Luthra S, Orlandi M, Hussain S B et al. Treatment of Periodontitis and C-Reactive Protein: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Clin Periodontol 2022; DOI: 10.1111/jcpe.13709. Online ahead of print.

Treatment of periodontitis reduces serum CRP levels to a degree equivalent to that observed after traditional lifestyle or drug interventions.

Systemic inflammation is implicated in the onset and progression of several chronic diseases. Periodontitis is a potential trigger of systemic inflammation. The purpose of this review was to comprehensively appraise all the evidence on the effects of the treatment of periodontitis on systemic inflammation assessed by serum CRP levels. Six electronic databases were searched up to February 2022. The study selection included 26 randomised controlled clinical trials reporting changes amongst 2,579 participants about CRP levels at six months or more after treatment. Meta-analyses were performed using random and fixed effect models. Treatment of periodontitis reduced CRP levels by 0.69 mg/L (95% CI: -0.97; -0.40) after six months but limited evidence was retrieved from studies with longer follow-ups. Similar findings were observed in participants with other co-morbidities in addition to periodontitis. Greatest reductions were observed in participants with concentrations of CRP >3 mg/L at baseline. This evidence supports a causal association between periodontitis and systemic inflammation.