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Evidence that periodontal treatment improves diabetes outcomes: a systematic review and meta‐analysis

2013; Wiley; Volume: 84; Issue: 4S Linguagem: Inglês

10.1902/jop.2013.1340017

1943-3670

Steven P. Engebretson, Thomas Kocher,

Diabetes, Cardiovascular Risks, and Lipoproteins

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 (I2 = 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.