The association between respiratory diseases and periodontitis: A systematic review and meta‐analysis.

Aim: To evaluate (1) whether periodontitis has an influence on the prevalence/incidence of respiratory diseases (chronic obstructive pulmonary disease [COPD], asthma, community‐acquired pneumonia [CAP], obstructive sleep apnoea [OSA] and COVID‐19), and (2) what is the impact of periodontal therapy on the onset or progression of respiratory diseases. Materials and Methods: An electronic search was performed on Pubmed, Cochrane Library and Scopus databases up to October 2021, to identify studies answering the PECOS and PICOS questions. Results: Seventy‐five articles were selected. Meta‐analyses identified statistically significant associations of periodontitis with COPD (nstudies = 12, odds ratio [OR] = 1.28, 95% confidence interval [CI] [1.16; 1.42], p <.001), and OSA (ns = 6, OR = 1.65, 95% CI [1.21; 2.25], p =.001), but not for asthma (ns = 9, OR = 1.53, 95% CI [0.82; 2.86], p =.181). For acute conditions, two studies were found for CAP, while for COVID‐19, significant associations were found for the need of assisted ventilation (ns = 2, OR = 6.24, 95% CI [2.78; 13.99], p <.001) and COVID‐related mortality (ns = 3, OR = 2.26, 95% CI [1.36, 3.77], p =.002). Only four intervention studies were found, showing positive effects of periodontal treatment on COPD, asthma and CAP. Conclusions: A positive association between periodontitis and COPD, OSA and COVID‐19 complications has been found, while there is a lack of intervention studies. [ABSTRACT FROM AUTHOR]