Impact of rehabilitation versus edentulism on systemic health and quality of life in patients affected by periodontitis: A systematic review and meta-analysis

Aim To investigate the effect of rehabilitation in fully/partially edentulous patients with stage IV periodontitis on oral-health-related quality of life (OHRQoL) and systemic health. Materials and methods A systematic electronic and manual search was conducted. Three authors independently reviewed, selected, and extracted the data. Outcomes were OHRQoL (Oral Health Impact Profile 14 [OHIP-14] and OHIP-49, General Oral Health Assessment Index [GOHAI], visual analogue scale, symptoms registration) and systemic health-related outcomes (incidence and prevalence of systemic diseases, values of systemic disease indicators). Qualitative data were synthesized for OHRQoL and systemic health-related outcomes. Meta-analysis was conducted on available quantitative data. Results The search identified 59 articles (6724 subjects in total). OHRQoL improved across all the studies, irrespective of the number of missing teeth, their location, or treatment modality. Meta-analysis showed significant improvement of OHIP-49 (36.86, p < .01) in manuscripts including subjects affected by periodontitis, consistently with the remaining literature (reduction of score points post rehabilitation: OHIP-14 = 10.52, OHIP-49 = 56.02, GOHAI = 5.40, p < .01 for all). Non-rehabilitated subjects exhibited inferior cognitive status, higher medication intake, and frailty. However, our data are limited and should be interpreted with caution. Conclusions Oral rehabilitation improves OHRQoL and, potentially, systemic health in edentulous patients. It is unclear whether these findings may be extrapolated to patients with stage IV periodontitis.