Periodontal Outcomes in Liver Transplantation Individuals: A Systematic Review and Meta-analysis

Aim: To systematically review the literature for observational studies evaluating periodontal outcomes in pre- and post-liver transplant (LT) individuals compared to a control group. Methods: Specific strategies were designed to search five databases and the grey literature. Hand-searches were also performed. The following periodontal outcomes were analyzed in pre-LT, post-LT and control groups: plaque index (PI), gingival index (GI), gingival growth (GO), alveolar bone loss (ABL) probing depth (PD) and clinical attachment level (CAL). Meta-analyses and subgroup analyses were conducted. Results: Among the 257 studies retrieved, 11 studies were included. Four studies were incorporated into the meta-analysis and showed that PI (mean difference=0.15, 95%CI: 0.12-0.18) and GI (mean difference=0.31, 95%CI: 0.06-0.56) were significantly higher in post-LT individuals compared to the control group. There was no significant mean difference of PD (mean difference=0.49, 95%CI: -0.26-1.25) but CAL (mean differ- ence=1.47, 95%CI: 0.19-2.75) were significantly higher in pre-LT individuals compared to the control group. Conclusion: The higher means of PI and GI in post-LT and CAL in pre-LT compared to healthy individuals suggest a relationship between the periodontal condition and the transplantation status.