Background and objectivePeriodontitis affects up to one billion people worldwide,
and has been proven to be associated with several systemic inflammatory conditions.
This study investigates the specific relationship between two multifactorial diseases:
Inflammatory bowel disease (IBD) and periodontitis. To thoroughly explore this issue,
we investigated separately whether IBD patients have a higher chance of developing
periodontitis, and equally, whether patients with periodontitis have a higher chance
of developing IBD.MethodsThe systematic search was performed in three databases:
MEDLINE, Cochrane Trials, and Embase, up to 26 October 2021. The protocol was registered
in PROSPERO. All eligible studies investigating the association between IBD and periodontitis
from either direction were included. The Newcastle-Ottawa Scale was used to assess
the risk of bias. As a primary outcome, we investigated the prevalence of IBD and
periodontitis, and calculated the odds ratio (OR). Our secondary outcomes involved
comparing the clinical periodontal outcomes of IBD patients to those of IBD-free patients.ResultsThe
systematic search resulted in 1,715 records, 14 of which were eligible for qualitative
synthesis and 8 for quantitative synthesis. On the basis of the results of the primary
outcome, IBD diagnosis was associated with significantly higher odds of periodontitis:
OR = 2.65 (CI: 2.09-3.36, I2 = 0 (CI: 0-0.75)). For subgroup analysis, we investigated
separately the odds in Crohn’s disease (CD) patients: OR = 2.22 (CI: 1.49-3.31, I2
= 0.05 (CI: 0-0.76)) and in ulcerative colitis (UC) patients: OR = 3.52 (CI: 2.56
to 4.83, I2 = 0 (CI: 0-0.75)); the odds were significantly higher in all cases. Two
studies investigated whether patients with periodontitis were more susceptible to
IBD, and both found that periodontitis was significantly associated with the risk
of subsequent UC, but not with subsequent CD. However, more studies are needed to
prove an association.ConclusionOur analysis confirmed that IBD patients
have a higher chance of developing periodontitis, and are a higher risk population
in dentistry. Both dentists and gastroenterologists should be aware of this relationship
and should emphasize the importance of prevention even more than in the healthy population.Systematic
review registration[https://www.crd.york.ac.uk/prospero/],
identifier [CRD42021286161].
