Systematic review and meta-analysis of randomized controlled trials evaluating the efficacy of non-surgical periodontal treatment in patients with concurrent systemic conditions

Abstract

Objective To conduct a systematic review of the published scientific evidence to evaluate the efficacy of nonsurgical periodontal therapy (NSPT) in treating periodontitis in patients with concurrent systemic conditions (diabetes, CVD, erectile dysfunction, chronic kidney disease, rheumatoid arthritis, polycystic ovarian syndrome, obesity, pregnancy). We hypothesised that NSPT results in better periodontal outcomes when compared to untreated controls after follow-up. Materials and methods A systematic search (PUBMED/EMBASE) was conducted from 1995 to 2023 to identify randomised controlled trials (RCTs) with a minimum follow-up of 3 months. The primary outcome was the difference in mean probing depth (PD), and the secondary outcomes were mean clinical attachment loss (CAL), percentage of sites with PD ≤ 3 mm (%PD ≤ 3 mm) and percentage of sites with bleeding on probing (%BOP) between the treated and untreated control group in patients with comorbidities. Results The electronic search resulted in 2,403 hits. After removing duplicates, 1,565 titles and abstracts were screened according to the eligibility criteria, resulting in 126 articles for full-text screening. Following this, 44 studies were analysed. Restricting to studies with low bias or some concerns, NSPT group demonstrated a 0.55 mm lower mean PD (95%CI: −0.69; −0.41) after 3 months compared to the control group. Conclusion Compared to the untreated controls, NSPT notably reduced mean PD, mean CAL, and %BOP while increasing %PD ≤ 3 mm in patients with concurrent systemic conditions. These findings suggest that NSPT is also an effective procedure in managing periodontitis in patients with concurrent systemic conditions. Trial registration This systematic review was registered under the protocol registration number CRD42021241517/PROSPERO.

Screening for Selenomonas noxia in a Pediatric and Adolescent Patient Population Reveals Differential Oral Prevalence across Age Groups

“…The oral pathogenic bacteria Selenomonas noxia has been associated with the development and progress of periodontal disease, along with other gram-negative organisms such as Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia and Fusobacterium nucleatum [1][2][3]. These bacteria are mainly associated with the development and progression of periodontitis, which has been linked with the host inflammatory response to these microbial pathogens, as well as underlying medical conditions, including diabetes [4]. The association of periodontitis among younger and pediatric patients in the United States has mainly been observed in adolescent and teenage patients with orthodontic appliances and brackets [5,6].…”

Association between Periodontal Disease and Obesity: Umbrella Review

“…Reason for Exclusion Paranhos et al [33] They associated obesity with periodontal treatment Zhang et al [34] Joseph et al [35] Akram et al [36] Nascimento et al [37] Gerber et al…”

“…Paranhos et al [33] They associated obesity with periodontal treatment Zhang et al [34] Joseph et al [35] Akram et al [36] Nascimento et al [37] Gerber et al [38] Papageorgiou et al [39] Deng et al [40] They associated obesity with salivary biomarkers of PD Akram et al [41]…”

Oral Health Education in Patients with Diabetes: A Systematic Review

“…In patients with concomitant systemic diseases, such as diabetes, cardiovascular disease, chronic kidney disease, obesity and rheumatoid arthritis, from an evaluation of published scientific evidence, non-surgical periodontal therapy (NSPT) appears to be effective in combination with oral hygiene instructions. Probing with a periodontal probe and inhibition of periodontitis progression appears to lead to better periodontal outcomes in terms of the mean periodontal pocket depth, connective tissue adhesion, and bleeding [14].…”