Periodontal Treatment Is Associated With Improvement in Gastric Helicobacter pylori Eradication: An Updated Meta-analysis of Clinical Trials

Objectives: The efficacy of conventional systemic antibiotic therapy for eradication of Helicobacter pylori has been seriously challenged by antibiotic resistance. Identification of alternative therapeutic strategies might help to overcome this limitation. The aim of this study was to update previou...

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Main Author: Ayla Ozturk
Format: Article
Language:English
Published: Elsevier 2021-06-01
Series:International Dental Journal
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S0020653920365187
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spelling doaj-6b451abaac074993b0bbb3a5c3865edc2021-06-05T06:02:18ZengElsevierInternational Dental Journal0020-65392021-06-01713188196Periodontal Treatment Is Associated With Improvement in Gastric Helicobacter pylori Eradication: An Updated Meta-analysis of Clinical TrialsAyla Ozturk0Corresponding author. Ayla Ozturk, Department of Periodontology, School of Dentistry, Ondokuz Mayıs University, OMÜ Kurupelit Kampüsü, Diş Hekimliği Fakültesi, 55139 Atakum, Samsun, Turkey.; Department of Periodontology, School of Dentistry, Ondokuz Mayıs University, Samsun, TurkeyObjectives: The efficacy of conventional systemic antibiotic therapy for eradication of Helicobacter pylori has been seriously challenged by antibiotic resistance. Identification of alternative therapeutic strategies might help to overcome this limitation. The aim of this study was to update previous meta-analyses that investigated the effect of periodontal treatment on gastric H. pylori eradication. Methods: A systematic electronic search of the literature was conducted to identify all published clinical trials that compared the effect of adjunct periodontal treatment on conventional systemic H. pylori eradication therapy. Results: The updated analysis (consisting of 541 participants representing six studies) demonstrated that, compared with conventional systemic eradication therapy alone, the addition of periodontal treatment resulted in improvements in gastric H. pylori eradication rates with OR 4.11 (P = 0.01). Moreover, not to lose any data, the previously presented Chinese results that could not be assessed by any available mechanism deduced from previously published meta-analysis and with other records were re-analysed. Similarly, the second meta-analysis adding up to a final cluster of 10 studies (909 participants) gives further credence to periodontal treatment as a useful concomitant therapy in the H. pylori eradication therapy (odds ratio [OR] = 2.65; P = 0.0002). Finally, the meta-analysis of four trials consisting of 177 cases and 161 controls showed that periodontal treatment also improved non-recurrence rates of gastric H. pylori infection, with an OR of 5.36 (P-value = 0.0002). Conclusion: Although the inclusion of five additional clinical trials in this updated meta-analysis has not changed the result of the previous review, the current meta-analysis is superior for having removed one study involving the use of chlorhexidine, which did not meet appropriate criteria for inclusion. Our results strengthen the value of periodontal treatment as an adjunctive remedy. Consistency of these results suggests that the incorporation of professional periodontal treatment with systemic eradication therapy may be a wise strategy, enhancing the efficacy of H. pylori eradication therapy. Systematic review registration: in PROSPERO ID number: CRD42019119347.http://www.sciencedirect.com/science/article/pii/S0020653920365187Periodontal medicineHelicobacter infectionsExtragastric reservoir
collection DOAJ
language English
format Article
sources DOAJ
author Ayla Ozturk
spellingShingle Ayla Ozturk
Periodontal Treatment Is Associated With Improvement in Gastric Helicobacter pylori Eradication: An Updated Meta-analysis of Clinical Trials
International Dental Journal
Periodontal medicine
Helicobacter infections
Extragastric reservoir
author_facet Ayla Ozturk
author_sort Ayla Ozturk
title Periodontal Treatment Is Associated With Improvement in Gastric Helicobacter pylori Eradication: An Updated Meta-analysis of Clinical Trials
title_short Periodontal Treatment Is Associated With Improvement in Gastric Helicobacter pylori Eradication: An Updated Meta-analysis of Clinical Trials
title_full Periodontal Treatment Is Associated With Improvement in Gastric Helicobacter pylori Eradication: An Updated Meta-analysis of Clinical Trials
title_fullStr Periodontal Treatment Is Associated With Improvement in Gastric Helicobacter pylori Eradication: An Updated Meta-analysis of Clinical Trials
title_full_unstemmed Periodontal Treatment Is Associated With Improvement in Gastric Helicobacter pylori Eradication: An Updated Meta-analysis of Clinical Trials
title_sort periodontal treatment is associated with improvement in gastric helicobacter pylori eradication: an updated meta-analysis of clinical trials
publisher Elsevier
series International Dental Journal
issn 0020-6539
publishDate 2021-06-01
description Objectives: The efficacy of conventional systemic antibiotic therapy for eradication of Helicobacter pylori has been seriously challenged by antibiotic resistance. Identification of alternative therapeutic strategies might help to overcome this limitation. The aim of this study was to update previous meta-analyses that investigated the effect of periodontal treatment on gastric H. pylori eradication. Methods: A systematic electronic search of the literature was conducted to identify all published clinical trials that compared the effect of adjunct periodontal treatment on conventional systemic H. pylori eradication therapy. Results: The updated analysis (consisting of 541 participants representing six studies) demonstrated that, compared with conventional systemic eradication therapy alone, the addition of periodontal treatment resulted in improvements in gastric H. pylori eradication rates with OR 4.11 (P = 0.01). Moreover, not to lose any data, the previously presented Chinese results that could not be assessed by any available mechanism deduced from previously published meta-analysis and with other records were re-analysed. Similarly, the second meta-analysis adding up to a final cluster of 10 studies (909 participants) gives further credence to periodontal treatment as a useful concomitant therapy in the H. pylori eradication therapy (odds ratio [OR] = 2.65; P = 0.0002). Finally, the meta-analysis of four trials consisting of 177 cases and 161 controls showed that periodontal treatment also improved non-recurrence rates of gastric H. pylori infection, with an OR of 5.36 (P-value = 0.0002). Conclusion: Although the inclusion of five additional clinical trials in this updated meta-analysis has not changed the result of the previous review, the current meta-analysis is superior for having removed one study involving the use of chlorhexidine, which did not meet appropriate criteria for inclusion. Our results strengthen the value of periodontal treatment as an adjunctive remedy. Consistency of these results suggests that the incorporation of professional periodontal treatment with systemic eradication therapy may be a wise strategy, enhancing the efficacy of H. pylori eradication therapy. Systematic review registration: in PROSPERO ID number: CRD42019119347.
topic Periodontal medicine
Helicobacter infections
Extragastric reservoir
url http://www.sciencedirect.com/science/article/pii/S0020653920365187
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