Does non-surgical periodontal therapy improve biomarkers associated with cardiovascular disease? An umbrella review.

OBJECTIVE

The aim of this umbrella review was to synthesize evidence on the effects of non-surgical periodontal therapy (NSPT) on cardiovascular biomarkers in adults with periodontitis.

MATERIALS AND

METHODS

Seven databases were searched up to March 2025 (PROSPERO: CRD420250656185). Included studies evaluated the impact of NSPT on cardiovascular biomarkers, including C-reactive protein (CRP), Interleukin-6, Tumor Necrosis Factor-α, lipid profiles (LDL, HDL, total cholesterol, and triglycerides), and vascular function measures (systolic and diastolic blood pressure, and flow-mediated dilation). The GROOVE tool was used to quantify review overlap, AMSTAR2 for methodological quality and GRADE for evidence certainty. Meta-analyses were recalculated using a random-effects model.

RESULTS

Of 1,525 records screened, 17 systematic reviews met the inclusion criteria. Pooled findings showed NSPT yielded reductions in CRP (-0.58 mg/L; 95% CI: - 0.91 to - 0.25), LDL (-0.10 mmol/L; 95% CI: - 0.17 to - 0.04), and increased HDL (0.03 mmol/L; 95% CI: 0.03 to 0.05), while other markers and vascular measures showed inconsistent and low-certainty results. Most evidence was classified as weak (Class IV) or non-significant due to heterogeneity, high risk of bias, and study overlap.

CONCLUSIONS

NSPT is modestly beneficial for CRP, IL-6, HDL, and LDL levels; however, the overall evidence is limited by methodological weaknesses.

CLINICAL RELEVANCE: NSPT may offer small yet clinically meaningful improvements in systemic cardiovascular risk markers in patients with periodontitis. Coordinated medical-dental care, targeted patient education, and timely delivery of NSPT can be pragmatically integrated to support cardiovascular risk reduction.