Relationship between periodontal disease and diabetic complications

Ota, Junya; Fukaya, Chie; Kasai, Shunsuke; Akamatsu, Mayako; Morikawa, Satoru; Tagomori, Junko; Eguchi, Toru; Saisho, Yoshifumi; Kawai, Takeshi; Ito, Hiroshi; Nakagawa, Taneaki

doi:10.2329/perio.54.336

Cited by 3 publications

(10 citation statements)

References 14 publications

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“…The evaluation of retinopathy was performed using an ophthalmic examination. Two studies did not specify the type of test used ( 11 , 18 ), while the others cited ophthalmoscopy as the exam of choice.…”

Section: Resultsmentioning

confidence: 99%

“…One study used only the community periodontal index (CPI) ( 16 ). PPD was the most used, observed in four studies ( 11 , 17 – 19 ), followed by the PI ( 11 , 17 , 19 ) and CAL ( 11 , 17 , 18 ), both used in three studies. BOP was analyzed in two studies ( 18 , 19 ), as well as the CPI ( 16 , 17 ).…”

Section: Resultsmentioning

confidence: 99%

“…Among the five studies included, two were classified as good quality, one as fair quality ( 11 ), and two studies as poor quality ( 18 , 19 ). Most problems were related to domains case definition, sample selection, and statistical analysis of outcomes.…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, two studies included in this review evaluated proliferative diabetic retinopathy (PDR) and severe periodontitis and found a significant correlation between them ( 11 , 18 ). In this regard, several studies support a relationship between some persistent systemic inflammation and angiogenesis, and this interplay might be also critical for PDR initiation and progression ( 37 , 38 ).…”

Section: Discussionmentioning

confidence: 98%

“…Periodontitis is characterized by the presence of PPD >4 mm, BOP >10% of sites, and CAL >3 mm ( 35 , 36 ). Regarding the diagnosis of diabetic retinopathy, out of the five studies, two did not specify the type of eye examination used ( 11 , 18 ), and the remaining four performed fundus photography ( 16 , 17 , 19 ).…”

Section: Discussionmentioning

confidence: 99%

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Association Between Diabetic Retinopathy and Periodontitis—A Systematic Review

Alvarenga

Miranda

Ferreira

et al. 2021

Front. Public Health

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Background: Diabetic retinopathy is a common microvascular complication in diabetic patients and is considered the main cause of visual loss worldwide. Periodontitis is a chronic inflammatory condition, which compromises dental supporting tissues. The chronic bacterial challenge in periodontitis is a persistent source of inflammatory mediators that may be associated with insulin resistance, increasing the risk of complications of diabetes mellitus. This systematic review aimed to summarize the evidence in the association between diabetic retinopathy and periodontitis.Methods: This review was registered under the number CRD 42019142267. A search strategy in five electronic databases and a gray literature source was performed based on the PECO acronym. After data extraction, the qualitative synthesis and risk of bias analyses were performed using the Newcastle–Ottawa scale. The level of evidence of all studies taken together was evaluated through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.Results: Out of the 253 citations screened, five cross-sectional studies met the eligibility criteria and were included in the qualitative analysis, in which two were judged to be of good quality, one as fair quality, and two as poor quality. Among the included studies, a significant relationship between the severity of periodontitis (CAL > 5 mm) and the severity of diabetic retinopathy (p < 0.05) was reported by four studies. Also, an association between both diseases in non-obese adults was found after adjustments [OR 2.206 (1.114–4.366); p = 0.0232). However, the analysis of evidence by GRADE assessment was rated as low.Conclusions: Although the results of individual studies suggest an association between diabetic retinopathy and periodontitis, the quality of the body of evidence was judged to be low by the GRADE approach. Further studies with larger sample sizes, adequate models of cofounders' adjustments, and prospective analysis of periodontitis and diabetes conditions ought to be conducted to clarify this association.

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Section: Resultsmentioning

confidence: 99%