Effect of periodontal treatment on glycemic control of patients with diabetes: A systematic review and meta‐analysis

Abstract

Aims/Introduction: The aim of the present study was to investigate whether non-surgical periodontal treatment reduces glycated hemoglobin (HbA 1c ) and fasting plasma glucose (FPG) levels in diabetic patients. Materials and Methods: An electronic search was carried out on MEDLINE (through PubMed interface), EMBASE and the Cochrane Central Register of Controlled Trials. Randomized controlled trials with a minimum of 3 months follow up were included. The risk of bias was assessed for each study. A meta-analysis was carried out to evaluate the effect of non-surgical periodontal treatment on HbA 1c and FPG levels. The effect of the adjunctive use of antimicrobials was also assessed. Results: A total of 15 studies were included. A reduction of -0.38% (95% confidence interval [CI] -0.23 to -0.53) after 3-4 months (P < 0.001) and of -0.31% (95% CI 0.11 to -0.74) after 6 months (P = 0.15) of follow-up was found for HbA 1c , favoring the treatment group. Similarly, in treated patients, a significantly greater decrease in FPG was observed in respect to control participants. Such difference amounted to -9.01 mg/dL (95% CI -2.24 to -15.78) after 3-4 months (P = 0.009) and -13.62 mg/dL (95% CI 0.45 to -27.69) after 6 months (P = 0.06) from treatment, respectively. In participants treated with adjunctive antimicrobials, a non-significant increase of HbA 1c was observed 3 months after treatment, whereas FPG decreased by 0.27 mg/dL (95% CI 39.56 to -40.11; P = 0.99). Conclusions:The meta-analysis showed that non-surgical periodontal treatment improves metabolic control in patients with both periodontitis and diabetes. (J Diabetes Invest,

Clinical and Metabolic Effects of two Periodontal Therapeutic Modalities in Diabetic Patients with Residual Pockets

“…Our results showed a mean reduction in Hb1Ac over time (0-3) and a tendency to decrease in the following quarter, similar to findings obtained from a systematic review [20], where similar results were demonstrated.…”

“…Since the 1960s, studies have been conducted with the aim of demonstrating the possible benefits of periodontal therapy in the glycemic control of diabetic patients [20], where surgical and non-surgical periodontal therapies may be able to reduce the systemic inflammatory gradient, thus favoring glycemic control although this fact is not yet a consensus in literature due to the lack of more homogenous and well delineated studies [5,7,12,[21][22][23].…”

Comparison of peri‐implant clinical and radiographic status around short (6 mm in length) dental implants placed in cigarette‐smokers and never‐smokers: Six‐year follow‐up results

“…Nonsurgical periodontal therapy (such as plaque and calculus debridement using ultrasonic hand instruments) contributes toward minimizing oral soft tissue inflammation. [24][25][26] The biannual visits to oral healthcare providers may also have encouraged the participants in both groups to routinely maintain their oral hygiene status. It is therefore likely that regular oral hygiene maintenance contributed toward maintaining a healthy peri-implant soft tissue status and minimizing ABR around short implants in both groups.…”

Diabetes and Periodontitis—A Dental Hygienist’s Perspective

“…& Chronic periodontal inflammation may increase the risk for type 2 diabetes [41••, 42-46, 47•]. & Although the predominance of evidence suggests that treatment of periodontal disease may improve glycemic control, this is inconclusive [48][49][50][51][52][53][54][55][56][57]. However, a recent Cochrane Review concluded that there is insufficient evidence that improvement in glycemic control can be maintained after 4 months following treatment using nonsurgical treatment modalities [58•].…”