the criteria of randomized clinical trial design. according to consort, the studies evaluated generally presented good quality with regard to the criteria analyzed. through meta-analysis, the reduction in mean levels of c-reactive protein (-0.231; p=0.000) after introducing periodontal treatment was estimated. the result was statistically significant, without evidence of heterogeneity between the studies (p=0.311). conclusions: the findings indicated that non-surgical periodontal treatment had a positive effect with regard to reduction of the serum levels of c-reactive protein.