title: Influence of periodontal therapy on C-reactive protein level: a systematic review and meta-analysis.
abstract: The influence of oral infections, especially periodontal disease, on systemic diseases has been extensively discussed in the literature. Because periodontal disease is a persistent infection, it promotes an inflammatory response. C-reactive protein is a marker for inflammatory reactions that is frequently studied, since elevated levels of this protein are related to coronary events.
  
  
  OBJECTIVE
  The aim of this study was to investigate the effect of periodontal therapy on reducing the serum levels of C-reactive protein, by means of a systematic review of the literature and meta-analysis.
  
  
  METHODS
  A systematic review of the English-language literature was conducted in the PUBMED-MEDLINE database, using the key words "periodontal disease", "C-reactive protein", "periodontal therapy" and "periodontal treatment", in accordance with the terms for Medical Subject Headings (MeSH), to evaluate the effect of periodontal therapy on C-reactive protein levels. A qualitative analysis of studies of randomized clinical trial design was performed using CONSORT, with subsequent meta-analysis.
  
  
  RESULTS
  The literature search initially retrieved 46 potentially relevant studies available in the databases. From these, in accordance with the inclusion criteria, only 11 were selected, of which only 4 fulfilled the criteria of randomized clinical trial design. According to CONSORT, the studies evaluated generally presented good quality with regard to the criteria analyzed. Through meta-analysis, the reduction in mean levels of C-reactive protein (-0.231; p=0.000) after introducing periodontal treatment was estimated. The result was statistically significant, without evidence of heterogeneity between the studies (p=0.311).
  
  
  CONCLUSIONS
  The findings indicated that non-surgical periodontal treatment had a positive effect with regard to reduction of the serum levels of C-reactive protein.
authors.affiliation: Bahia School of Medicine and Public Health, Salvador, BA, Brazil. camila.otf@gmail.com
authors.forename: Camila Oliveira Teixeira de
authors.initials: CO
authors.lastname: Freitas
authors.forename: Isaac Suzart
authors.initials: IS
authors.lastname: Gomes-Filho
authors.forename: Roberta Catapano
authors.initials: RC
authors.lastname: Naves
authors.forename: Getúlio da Rocha
authors.initials: Gda R
authors.lastname: Nogueira Filho
authors.forename: Simone Seixas da
authors.initials: SS
authors.lastname: Cruz
authors.forename: Carlos Antonio de Souza Teles
authors.initials: CA
authors.lastname: Santos
authors.forename: Leonardo
authors.initials: L
authors.lastname: Dunningham
authors.forename: Lituânia Fialho de
authors.initials: LF
authors.lastname: Miranda
authors.forename: Mônica Dourado da Silva
authors.initials: MD
authors.lastname: Barbosa
mesh_terms: D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D002318:Cardiovascular Diseases / Q000209:etiology; D006801:Humans; D010510:Periodontal Diseases / Q000097:blood* / Q000628:therapy*; D016032:Randomized Controlled Trials as Topic
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein