Effect of non‐surgical periodontal treatment on HbA1c: a meta‐analysis of randomized controlled trials

Liew, Ashley; Punnanithinont, Natdanai; Lee, Gary; Yang, Justin

doi:10.1111/adj.12091

Cited by 51 publications

(40 citation statements)

References 40 publications

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“…Several meta‐analyses concluded that there is evidence that periodontal treatment has a modest effect on glycaemic control in individuals with diabetes (Darre, Vergnes, Gourdy, & Sixou, ; Engebretson & Kocher, ; Liew, Punnanithinont, Lee, & Yang, ; Sgolastra, Severino, Pietropaoli, Gatto, & Monaco, ; Simpson, Needleman, Wild, Moles, & Mills, ; Teeuw, Gerdes, & Loos, ) (Table , Figure ). The review by Taylor et al.…”

Section: Resultsmentioning

confidence: 99%

An update on the evidence for pathogenic mechanisms that may link periodontitis and diabetes

Polak

Shapira

2017

J Clinic Periodontology

297

234

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The elevated pro-inflammatory factors in the gingiva of patients with poorly controlled diabetes suggest a biological pathway that may aggravate periodontitis. Some evidence suggests that the systemic inflammatory burden in periodontitis has the potential to affect diabetes control, but no studies addressed the impact of successful periodontal therapy on the pathophysiological mechanisms involved in systemic complications of diabetes.

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Section: Resultsmentioning

confidence: 99%

An update on the evidence for pathogenic mechanisms that may link periodontitis and diabetes

Polak

Shapira

2017

J Clinic Periodontology

297

234

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“…Eight SRs included randomized controlled trials (RCTs) only, and three SRs RCTs and controlled clinical trials. Most RCTs included in the SRs presented at least one of the domains assessed with unclear or high risk of bias.…”

Section: Resultsmentioning

confidence: 99%

An overview of systematic reviews on the effectiveness of periodontal treatment to improve glycaemic control

Faggion

Cullinan

Atieh

2016

J of Periodontal Research

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Several systematic reviews with meta-analyses on the effectiveness of periodontal treatment to improve glycaemic control have been published. So far no overview of these systematic reviews has been performed. The main objective of this report was to assess critically these systematic reviews to provide the reader with a high-level synthesis of research evidence. MEDLINE (via PubMed) and EMBASE databases were searched independently and in duplicate to identify systematic reviews with meta-analyses of clinical studies that assessed the relationship between diabetes mellitus and periodontitis. The last database search was performed on 10 March 2015. The reference lists of included systematic reviews were also scrutinized for further publications. The methodological quality of the included systematic reviews was assessed independently with two validated checklists (AMSTAR and OQAQ) by two authors. Disagreements in the assessment were resolved by consensus. A total of 226 potential publications were initially retrieved. Eleven systematic reviews with meta-analyses were finally included. Glycosylated haemoglobin A1c (HbA1c) was the most commonly used clinical endpoint. Meta-analytic estimates from systematic reviews generated an average reduction of 0.46% (median 0.40%) of HbA1c in patients with diabetes mellitus who received periodontal treatment. These meta-analyses had, nevertheless, methodological limitations such as inclusion of trials with different types of risk of bias that hinder more robust conclusions. A recent meta-analysis that included recently published large randomized controlled trials did not show significant change in the level of HbA1c at the 6 mo follow-up. The AMSTAR checklist generated results that were more conservative than OQAQ. Findings from this overview do not support the information that periodontal treatment may improve glycaemic control. Methodological issues described in this overview may guide further research on this topic.

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“…When not reported, it was calculated for the intervention and the control groups by means of the formula [35]:where HbA1c f is the mean HbA1c value after treatment and HbA1c b is the mean HbA1c value before treatment. And if the standard deviation was not reported, it was obtained by the formula [35], [38]:Where SD c is the standard deviation of mean change of HbA1c, SD b is the standard deviation of mean baseline HbA1c values, SD f is the standard deviation of mean end HbA1c values. Corr is the correlation between the baseline and end values, it was set at 0.5, consistent with the previous reviews [35], [38].…”

Section: Methodsmentioning

confidence: 99%

“…And if the standard deviation was not reported, it was obtained by the formula [35], [38]:Where SD c is the standard deviation of mean change of HbA1c, SD b is the standard deviation of mean baseline HbA1c values, SD f is the standard deviation of mean end HbA1c values. Corr is the correlation between the baseline and end values, it was set at 0.5, consistent with the previous reviews [35], [38].…”

Section: Methodsmentioning

confidence: 99%

The Effect of Periodontal Treatment on Hemoglobin A1c Levels of Diabetic Patients: A Systematic Review and Meta-Analysis

et al. 2014

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BackgroundThere is growing evidence that periodontal treatment may affect glycemic control in diabetic patients. And several systematic reviews have been conducted to assess the effect of periodontal treatment on diabetes outcomes. Researches of this aspect are widely concerned, and several new controlled trials have been published. The aim of this study was to update the account for recent findings.MethodsA literature search (until the end of January 2014) was carried out using various databases with language restriction to English. A randomized controlled trial (RCT) was selected if it investigated periodontal therapy for diabetic subjects compared with a control group received no periodontal treatment for at least 3 months of the follow-up period. The primary outcome was hemoglobin A1c (HbA1c), and secondary outcomes were periodontal parameters included probing pocket depth (PPD) and clinical attachment level (CAL).ResultsTen trials of 1135 patients were included in the analysis. After the follow-up of 3 months, treatment substantially lowered HbA1c compared with no treatment after periodontal therapy (–0.36%, 95%CI, −0.52% to −0.19%, P<0.0001). Clinically substantial and statistically significant reduction of PPD and CAL were found between subjects with and without treatment after periodontal therapy (PPD −0.42 mm, 95%CI: −0.60 to −0.23, P<0.00001; CAL −0.34 mm, 95%CI: −0.52 to −0.16, P = 0.0002). And there is no significant change of the level of HbA1c at the 6-month comparing with no treatment (–0.30%, 95%CI, −0.69% to 0.09%, P = 0.13).ConclusionsPeriodontal treatment leads to the modest reduction in HbA1c along with the improvement of periodontal status in diabetic patients for 3 months, and this result is consistent with previous systematic reviews. And the effect of periodontal treatment on HbA1c cannot be observed at 6-month after treatment.

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Effect of non‐surgical periodontal treatment on HbA1c: a meta‐analysis of randomized controlled trials

Cited by 51 publications

References 40 publications

An update on the evidence for pathogenic mechanisms that may link periodontitis and diabetes

An update on the evidence for pathogenic mechanisms that may link periodontitis and diabetes

An overview of systematic reviews on the effectiveness of periodontal treatment to improve glycaemic control

The Effect of Periodontal Treatment on Hemoglobin A1c Levels of Diabetic Patients: A Systematic Review and Meta-Analysis

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