Invasive dental treatment and acute vascular events: A systematic review and meta-analysis

Background: Acute infection/inflammation increases the risk of acute vascular events (AVEs). Invasive dental treatments (IDTs) trigger short-term acute inflammation.

Purpose: The aim of this work is to critically appraise the evidence linking IDTs and AVEs.

Data sources: Six bibliographical databases were searched up to 31 August 2021. A systematic review following PRISMA guidelines was performed.

Study selection: Intervention and observational studies reporting any AVEs following IDT were included.

Data extraction: Two reviewers independently extracted data and rated the quality of studies. Data were pooled using fixed-effect, inverse variance weights analysis.

Risk of bias: Risk of bias was assessed by the Newcastle-Ottawa Quality Assessment Scale for observational studies and the Cochrane Handbook-Rob 2.0 for randomized controlled trials.

Data synthesis: In 3 out of 16 clinical studies, a total of 533,175 participants, 124,344 myocardial infarctions, and 327,804 ischaemic strokes were reported. Meta-analysis confirmed that IDT did not increase incidence ratios (IR) for combined vascular events either at 1-4 weeks (IR of 1.02, 95% CIs: 0.92 to 1.13) and at 5-8 weeks (IR of 1.04, 95% CIs: 0.97 to1.10) after treatment.

Limitations: A high level of heterogeneity (study designs and time point assessments) was found.

Conclusion: Patients who received IDT exhibited no substantial increase in vascular risk over 8 weeks post treatment.