Table 6.

Summary of issues identified by authors of systematic reviews of RCTs

1. Inconsistency in defining periodontal disease and periodontal disease severity

2. Inconsistency in the type of periodontal treatment provided, i.e., timing, frequency, clinician, use of antibiotics, etc.

3. Quality of studies (methodological shortcomings)

4. Variation in outcomes measured and measurement technique used

5. No uniform methods for adjustment of confounders (i.e., smoking, obesity, comorbidities)

6. Publication bias: studies showing no (negative) effect may not have been published

7. Only 1 study identified that used a cardiovascular event as the endpoint

8. All other studies used surrogate measures for cardiovascular disease risk