Spyridon N Papageorgiou1, Christoph Reichert, Andreas Jäger, James Deschner. 1. Department of Orthodontics, School of Dentistry, University of Bonn, Bonn, Germany; Department of Oral Technology, School of Dentistry, University of Bonn, Bonn, Germany; Clinical Research Unit 208, University of Bonn, Bonn, Germany.
Abstract
AIM: The objective of this study was to investigate whether the response to periodontal treatment differs among obese, overweight or normal-weight patients. MATERIALS & METHODS: Both randomized and non-randomized studies were identified from searches up to July 2013. Risk of bias was assessed with the Downs-Black checklist, the Cochrane tool and the GRADE framework. Quantitative synthesis was conducted with random-effects meta-analyses in subgroups for systemically healthy and diabetic patients. RESULTS: A total of 15 studies including 867 patients were included. No significant difference was found for any clinical periodontal parameter between overweight/obese and normal-weight patients. Periodontal treatment in systemically healthy overweight/obese patients was associated with higher decrease in TNFα levels (1 study) and higher decrease in HbA1c levels (1 study) compared to systemically healthy normal-weight patients. Contrary to diabetic normal-weight patients, periodontal treatment in diabetic overweight/obese patients was associated with an increase in adiponectin levels (2 studies) and a decrease in leptin levels (2 studies). However, the quality of existing evidence is low due to inconsistency, imprecision and lack of studies. CONCLUSIONS: Whereas no difference was found in clinical periodontal parameters, significant differences in inflammatory or metabolic parameters were found between overweight/obese and normal-weight patients, but existing evidence is weak.
AIM: The objective of this study was to investigate whether the response to periodontal treatment differs among obese, overweight or normal-weight patients. MATERIALS & METHODS: Both randomized and non-randomized studies were identified from searches up to July 2013. Risk of bias was assessed with the Downs-Black checklist, the Cochrane tool and the GRADE framework. Quantitative synthesis was conducted with random-effects meta-analyses in subgroups for systemically healthy and diabeticpatients. RESULTS: A total of 15 studies including 867 patients were included. No significant difference was found for any clinical periodontal parameter between overweight/obese and normal-weight patients. Periodontal treatment in systemically healthy overweight/obesepatients was associated with higher decrease in TNFα levels (1 study) and higher decrease in HbA1c levels (1 study) compared to systemically healthy normal-weight patients. Contrary to diabetic normal-weight patients, periodontal treatment in diabetic overweight/obesepatients was associated with an increase in adiponectin levels (2 studies) and a decrease in leptin levels (2 studies). However, the quality of existing evidence is low due to inconsistency, imprecision and lack of studies. CONCLUSIONS: Whereas no difference was found in clinical periodontal parameters, significant differences in inflammatory or metabolic parameters were found between overweight/obese and normal-weight patients, but existing evidence is weak.
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