Effects of periodontitis on micro and macro vascular complications of diabetes: A systematic review

Background. Periodontitis (PD) is a chronic inflammatory disease of the oral cavity. PD can adversely affect glycemic control and cause macro- and micro-vascular diseases in diabetic patients. This article aims to systematically review the association between periodontitis and micro- and macro-vascular complications of diabetes. Methods. This review was conducted under the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). A thorough search of the Scopus and PubMed databases was performed up to 2022. English articles were included. Results. In this study, seven studies with 29,679 participants investigated the relationship between periodontitis and micro- and macro-vascular complications. There were two cohort studies, six cross-sectional studies, and one case‒control study. Follow-up durations ranged from 6 months to 11.64 years. The reports were published between 2002 and 2022. There was a relationship between periodontitis and the microvascular complications of diabetes in four studies. One study found no significant association between periodontitis and the microvascular complications of diabetes. The correlation between coronary heart disease (CHD) and periodontal disease was confirmed by one study. Furthermore, another study found that periodontitis increased the risk of cerebral and myocardial infarctions. Conclusion. The present study demonstrated that diabetes mellitus (DM) patients with periodontitis are at an increased risk of macro- and micro-vascular complications, particularly myocardial and cerebral infarctions.