The issue mentioned in the title was dealt with in a systematic review of the Cochrane Collaboration which was published 3 1/2 years ago. It confirmed that, since the publication of the PAVE pilot study in 2009, no further evidence had emerged. The authors of the Cochrane review concluded,
We found very low quality evidence that was insufficient to support or refute whether periodontal therapy can prevent the recurrence of CVD in the long term in patients with chronic periodontitis. No evidence on primary prevention was found.
Possible systemic effects of periodontal treatment had been claimed for a very long time, and lack of evidence, or evidence for their clinical irrelevance, had never been accepted by many colleagues, indeed.
The most recent attempt of reviving the largely lapsed interest by most of our medical colleagues in the Perio-Systemic link, in particular its cardiovascular branch, was launched earlier this week when a delegation of the European Federation of Periodontology (EFP) met colleagues of the World Heart Federation (WHF) in Madrid. The aim of the workshop was to “explore the links between periodontal disease and cardiovascular disease and draw up a series of recommendations.”
In a previous post, I have expressed considerable concern about an assumed advertorial in our leading periodontal journal, JCP. Quintessence Publishing was about to launch their fourth installment of “3D” animated, short (each 15-17 min) movies all called Cell-to-Cell Communication, “Oral Health and General Health – The Links between Periodontitis, Atherosclerosis, and Diabetes.” Previous movies have been offered for purchase by QuintPub for a remarkable amount of around $100. Luckily, the new one can now be found on the EFP homepage and accessed by members and non-members for free.
It is remarkable that the prestigious Journal of Clinical Periodontology, founded by Hans Mühlemann and edited for decades by Jan Lindhe, is going to publish a commercial for a Quintessence Publishing and Sunstar production, part of a Quintpub series of DVDs (all called Cell-to-Cell Communication) of short (each runs for about 15 minutes) animated (“3D”) movies. The first installations in this series had been about inflammatory reactions in the periodontium (I had critically reported on its educational value here), periodontal regeneration and osseointegration.
On November 9, EFP leaders had live-streamed a webinar in which their guidelines were provided based on conclusions drawn from the 2014 EFP workshop in Segovia, Spain. The 11th European workshop was by and large about prevention, and extensive systematic reviews and position papers had been published earlier this year in the Journal of Clinical Periodontology. A video of the webinar can be seen here.
The panel comprising Professors Mariano Sanz, Maurizio Tonetti, Iain Chapple and Søren Jepsen had an emphasis on primary prevention in subjects without periodontal or peri-implant diseases, especially the former of which had largely been ignored in recent decades. Tonetti stressed several times that, while prevention of dental caries and oral cancer has been very successful, periodontal disease has apparently lost ground.
Europerio 8 in London earlier this year saw the world premiere of the 3D video animation, Oral Health and General Health – The Links Between Periodontitis, Atherosclerosis and Diabetes. The movie was produced by Sunstar and Quintessence Publishing and is the fourth in a series commonly called Cell-to-Cell Communications (I had written a critical review about the first installment here; empty knowledge, Matrix-Reloaded style) and the trailer can currently be seen on the EFP website. A pumping heart gets an infarction.
Myocardial infarction. A life-threatening manifestation of a series of inflammatory changes in the walls of the coronary arteries. It is a leading cause of death in the western world. Can periodontitis or other inflammatory processes in the oral cavity contribute to the development of cardiovascular diseases and systemic conditions such as artherosclerosis or diabetes or negatively influence their course?
This is fear-mongering and, to say the least, misleading the public by completely ignoring all established risk factors for cardiovascular disease (high blood pressure, high cholesterol, smoking, unhealthy diet, obesity, lack of physical activity) and diabetes as well.
As the German version of The Links will be presented at the big national dental congress in November, authors Stadlinger, Terheyden and Jepsen have published a respective essay in Zahnärztliche Mitteilungen, the German Dental Associations’ biweekly tabloid (scroll to page 38). It is strangely called “Storyboard”; and, as before in the series, biofilm and cells become actors. Apparently, Quintessence goes Hollywood. The article (unfortunately in German) is prominently featured on its cover. A careful review reveals, unsurprisingly, a remarkable mixture of undeniable facts about the well-known pathogenesis of both artherosclerosis and its sequels and diabetes, and wild speculation regarding possible contributions of periodontal pathogens. It once more seems that “visualizing the invisible” may in fact create more confusion than understanding.