The association between periodontitis and coronary heart disease A quality assessment of systematic reviews

Background. The existence of an association between periodontitis and cardiovascular disease has been proposed by investigators in several clinical studies and further confirmed by the results of several systematic reviews. The aim of the authors' study was to assess the quality of published systematic reviews focused on the association between periodontitis and coronary heart disease (CHD) by using established systematic review assessment checklists. Methods. Two reviewers conducted a search for systematic reviews focusing on the association between periodontitis and CHD. Three independent reviewers appraised the quality of the selected 13 reviews by using an established and validated assessment tool for systematic reviews and another checklist. They gave each article a total score according to the number of criteria on each checklist that the article fulfilled. Results. Nine reviews satisfied six or more items on the assessment tool, whereas two reviews each satisfied only one item. This assessment shows that published systematic reviews of the periodontitis-CHD association exhibit significant structural and methodological variation, which the authors further confirmed: by using the second checklist. Conclusion. Systematic reviews of the association between periodontitis and CHD exhibited significant differences in their methodological quality. Practical Implications. Clinicians should be aware that not all systematic reviews of the periodontitis-CHD association are conducted in a rigorous manner and should be capable of differentiating well-conducted reviews from poorly conducted ones.