Effects of Periodontal Treatment on Glycated Hemoglobin A Levels in Patients with Type 2 Diabetes: A Meta-Analysis of Randomized Clinical Trials

Abstract

This systematic review aimed to investigate the effects of periodontal treatment on glycated hemoglobin A (HbA1c) levels in patients with type 2 diabetes who develop periodontal disease. The search of the MEDLINE, Embase, CINAHL, and Cochrane Library databases was completed on April 8, 2018. The study design was based on randomized clinical trials. Scaling and root planing was performed for the test group, whereas no periodontal treatment or simple oral training was performed for the control group. The main outcome variable was the change in HbA1c levels. We used the Review Manager statistical analysis software for the quantitative analysis of selected documents. Meta-analysis was performed using the inverse variance estimation method of the fixed-effect model to estimate the effects of periodontal treatment on HbA1c levels in patients with type 2 diabetes. A total of 1,011 documents were searched using search strategies, and 10 documents were included in the meta-analysis. The meta-analysis of the selected literature showed that periodontal treatment significantly reduced the HbA1c levels in patients with type 2 diabetes who develop periodontal disease (mean difference, −0.34; 95% confidence interval, −0.43 to -0.26; p＜0.001). This study aimed to investigate the effects of periodontal treatment on HbA1c levels, which can be used as a basis for the increasing management of diabetic complications. To improve the quality of life and reduce the burden of medical expenses for patients with diabetes, periodontal disease management through nonsurgical periodontal treatment, such as scaling and root planing, is necessary.

Effectiveness of the Oral Care Program in Type 2 Diabetic Elderly Patients with Periodontitis: A Clustered Randomised Controlled Study With 6-month Follow-Up

“…However, the reduction of HbA1c level did not meet the target of American Diabetes Association treatment goal that the HbA1c level must be reduced to less than 7.5 in healthy older people 12 . In other previous studies [24][25][26][27] , periodontal therapy in diabetic patients could signi cantly reduce HbA1c levels from 0.29-0.64% in 3-month and 0.2% in 6-month after completion of the therapy 28 . As the combination of lifestyle changes and dental care program also decreased HbA1c (0.29%) after 3-months follow-ups, whereas the HbA1c increased 0.09% in the control group 19 .…”