Effect of Preoperative Periodontal Treatment on Postoperative Infection and Mortality After Aortic and Mitral Valve Surgery (Perio-CVS)

May 31, 2026 updated by: Mehmet Selim Yildiz, Istanbul University - Cerrahpasa

Effect of Preoperative Periodontal Treatment on Postoperative Infection and Mortality in Patients Undergoing Aortic and Mitral Valve Surgery: A Retrospective Study

This retrospective observational study aims to evaluate the effect of preoperative periodontal treatment on postoperative infection and mortality in patients undergoing aortic and mitral valve surgery.

Patient records between 2015 and 2024 analyzed. Demographic, clinical, and and radiographic findings, evaluated. Postoperative outcomes such as infection, antibiotic use, length of hospital and intensive care unit stay, and mortality assessed.

The findings of this study may contribute to understanding the role of periodontal health in improving postoperative outcomes in cardiac surgery patients.

Study Overview

Status

Completed

Conditions

Detailed Description

Periodontitis is a chronic inflammatory disease that has been associated with various systemic conditions, including cardiovascular diseases and infective endocarditis. Oral pathogens and inflammatory mediators originating from periodontal tissues may enter the bloodstream and contribute to systemic inflammation and postoperative complications.

This retrospective observational study includes patients aged 18 years and older who underwent aortic and mitral valve surgery and received or not periodontal treatment within 15 days prior to surgery. Patient records from 2015 to 2024 has been reviewed. Inclusion and exclusion criteria has been applied to ensure data consistency and reliability.

Collected data included demographic characteristics, medical history, periodontal disease stages, DMFT scores, and radiographic findings. Postoperative variables such as infection status, antibiotic use, duration of hospitalization, intensive care unit stay, and mortality has been evaluated.

Statistical analyses performed using appropriate parametric and non-parametric tests. Multivariate regression models used to identify factors associated with postoperative infection and mortality.

The aim of this study is to determine whether preoperative periodontal treatment has a significant impact on postoperative outcomes in patients undergoing cardiac valve surgery.

Study Type

Observational

Enrollment (Actual)

200

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Turkey (Türkiye)
    • Bakirköy
      • Istanbul, Bakirköy, Turkey (Türkiye), 34147
        • Bakirköy Dr. Sadi Konuk Education and Research Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

This retrospective study population consists of adult patients who underwent cardiac valve surgery and had available preoperative panoramic radiographs and complete clinical records. The study aims to evaluate the association between oral health status (DMFT index and radiographic periodontal condition) and postoperative clinical outcomes.

Description

Inclusion Criteria:

  • Adult patients (≥18 years) who underwent cardiac valve surgery
  • Availability of preoperative panoramic radiographs
  • Complete medical and dental records, including DMFT index and systemic clinical parameters
  • Patients with documented postoperative clinical follow-up data

Exclusion Criteria:

  • Patients under 18 years of age
  • Patients with incomplete or missing medical or radiographic records
  • Patients with a history of systemic conditions severely affecting bone metabolism (e.g., advanced malignancy, metabolic bone disease)
  • Patients who received recent periodontal treatment prior to radiographic assessment
  • Poor-quality radiographs that do not allow accurate evaluation

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Elective Surgery Patients
This cohort includes patients who underwent elective aortic or mitral valve surgery and had complete medical and dental records available. All patients received standard preoperative evaluation, and those with documented periodontal treatment within 15 days prior to surgery were included.
Emergency Surgery Patients
This cohort consists of patients who underwent emergency aortic or mitral valve surgery. Due to the urgent nature of the procedure, preoperative periodontal assessment and treatment not have been consistently performed.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Radiographic Alveolar Bone Loss Percentage Assessed on Panoramic Radiographs
Time Frame: Preoperative assessment (baseline)
Radiographic periodontal bone loss have been assessed on panoramic radiographs by measuring the percentage of alveolar bone loss relative to root length. Bone loss severity will be categorized according to the extent of radiographic alveolar bone loss. Higher percentages indicate greater periodontal destruction and more severe periodontal disease.
Preoperative assessment (baseline)
Periodontal disease diagnosis (presence and severity)
Time Frame: Preoperative assessment (baseline)
Periodontal disease diagnosed based on radiographic findings and classified according to established periodontal disease criteria (e.g., mild, moderate, or severe periodontitis).
Preoperative assessment (baseline)
DMFT index (Decayed, Missing, Filled Teeth score)
Time Frame: Preoperative assessment (baseline)
The DMFT index calculated from radiographic and clinical records to quantify cumulative dental caries experience in each patient.
Preoperative assessment (baseline)
Postoperative infection-related clinical outcomes (fever duration)
Time Frame: Measured within the first 7 postoperative days following cardiac surgery.
The number of days with postoperative fever (≥37.5°C) recorded from patient medical records and used as an indicator of postoperative infection.
Measured within the first 7 postoperative days following cardiac surgery.
Length of postoperative hospital stay (days)
Time Frame: From the date of cardiac surgery until hospital discharge, assessed up to 30 days postoperatively.
The duration of hospitalization has been recorded in days from the date of cardiac surgery until hospital discharge and compared according to preoperative oral and periodontal status.
From the date of cardiac surgery until hospital discharge, assessed up to 30 days postoperatively.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Duration of intensive care unit (ICU) stay (days)
Time Frame: From admission to the intensive care unit following cardiac surgery until ICU discharge, assessed up to 30 days postoperatively.
The number of days spent in the intensive care unit following cardiac surgery recorded and analyzed according to preoperative oral and periodontal health status.
From admission to the intensive care unit following cardiac surgery until ICU discharge, assessed up to 30 days postoperatively.
Time to initiation of oral feeding (days)
Time Frame: From the date of cardiac surgery until initiation of oral feeding, assessed up to 30 days postoperatively.
The number of days from cardiac surgery to the initiation of oral feeding recorded and evaluated as an indicator of postoperative recovery.
From the date of cardiac surgery until initiation of oral feeding, assessed up to 30 days postoperatively.
Postoperative C-Reactive Protein (CRP) Level
Time Frame: Measured within the first 7 postoperative days following cardiac surgery.
Serum C-reactive protein (CRP) concentration, measured in milligrams per liter (mg/L), obtained from medical records and analyzed as an indicator of postoperative systemic inflammatory response. Higher values indicate a greater inflammatory response.
Measured within the first 7 postoperative days following cardiac surgery.
Postoperative White Blood Cell (WBC) Count
Time Frame: Measured within the first 7 postoperative days following cardiac surgery.
White blood cell count, measured in ×10⁹ cells/L, obtained from medical records and analyzed as an indicator of postoperative systemic inflammatory response. Higher values indicate a greater inflammatory response.
Measured within the first 7 postoperative days following cardiac surgery.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Istanbul University - Cerrahpasa

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

January 1, 2015

Primary Completion (Actual)

December 1, 2024

Study Completion (Actual)

May 1, 2025

Study Registration Dates

First Submitted

May 19, 2026

First Submitted That Met QC Criteria

May 31, 2026

First Posted (Actual)

June 4, 2026

Study Record Updates

Last Update Posted (Actual)

June 4, 2026

Last Update Submitted That Met QC Criteria

May 31, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2025/168

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

De-identified participant data including questionnaire responses and periodontal measurements will be available upon reasonable request after publication.

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • ICF
  • ANALYTIC_CODE

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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