Jean-Noel Vergnes1,2, Thibault Canceill3, Alexia Vinel4,5, Sara Laurencin-Dalicieux4,6, Françoise Maupas-Schwalm5,7, Vincent Blasco-Baqué4,5, Hélène Hanaire5,8, Elise Arrivé9,10, Vincent Rigalleau11, Cathy Nabet1,12, Michel Sixou1, Pierre Gourdy5,8, Paul Monsarrat3,13. 1. The Department of Epidemiology and Public Health, Faculty of Dentistry, Toulouse University Hospital (CHU de Toulouse), Paul Sabatier University, Toulouse, France. 2. The Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada. 3. The Department of Oral Rehabilitation, Faculty of Dentistry, Toulouse University Hospital (CHU de Toulouse), Paul Sabatier University, Toulouse, France. 4. The Department of Oral Surgery, Periodontology and Oral Biology, Faculty of Dentistry, Toulouse University Hospital (CHU de Toulouse), Paul Sabatier University, Toulouse, France. 5. The Institute of Metabolic and Cardiovascular Diseases (I2MC), UMR1048, INSERM, UPS, Université de Toulouse, Toulouse, France. 6. INSERM U1043, Université Toulouse III CHU Purpan, Toulouse, France. 7. The Department of Biochemistry and Molecular Biology, Faculty of Medicine-Rangueil (CHU de Toulouse), Paul Sabatier Toulouse-3, IFR-150, Toulouse, France. 8. The Department of Diabetology - Metabolic Diseases - Nutrition, CHU of Toulouse, Toulouse, France. 9. Department of Dentistry and Oral health, Bordeaux University Hospital, Bordeaux, France. 10. Department of Odontology, University of Bordeaux, Bordeaux, France. 11. The Department of Endocrinology, Bordeaux CHU, Bordeaux, France. 12. INSERM U1027, Paul Sabatier University, Toulouse, France. 13. STROMALab, Université de Toulouse, CNRS ERL 5311, EFS, ENVT, Inserm U1031, UPS, Toulouse, France.
Abstract
AIM: To assess whether periodontal treatment can lead to clinical, glycaemic control and quality of life improvements in metabolically unbalanced diabetic patients (type 1 or type 2) diagnosed with periodontitis. METHODS: In this open-labelled randomized controlled trial, diabetic subjects (n = 91) were given "immediate" or "delayed" periodontal treatment (full-mouth non-surgical scaling and root planing, systemic antibiotics, and oral health instructions). The main outcome was the effect on glycated haemoglobin (HbA1C ) and fructosamine levels. The General Oral Health Assessment Index and the SF-36 index were used to assess quality of life (QoL). RESULTS:Periodontal health significantly improved after periodontal treatment (p < 0.001). Periodontal treatment seemed to be safe but had no significant effects on glycaemic control based on HbA1C (adjusted mean difference with a 95% confidence interval (aMD) of 0.04 [-0.16;0.24]) and fructosamine levels (aMD 5.0 [-10.2;20.2]). There was no obvious evidence of improvement in general QoL after periodontal treatment. However, there was significant improvement in oral health-related QoL (aMD 7.0 [2.4;11.6], p = 0.003). CONCLUSION: Although periodontal treatment showed no clinical effect on glycaemic control in this trial, important data were provided to support periodontal care among diabetic patients. Periodontal treatment is safe and improves oral health-related QoL in patients living with diabetes. ISRCTN15334496.
RCT Entities:
AIM: To assess whether periodontal treatment can lead to clinical, glycaemic control and quality of life improvements in metabolically unbalanced diabeticpatients (type 1 or type 2) diagnosed with periodontitis. METHODS: In this open-labelled randomized controlled trial, diabetic subjects (n = 91) were given "immediate" or "delayed" periodontal treatment (full-mouth non-surgical scaling and root planing, systemic antibiotics, and oral health instructions). The main outcome was the effect on glycated haemoglobin (HbA1C ) and fructosamine levels. The General Oral Health Assessment Index and the SF-36 index were used to assess quality of life (QoL). RESULTS: Periodontal health significantly improved after periodontal treatment (p < 0.001). Periodontal treatment seemed to be safe but had no significant effects on glycaemic control based on HbA1C (adjusted mean difference with a 95% confidence interval (aMD) of 0.04 [-0.16;0.24]) and fructosamine levels (aMD 5.0 [-10.2;20.2]). There was no obvious evidence of improvement in general QoL after periodontal treatment. However, there was significant improvement in oral health-related QoL (aMD 7.0 [2.4;11.6], p = 0.003). CONCLUSION: Although periodontal treatment showed no clinical effect on glycaemic control in this trial, important data were provided to support periodontal care among diabeticpatients. Periodontal treatment is safe and improves oral health-related QoL in patients living with diabetes. ISRCTN15334496.
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