Effectiveness of Periodontal Treatment to Improve Metabolic Control in Patients With Chronic Periodontitis and Type 2 Diabetes: A Meta‐Analysis of Randomized Clinical Trials

Sgolastra, Fabrizio; Severino, Marco; Pietropaoli, Davide; Gatto, Roberto; Monaco, Annalisa

doi:10.1902/jop.2012.120377

Cited by 132 publications

(110 citation statements)

References 88 publications

(238 reference statements)

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“…An improvement in the mean HbA 1 c and FPG values was demonstrated in type 2 DM patients who received non-surgical periodontal treatment. This result is consistent with the findings of earlier studies 7,16) suggesting the contribution of non-surgical periodontal therapy to glycemic control in DM patients. A reduction in HbA 1 c is important, as it is associated with a reduced risk for complications in diabetes 15) .…”

Section: Discussionsupporting

confidence: 93%

A Collaborative Approach to Care for Patients with Periodontitis and Diabetes

Ota

Seshima

Okubo

et al. 2013

Bull. Tokyo Dent. Coll.

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As periodontal disease and diabetes mellitus (DM) have bidirectional interactions, an effective approach to periodontal treatment for patients with diabetes in the clinical setting is essential. This paper reports an effort in collaborative care for patients with periodontitis and diabetes between dental and medical professionals, and provides a preliminary evaluation regarding the clinical outcomes. We have introduced a clinical pathway program at our institution applicable to patients with periodontitis and DM. Physicians and dentists utilize the clinical pathway to share medical and dental information in order to provide the optimal care for each patient. So far, this clinical pathway has been applied to the treatment of 50 patients. We analyzed clinical outcomes in 10 patients with the chief complaint of periodontal problems who had also been diagnosed with type 2 DM. After initial periodontal therapy and diabetes care, a significant improvement in the mean value of glycated hemoglobin and fasting plasma glucose was observed, accompanied by clinical resolution of periodontal parameters. Within the limitations of the present study, the results suggest that collaborative care between periodontists and physicians based on the clinical pathway is effective in glycemic control of patients with periodontitis and type 2 DM. This indicates the need for closer collaboration between medical and dental professionals in improving the management of these diseases.

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Section: Discussionsupporting

confidence: 93%

A Collaborative Approach to Care for Patients with Periodontitis and Diabetes

Ota

Seshima

Okubo

et al. 2013

Bull. Tokyo Dent. Coll.

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“…Scaling and root planing (SRP) is a common and non-invasive periodontal therapeutic strategy which has been reported to improve glycemic status in patients with type 2 diabetes mellitus (T2DM) [16][17][18][19][20][21]. Similar results were reported by Javed et al [8] in a patient population of prediabetic individuals.…”

Section: Introductionmentioning

confidence: 53%

Impact of scaling and root planing on clinical periodontal status and glycemic levels in prediabetic patients

Alshehri¹,

Javed²

2015

Interventional Medicine and Applied Science

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Objective:The aim was to assess the eff ect of scaling and root planing (SRP) on clinical periodontal parameters and glycemic levels in prediabetic patients. Methods: Fifty prediabetic patients with periodontal disease were included. Demographic data (age, gender, education status, duration of prediabetes, type of treatment adopted for prediabetes management, and oral hygiene maintenance protocols) were recorded using a questionnaire. Patients were randomly divided into two groups (25 patients/group). In Group 1, SRP alone was performed, in Group 2, SRP + oral doxycycline (100 mg) administration. In both groups, fasting blood glucose (FBG) levels and periodontal parameters (plaque index [PI], bleeding on probing [BOP], and probing depth [PD]) were assessed at baseline and after 6 months. Statistical analysis was performed using one-way analysis of variance. Results: Age, gender, and duration and treatment of prediabetes were comparable among patients in Groups 1 and 2. PI, BOP, and PD signifi cantly reduced in both groups than baseline values. Reduction in periodontal parameters among Groups 1 and 2 were comparable. There was no signifi cant reduction in FBG levels among patients in Groups 1 and 2 after 6 months of SRP. Conclusion: SRP was eff ective in reducing periodontal infl ammation in prediabetic patients. FBG levels did not show any signifi cant diff erence after SRP in both groups.

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“…Both the 2013 consensus report of the Joint European Federation for Periodontology and American Academy of Periodontology Dental-Medical care delivery in T2DM workshop on periodontitis and systemic diseases 13 and metaanalysis of the impact of periodontal treatment on hemoglobin A1c levels (HbA1C), 14 concluded that guideline provision surrounding periodontal care in diabetic patients was supportable and associated with efficacy, and was further supported by meta-analysis of level A clinical trial evidence demonstrating moderate reduction in HbA1c and inflammatory biomarker levels and improvement in oral indices post intervention. 15 The American Academy of Oral Medicine also advanced evidence-based CPGs that include recommendations for optimizing clinical interventions to reduce risk of PD, caries, and oral infection in patients with Glurich, Nycz, Acharya Characterize current practice patterns for integrating dental practitioners into the medical home model. Study focused on identifying best practices and education on strategic initiatives for medical-dental home set-up.…”

Section: Current Interdisciplinary Practice Patterns: Does Oral Healtmentioning

confidence: 99%

Status Update on Translation of Integrated Primary Dental-Medical Care Delivery for Management of Diabetic Patients

2017

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Escalating prevalence of both diabetes and periodontal disease, two diseases associated with bi-directional exacerbation, has been reported. Periodontal disease represents a modifiable risk factor that may reduce diabetes onset or progression, and integrated models of cross-disciplinary care are needed to establish and manage glycemic control in affected patients. An ad-hoc environmental scan of current literature and media sought to characterize factors impacting status of integrated care models based on review of the existing evidence base in literature and media surrounding: (1) current cross-disciplinary practice patterns, (2) epidemiological updates, (3) status on risk assessment and screening for dysglycemia in the dental setting, (4) status on implementation of quality metrics for oral health, (5) care model pilots, and (6) public health perspectives. The survey revealed: escalating prevalence of diabetes and periodontitis globally; greater emphasis on oral health assessment for diabetic patients in recent medical clinical practice guidelines; high knowledgeability surrounding oralsystemic impacts on diabetes and growing receptivity to medical-dental integration among medical and dental providers; increasing numbers of programs/studies reporting on positive impact of emerging integrated dental-medical care models on diabetic patient healthcare access and health outcomes; a growing evidence base for clinically significant rates of undiagnosed dysglycemia among dental patients reported by point-of-care pilot studies; no current recommendation for population-based screening for dysglycemia in dental settings pending a stronger evidence base; improved definition of true periodontitis prevalence in (pre)/diabetics; emerging recognition of the need for oral health quality indicators and tracking; evidence of persistence in dental access disparity; updated status on barriers to integration. The potential benefit of creating clinically-applicable integrated care models to support holistic management of an escalating diabetic population by targeting modifiable risk factors including periodontitis is being recognized by the health industry. Cross-disciplinary efforts supported by high quality research are needed to mitigate previously-and newly-defined barriers of care integration and expedite development and implementation of integrated care models in various practice settings. Implementation of quality monitoring in the dental setting will support definition of the impact and efficacy of interventional clinical care models on patient outcomes.

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Effectiveness of Periodontal Treatment to Improve Metabolic Control in Patients With Chronic Periodontitis and Type 2 Diabetes: A Meta‐Analysis of Randomized Clinical Trials

Abstract: The meta-analysis results seem to support the effectiveness of SRP in the improvement of glycemic control in patients with CP and DM2; however, future studies are needed to confirm these results.

Cited by 132 publications

References 88 publications

A Collaborative Approach to Care for Patients with Periodontitis and Diabetes

A Collaborative Approach to Care for Patients with Periodontitis and Diabetes

Impact of scaling and root planing on clinical periodontal status and glycemic levels in prediabetic patients

Status Update on Translation of Integrated Primary Dental-Medical Care Delivery for Management of Diabetic Patients

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