Association of chronic periodontitis with multiple sclerosis: A systematic review and meta-analysis

Athanasios Tsimpiris; Ioannis Tsolianos; Andreas Grigoriadis; Zoi Tsimtsiou; Dimitrios G Goulis; Nikolaos Grigoriadis

doi:10.1016/j.msard.2023.104874

Association of chronic periodontitis with multiple sclerosis: A systematic review and meta-analysis

Mult Scler Relat Disord. 2023 Sep:77:104874. doi: 10.1016/j.msard.2023.104874. Epub 2023 Jul 7.

Authors

Athanasios Tsimpiris¹, Ioannis Tsolianos², Andreas Grigoriadis³, Zoi Tsimtsiou⁴, Dimitrios G Goulis⁵, Nikolaos Grigoriadis⁶

Affiliations

¹ Dental Sector, 424 General Military Training Hospital, Thessaloniki, Greece. Electronic address: atsimpir@gmail.com.
² Dental School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
³ Dental Sector, 424 General Military Training Hospital, Thessaloniki, Greece; Department of Preventive Dentistry, Periodontology and Implant Biology, Dental School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
⁴ Department of Hygiene, Social-Preventive Medicine and Medical Statistics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
⁵ Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece.
⁶ 2nd Department of Neurology, AHEPA Hospital, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.

PMID: 37478676
DOI: 10.1016/j.msard.2023.104874

Abstract

Background: Chronic periodontitis (CP) is a multifactorial, chronic inflammatory disease of microbial etiology that manifests as a result of the dysfunction of the immune mechanism, culminating in the destruction of the alveolar bone of the jaws. Multiple sclerosis (MS) is an autoimmune disorder that affects the central nervous system (CNS), leads to demyelination and degeneration of nerve axons and often causes severe physical and/or cognitive impairment. As CP and MS involve inflammatory mechanisms and immune dysfunction, researchers have attempted to study the association between them.

Aim: To systematically review the literature on the epidemiological association between CP and MS in adults.

Methods: PRISMA 2020 statement was used in the study protocol. The design was done according to the Cochrane methodology. A comprehensive literature search was performed in PubMed, Scopus and Cochrane databases; a manual search and evaluation of the gray literature was also performed. The meta-analysis was performed by Review Manager (RevMan) 5.4. Odds ratio (OR) with 95% confidence interval (CI) was defined as the effect size of the outcome. Heterogeneity was assessed by Chi-square and I². The articles evaluated were written in English, without a time limit, concern observational studies (patient-controls) and report the diagnostic criteria of the diseases. Duplicate entries were excluded. To evaluate the reliability of the results of each study, Newcastle-Ottawa Scale (NOS) and GRADE tools were used. Two independent reviewers did all evaluations with a resolution of discrepancies by a third.

Results: Meta-analysis included three observation studies examined 3376 people. MS patients are significantly more likely to be diagnosed with CP than healthy controls (OR 1.93, 95% CI 1.54-2.42, p<0.0001).

Conclusion: A high prevalence of CP was found among MS patients compared with healthy controls. Healthcare professionals should be aware of the association between these pathological entities to provide patients with high-quality care through an effective and holistic diagnostic and therapeutic approach.

Keywords: Chronic periodontitis; Meta-analysis; Multiple sclerosis; Systematic review.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Adult
Autoimmune Diseases* / complications
Chronic Disease
Chronic Periodontitis* / complications
Chronic Periodontitis* / epidemiology
Humans
Multiple Sclerosis* / complications
Multiple Sclerosis* / epidemiology
Reproducibility of Results