Cited by 1,482Oral microbiology and periodontitis researchDental Research and COVID-19Periodontal Regeneration and Treatments

Periodontitis and cardiovascular diseases: Consensus report

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Sanz, Mariano, Marco del Castillo, Alvaro, Jepsen, Søren, Gonzalez‐Juanatey, Jose R., D’Aiuto, Francesco, Bouchard, Philippe, Chapple, Iain, Dietrich, Thomas +13 more·2020·Journal of Clinical Periodontology

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.

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  • Patients with severe periodontitis have higher blood neutrophil counts and pro-inflammatory mediator levels (IL-1, IL-6, CRP, fibrinogen) compared to healthy controls.

    “Patients with severe periodontitis had higher blood neutrophil counts and pro-inflammatory mediator levels (such as IL-1, IL-6, CRP, and fibrinogen) compared to healthy controls [14–17]”

    From Effect of non-surgical periodontal therapy on risk markers of cardiovascular disease: a systematic review and meta-analysis (2024) · cites this paper as [16]

    The Mechanisms sections report higher CRP and fibrinogen versus healthy controls, elevated serum IL-6, and excess IL-1β release by stimulated neutrophils in periodontitis patients. They describe neutrophil hyper-responsiveness, not higher blood neutrophil counts, and do not establish these findings specifically for severe periodontitis. Page numbers are unavailable in our copy. (LLM, conf=0.88)

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Authors
Sanz, M., Marco del Castillo, A., Jepsen, S., Gonzalez‐Juanatey, J. R., D’Aiuto, F., Bouchard, P., Chapple, I., Dietrich, T., Gotsman, I., Graziani, F., Herrera, D., Loos, B., Madianos, P., Michel, J., Perel, P., Pieske, B., Shapira, L., Shechter, M., Tonetti, M., Vlachopoulos, C., & Wimmer, G.
Affiliations
  • Universidad Complutense de Madrid (ES)
  • Cardiology Department Hospital Universitario Ramon y Cajal Madrid Spain
  • University of Bonn (DE)
  • Cardiology Department University Hospital IDIS CIBERCV Univerity of Santiago de Compostela Santiago de Compostela Spain
  • Eastman Dental Hospital (GB)
  • Hôpital Rothschild (FR)
  • University of Birmingham (GB)
  • Hadassah Medical Center (IL)
  • University of Pisa (IT)
  • Academic Center for Dentistry Amsterdam (NL)
  • National and Kapodistrian University of Athens (GR)
  • Inserm (FR)
  • London School of Hygiene & Tropical Medicine (GB)
  • German Centre for Cardiovascular Research (DE)
  • Hebrew University of Jerusalem (IL)
  • Tel Aviv University (IL)
  • Prince Philip Dental Hospital (CN)
  • University of Graz (AT)
Corresponding author
Sanz, Mariano
Venue
Journal of Clinical Periodontology
Publisher
Wiley
Published
2020-02-03
Volume
47
Issue
3
Pages
268-288
ISSN
  • 0303-6979 (ISSN-L)
  • 1600-051X
OpenAlex
W2995886183
Cited by
1,482
References
152
Citations by year
2026: 231 · 2025: 262 · 2024: 312 · 2023: 243 · 2022: 200 · 2021: 175 · 2020: 59
FWCI
173.30
Type
journal article
Language
en
Open access
Locations
  • Journal Of Clinical Periodontology (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • VU Research Portal (publishedVersion, other-oa)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by-nc-nd)
  • Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
Funders
DENTAID Oral Health Experts
Topics
  • Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
  • Health Sciences › Dentistry › General Dentistry › Dental Research and COVID-19
  • Health Sciences › Medicine › Urology › Periodontal Regeneration and Treatments
Keywords
periodontitis, cardiovascular disease, severe periodontitis, ischemic heart disease, stroke, hypertension, periodontal treatment, antiplatelet therapy, systemic disease, cardiovascular risk
MeSH terms
Cardiovascular Diseases, Europe, Humans, Periodontal Diseases, Periodontics, Periodontitis, Consensus

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