IADR Abstract Archives
Invasive Dental Treatment and Acute Vascular Events: a Systematic Review and Meta-Analysis.
Objectives: Acute infection/inflammation is linked with increased risk of acute vascular events. Invasive dental treatments are a common cause of acute inflammation. Our aim was to critically appraise the evidence linking invasive dental treatments and acute vascular events.
Methods: Medline, Embase, CINAHL, Cochrane, Web of Sciences, SIGLE and hand search was done up to up to 30thApril 2021, to find articles in English language only. A systematic review following PRISMA guidelines was performed. Intervention studies: randomised controlled trials (RCT), controlled clinical trials (CCT), pilot trials, and observational studies: cohort studies, case-control and cross-sectional studies which reported any acute vascular events following invasive dental treatments. Two reviewers independent extracted data and rated the quality of studies using Newcastle-Ottawa Quality Assessment Scale and the Cochrane Handbook –Rob 2.0 tool.
Results: Sixteen studies including 15 observation studies and one randomised control trial were assessed. The primary outcome was any measure of prevalence of acute vascular events including myocardial infarction, stroke, peripheral arterial disease, or death within 8 weeks from the intervention. Heterogeneous study designs and timepoint assessments influenced the number of studies used for quantitative analyses. Two out of the final 16 clinical studies examined, recruited 533,175 participants and reported 124,344 myocardial infarctions and 327,804 ischemic strokes events. Quantitative analysis confirmed that invasive dental treatment was associated with an incidence ratio of 1.02 at 1-4 weeks (p=0.722; 95% CI: 0.92, 1.13) and of 1.04 at 5-8 weeks (p=0.191; 95% CI -0.97;1.10) for combined vascular events.
Conclusions: These findings suggest that patients undergoing common invasive dental procedures do not exhibit an increased risk of acute vascular events during the first 8 weeks after treatment. Since large number of dental procedures are performed worldwide, health care systems should facilitate better integration and communication between dental and medical teams, especially in patients with multiple co-morbidities.
Methods: Medline, Embase, CINAHL, Cochrane, Web of Sciences, SIGLE and hand search was done up to up to 30thApril 2021, to find articles in English language only. A systematic review following PRISMA guidelines was performed. Intervention studies: randomised controlled trials (RCT), controlled clinical trials (CCT), pilot trials, and observational studies: cohort studies, case-control and cross-sectional studies which reported any acute vascular events following invasive dental treatments. Two reviewers independent extracted data and rated the quality of studies using Newcastle-Ottawa Quality Assessment Scale and the Cochrane Handbook –Rob 2.0 tool.
Results: Sixteen studies including 15 observation studies and one randomised control trial were assessed. The primary outcome was any measure of prevalence of acute vascular events including myocardial infarction, stroke, peripheral arterial disease, or death within 8 weeks from the intervention. Heterogeneous study designs and timepoint assessments influenced the number of studies used for quantitative analyses. Two out of the final 16 clinical studies examined, recruited 533,175 participants and reported 124,344 myocardial infarctions and 327,804 ischemic strokes events. Quantitative analysis confirmed that invasive dental treatment was associated with an incidence ratio of 1.02 at 1-4 weeks (p=0.722; 95% CI: 0.92, 1.13) and of 1.04 at 5-8 weeks (p=0.191; 95% CI -0.97;1.10) for combined vascular events.
Conclusions: These findings suggest that patients undergoing common invasive dental procedures do not exhibit an increased risk of acute vascular events during the first 8 weeks after treatment. Since large number of dental procedures are performed worldwide, health care systems should facilitate better integration and communication between dental and medical teams, especially in patients with multiple co-morbidities.