Two-Way Relationship Between Helicobacter Pylori Infection and Periodontitis: Results from A Systematic Review and Meta-Analysis

Felipe Rodolfo,Alessandro Luiz Araújo Bentes Leal,Any Carolina Cardoso Guimarães Vasconcelos,Reyce Dos Santos Koga,Juliana Gomes Galeno,Zinalton Gomes De Andrade,José Fernando Marques Barcellos,Larissa Dos Santos Pessoa,Daniel Fernando Pereira Vasconcelos,Silvania Conceição Furtado

doi:10.31487/j.cei.2020.01.03

Abstract

Aim: Helicobacter pylori (H. pylori) infection and periodontitis have considerable worldwide prevalence once they both present systemic alterations with a possible association between them. Therefore, we have performed this meta-analysis to assess the possible association between H. pylori infection and periodontitis. Material and Methods: A systematic search in the literature was performed for studies published before December 2, 2019 in diverse scientific and educational databases. The data was extracted by two investigators and the statistical analysis was performed by Review Manager statistical program with heterogeneity and Odds Ratio (OR) with 95% of Confidence Intervals (CI) calculations as well as a sensitive analysis to assess the accuracy of the results. The value of P<0.05 was considered as significant. In addition, we performed the analysis of the quality of included studies as well as the evaluation for risk of bias. Results: In overall analysis, H. pylori infection was associated with the risk of periodontitis development (OR = 1.72, CI: 1.47, 2.02, P<0.00001) and the periodontitis was considered as a risk factor for H. pylori infection (OR = 3.21, CI: 2.31, 4.47, P<0.00001). Moreover, the evaluation of dental plaque from patients with periodontitis reveled increased risk of H. pylori infection (OR = 3.46, CI: 2.39, 5.01, P<0.00001). Conclusions: This current systematic review and meta-analysis composed by 12 studies in 7,059 participants showed that H. pylori infection increased significantly the risk of the development of periodontitis and the periodontitis may be a risk for this bacterial infection.

Highlights

Helicobacter pylori (H. pylori) are gram-negative, spiral-shaped and microaerophilic microorganisms that colonize the human gastricintestinal tract, the stomach [1]
To the best of our knowledge, this is the first meta-analysis to focus on the association between H. pylori and periodontitis as a two-way relationship
A specific two-way association between H. pylori infection and periodontitis by a complete meta-analysis has never been in the literature so far

Summary

Introduction

Helicobacter pylori (H. pylori) are gram-negative, spiral-shaped and microaerophilic microorganisms that colonize the human gastricintestinal tract, the stomach [1]. This bacteria species is commonly transmitted by oral-fecal way within family since early childhood with possibly persistence for decades in the gastric mucosa despite the host immune response [2]. This microorganism is already associated with several gastric disorders from gastritis to gastric cancer [3, 4]. Results from a meta-analysis showed a significant association between halitosis and H. pylori present in stomach with an Odds Ratio value of 4.03 [13]

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