Steven Engebretson1, Thomas Kocher. 1. Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY 10010, USA. spe2002@nyu.edu
Abstract
CONTEXT: The effect of periodontal therapy on diabetes outcomes has not been established. OBJECTIVE: This update examines the effect of periodontal treatment on diabetes outcomes. DATA SOURCES: Literature since October 2009 using MEDLINE. STUDY ELIGIBILITY CRITERIA: Published RCTs including periodontal therapy for diabetic subjects, a metabolic outcome, an untreated control group, and follow-up of 3 months. DATA EXTRACTION: Pre-defined data fields, including study quality indicators were used. DATA SYNTHESIS: A search revealed 56 publications of which 9 met inclusion criteria. Mean change of HbA1c from baseline was compared across treatment groups. Pooled analysis was based on random effects models. RESULTS: A meta-analysis indicated a mean treatment effect of -0.36% HbA1c (CI -0.54, -0.19) compared to no treatment after periodontal therapy (p < 0.0001). Heterogeneity tests revealed only minimal evidence of publication bias (I(2 ) = 9%). LIMITATIONS: Small sample size and high risk of bias remain problematic for studies of this type. Periodontal therapy varied considerably. CONCLUSION: The modest reduction in HbA1c observed as a result of periodontal therapy in subjects with type 2 diabetes is consistent with previous systematic reviews. Despite this finding, there is limited confidence in the conclusion due to a lack of multi-centre trials of sufficient sample size are lacking.
CONTEXT: The effect of periodontal therapy on diabetes outcomes has not been established. OBJECTIVE: This update examines the effect of periodontal treatment on diabetes outcomes. DATA SOURCES: Literature since October 2009 using MEDLINE. STUDY ELIGIBILITY CRITERIA: Published RCTs including periodontal therapy for diabetic subjects, a metabolic outcome, an untreated control group, and follow-up of 3 months. DATA EXTRACTION: Pre-defined data fields, including study quality indicators were used. DATA SYNTHESIS: A search revealed 56 publications of which 9 met inclusion criteria. Mean change of HbA1c from baseline was compared across treatment groups. Pooled analysis was based on random effects models. RESULTS: A meta-analysis indicated a mean treatment effect of -0.36% HbA1c (CI -0.54, -0.19) compared to no treatment after periodontal therapy (p < 0.0001). Heterogeneity tests revealed only minimal evidence of publication bias (I(2 ) = 9%). LIMITATIONS: Small sample size and high risk of bias remain problematic for studies of this type. Periodontal therapy varied considerably. CONCLUSION: The modest reduction in HbA1c observed as a result of periodontal therapy in subjects with type 2 diabetes is consistent with previous systematic reviews. Despite this finding, there is limited confidence in the conclusion due to a lack of multi-centre trials of sufficient sample size are lacking.
Authors: Emrah Koçak; Mehmet Sağlam; Seyit Ali Kayış; Niyazi Dündar; Levent Kebapçılar; Bruno G Loos; Sema S Hakkı Journal: Lasers Med Sci Date: 2016-01-11 Impact factor: 3.161
Authors: Wenche S Borgnakke; Iain L C Chapple; Robert J Genco; Gary Armitage; P Mark Bartold; Francesco D'Aiuto; Paul I Eke; William V Giannobile; Thomas Kocher; Kenneth S Kornman; Niklaus P Lang; Phoebus N Madianos; Shinya Murakami; Fusanori Nishimura; Steven Offenbacher; Philip M Preshaw; Amin Ur Rahman; Mariano Sanz; Jørgen Slots; Maurizio S Tonetti; Thomas E Van Dyke Journal: J Evid Based Dent Pract Date: 2014-05-21 Impact factor: 5.267