Purpose To determine the clinical and radiological profile of periodontitis according to the 2018 NCPD, in a Dakar (Senegal) based periodontal clinic. Methods This is a descriptive study based on patient’s records in the periodontology clinic. The study was conducted between November 2018 and February 2020 (15 months). All periodontitis cases were included in the study. Incomplete records (due to lack of radiographic workup or unusable periodontal charting) were excluded. Periodontitis diagnosis was established based on criteria used in the 2018 NCPD. Statistical analysis was carried out using SPSS version 20.0, with the significance threshold set at 0.05. Results A total number of 517 patient records were collected during the study period but only 127 periodontitis records were complete. The mean age of participants was 46.8 ± 13.8 years and 63.8% of participants were males. The mean plaque index and bleeding on probing (BOP) were 74% ± 21.3 and 58.1% ± 25.1, respectively. The mean maximum clinical attachment loss was 8.7 mm ±2.7, with a probing depth greater than 6 mm present in 50.4% of the sample. The median number of missing teeth was 3 (interquartile range 5–1). Pathological mobility was present in 60.6% of the patients and 78.0% had occlusion problems. Bone crest defect at the most affected site was moderate in 52.8% of cases. The ratio of bone loss to age greater than one concerned 66.1% of the sample. Generalised (81.9%), Stage IV (70.1%) and grade C (69.3%) were the most encountered diagnosis. The disease severity was associated with age (r = 0.241; P < 0.001), BOP (r = 0.230; P = 0.013) and the number of teeth with pathological mobility (r = 0.318; P < 0.001). Conclusion Patients with periodontitis in this study had advanced forms of the disease and required multidisciplinary care. Clinical hindsight is necessary to improve this classification.
IntroductionNon-surgical periodontal therapy consisting of scaling and root planning has been shown to be effective in the improvement of glycaemic control in patients with diabetes with periodontitis for up to 3 months. However, questions remain about this beneficial effect over a longer period of time. This systematic review and meta-analysis aims to determine the long-term effect (at least 6 months from the therapy) of non-surgical periodontal therapy with or without adjuvant on glycaemic control of patients with diabetes with periodontitis.Methods and analysisThis systematic review will include randomised control trials with a follow-up period of at least 6 months after initial therapy, with measurement of glycated haemoglobin as the primary endpoint. A literature search will be conducted in MEDLINE, CENTRAL, EMBASE, CINAHL, The Cochrane Oral Health Group Trials Register, and the US National Institutes of Health Trials Registry: ClinicalTrials.gov, from inception to 30 June 2020. Selection of studies, data extraction and bias assessment will be conducted independently by two reviewers. A DerSimonian-Laird random-effect meta-analysis will be conducted to pool studies deemed to be homogeneous. A subgroup analysis will be conducted in case of substantial heterogeneity. Egger’s test and observation of the funnel plot will be used to assess publication bias. The statistical analysis will be done using R V.4.0.0 software.Ethics and disseminationSince primary data are not collected, ethical approval is not required. The final report will be published in a peer-reviewed journal.PROSPERO registration numberCRD42020192635.
Aim This study aimed to determine whether non-surgical periodontal therapy (NSPT), with or without antimicrobial adjuvant therapy, in diabetic patients with periodontitis was effective in significantly reducing glycated haemoglobin (HbA1c) over six months compared to no active treatment. Methods MEDLINE, EMBASE and CENTRAL were searched to identify randomized controlled trials with a follow-up period of at least 6 months. The risk of bias was investigated by the Cochrane intention-to-treat risk of bias assessment tool (ROB 2) with 6-month HbA1C as the primary outcome. A random-effects meta-analysis was conducted to obtain the overall effect of non-surgical periodontal therapy on HbA1c levels. A subgroup analysis according to the type of adjuvant therapy was conducted. Results The literature search yielded 1848 studies, of which 10 were finally retained. An overall low risk of bias was found in four studies. The pooled mean difference of HbA1c between the intervention and control groups at 6 months and 9 months for non-surgical periodontal therapy was − 0.11% (95% CI: -0.31 to 0.09) and − 0.21 (95% CI: -0.72 to 0.29) respectively. Compared to the control group, periodontal parameters (plaque index, bleeding on probing, probing pockets depth, and clinical attachment levels) as well as levels of selected inflammation markers (C-reactive protein and tumor necrosis factor-α) were significantly (P-value < 0.05) improved in the intervention group. Conclusion NSPT with or without adjuvant contributed to a modest, although not statistically significant, improvement in glycaemic control at 6 and 9 months in diabetic patients with periodontitis.
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