Periodontal status of diabetics compared with nondiabetics: A meta-analysis

Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid 22110, P.O. BOX 121, Jordan.
Journal of Diabetes and its Complications (Impact Factor: 1.93). 02/2006; 20(1):59-68. DOI: 10.1016/j.jdiacomp.2005.05.006
Source: PubMed

ABSTRACT This meta-analysis was conducted to assess the association between diabetes mellitus and periodontal diseases by comparing the extent and severity of periodontal diseases between diabetics and nondiabetics.
A literature search was performed using MEDLINE database for published studies from January 1970 through October 2003 with manual search for references in relevant studies. This meta-analysis was based on 18 comparative cross-sectional studies, three prospective cohort studies and baseline data of two clinical trials that compared oral hygiene, gingival and periodontal status between diabetics and nondiabetics. Heterogeneity was obvious among included studies; therefore, the analysis using random-effects model was conducted.
This study demonstrated that diabetics had significantly worse oral hygiene as measured by the average of plaque index (P1I), higher severity of gingival disease as measured by the average of gingival index (GI) and higher severity of periodontal disease as measured by the average of probing pocket depth (PPD) and clinical attachment loss (CAL). However, diabetics had similar extent of oral hygiene, gingival and periodontal disease as measured by percentages of surfaces or sites with specific scores of P1I, GI, bleeding on probing (BOP), PPD and CAL.
Diabetics had a significantly higher severity but the same extent of periodontal disease than nondiabetics.

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    • "Individuals with diabetes are about two and a half times more likely to have periodontitis than medically healthy controls [9]. Periodontitis also is more severe in those with than without diabetes [10] [11] and the disease tends to be most severe in patients with the poorest glycemic control [12]. Because of its consistent and severitydependent association with diabetes, some have argued that periodontitis should be considered more formally as a diabetes complication [13]. "
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    • "A recent meta-analysis suggests that periodontitis may be an independent risk factor for coronary heart disease (Bahekar et al. 2007) and that aggressive treatment of periodontal inflammation improves biomarkers of vascular endothelial function (Tonetti et al. 2007). Interestingly, while it is well established that Type 2 diabetes patients have a significantly elevated risk of periodontitis (Löe 1993, Khader et al. 2006), the presence of periodontitis may exert a converse, negative impact upon cardio-metabolic risk status in Type 2 diabetes patients. Periodontal inflammation has been associated with impaired fasting glucose (Choi et al. 2011) and, in Pima Indians, is an independent predictor of mortality from ischaemic heart disease and diabetic nephropathy (Saremi et al. 2005). "
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