Periodontal status of diabetics compared with nondiabetics: a meta-analysis.
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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ABSTRACT: Evidence suggests that periodontitis is associated with prevalent and incident type 2 diabetes mellitus (T2DM), raising the question of whether periodontitis treatment may improve glycemic control in patients with T2DM. Meta-analyses of mostly small clinical trials suggest that periodontitis treatment results in a modest reduction in glycosylated hemoglobin (Hb) A1c. The purpose of the Diabetes and Periodontal Therapy Trial (DPTT) was to determine if periodontal treatment reduces HbA1c in patients with T2DM and periodontitis. DPTT was a phase-III, single-masked, multi-center, randomized trial with a planned enrollment of 600 participants. Participants were randomly assigned to receive periodontal treatment immediately (Treatment Group) or after 6months (Control Group). HbA1c values and clinical periodontal measures were determined at baseline and 3 and 6months following randomization. Medication usage and dosing were assessed at each visit. Periodontal treatment consisted of scaling and root planing for a minimum of two 90-minute sessions, plus the use of an antibacterial mouth rinse for at least 32days afterwards. The primary outcome was change in HbA1c from baseline to 6months and the trial was powered to detect a between-group difference of 0.6%. Secondary outcomes included changes in periodontal clinical measures, fasting plasma glucose, the Homeostasis Model Assessment (HOMA2) and the need for rescue diabetes or periodontal therapy. Dental and medical researchers collaborated to recruit, treat and monitor participants with two chronic diseases to determine if treatment of one condition affects the status of the other.Contemporary clinical trials 09/2013; 36(2). DOI:10.1016/j.cct.2013.09.010 · 1.99 Impact Factor
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ABSTRACT: To determine the impact of periodontitis on oxidative/inflammatory status and diabetes control in Type 2 diabetes. A comparative study of 20 Type 2 diabetes patients with periodontitis [body mass index (BMI) 31+5], 20-age/gender-matched, non-periodontitis Type 2 diabetes controls (BMI 29+6) and 20 non-diabetes periodontitis controls (BMI 25+4) had periodontal examinations and fasting blood samples collected. Oxidative stress was determined by plasma small molecule antioxidant capacity (pSMAC) and protein carbonyl levels; inflammatory status by total/differential leucocytes, fibrinogen and high sensitivity C-reactive protein (hsCRP); diabetes status by fasting glucose, HbA1c, lipid profile, insulin resistance and secretion. Statistical analysis was performed using SPSS. pSMAC was lower (p=0.03) and protein carbonyls higher (p=0.007) in Type 2 diabetes patients with periodontitis compared with those without periodontitis. Periodontitis was associated with significantly higher HbA1c (p=0.002) and fasting glucose levels (p=0.04) and with lower β-cell function (HOMA-β; p=0.01) in diabetes patients. Periodontitis had little effect on inflammatory markers or lipid profiles, but Type 2 diabetes patients with periodontitis had higher levels of hsCRP than those without diabetes (p=0.004) and the lowest levels of HDL-cholesterol of all groups. Periodontitis is associated with increased oxidative stress and compromised glycaemic control in Type 2 diabetes patients.Journal Of Clinical Periodontology 10/2011; 38(10):894-901. DOI:10.1111/j.1600-051X.2011.01764.x · 3.61 Impact Factor
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ABSTRACT: To investigate the prevalence of oral mucosa alterations in patients with type 2 diabetes and to identify possible risk factors related to oral mucosa alterations. 146 patients with type 2 diabetes and 111 age- and gender-matched healthy controls subjects were consecutively recruited from Araraquara School of Dentistry to answer a structured questionnaire designed to collect demographic data as well as current and former history of diabetes. Clinical examination of the oral mucosa was carried out by a stomatologist. A higher prevalence of oral mucosa alterations was found in patients with diabetes than in patients without diabetes (p<0.001), with significant difference to development conditions (p<0.0001), potentially malignant disorders (p<0.0001) and fungal infections (p<0.05). In the multiple logistic regression, diabetes (odds ratio 9.9 IC 5.11-19.16) and smoking habit (odds ratio 3.17 IC 1.42-7.12) increased the odds of oral mucosa alterations significantly. Patients with diabetes mellitus not only showed an increased prevalence of oral mucosa alterations but also a significant percentage of potentially malignant disorders. These findings elucidate the necessity of regular clinical examination to ensure early diagnosis and prompt management of oral mucosa lesions in patients with diabetes.Diabetes research and clinical practice 02/2011; 92(1):100-5. DOI:10.1016/j.diabres.2011.01.011 · 2.54 Impact Factor