title: Progression of periodontitis and tooth loss associated with glycemic control in individuals undergoing periodontal maintenance therapy: a 5-year follow-up study.
abstract: BACKGROUND
  Prospective studies that investigated the influence of glycemic control in the progression of periodontitis and tooth loss during periodontal maintenance therapy (PMT) programs have not previously been reported. The aim of the present study is to evaluate associations between glycemic control status and progression of periodontitis and tooth loss among individuals during PMT.
  
  
  METHODS
  A total of 92 individuals, all recruited from a prospective cohort with 238 participants undergoing PMT, participated in this study. Diabetes control was assessed according to percentage of glycated hemoglobin (HbA1c). Individuals were matched for sex and smoking and were divided into three groups: 23 individuals with diabetes and poor glycemic control (PGC), 23 individuals with diabetes and good glycemic control (GGC), and 46 controls with no diabetes (NDC). Full-mouth periodontal examination, including bleeding on probing (BOP), probing depth (PD), and clinical attachment level, was performed at all PMT visits during a 5-year interval.
  
  
  RESULTS
  Progression of periodontitis and tooth loss were significantly higher among PGC compared to GGC and NDC. The final logistic model in the final examination included: 1) for the progression of periodontitis, HbA1c ≥6.5% (odds ratio [OR] = 2.9), smoking (OR = 3.7), and BOP in >30% of sites (OR = 4.1); and 2) for tooth loss, HbA1c ≥6.5% (OR = 3.1), smoking (OR = 4.1), and PD 4 to 6 mm in ≤10% of sites (OR = 3.3).
  
  
  CONCLUSIONS
  PGC individuals, especially smokers, presented with a higher progression of periodontitis and tooth loss compared to NDC and GGC individuals. This result highlights the influence of glycemic control in maintaining a good periodontal status.
authors: Department of Periodontology, Federal University of Minas Gerais, Belo Horizonte, Brazil.
authors: Fernando Oliveira
authors: FO
authors: Costa
authors: Luís Otávio
authors: LO
authors: Miranda Cota
authors: Eugênio José
authors: EJ
authors: Pereira Lages
authors: Alcione Maria
authors: AM
authors: Soares Dutra Oliveira
authors: Peterson Antônio
authors: PA
authors: Dutra Oliveira
authors: Renata Magalhães
authors: RM
authors: Cyrino
authors: Telma Campos
authors: TC
authors: Medeiros Lorentz
authors: Sheila Cavalca
authors: SC
authors: Cortelli
authors: José Roberto
authors: JR
authors: Cortelli
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001786:Blood Glucose / Q000378:metabolism; D016022:Case-Control Studies; D012534:Dental Scaling; D048909:Diabetes Complications / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000378:metabolism*; D018450:Disease Progression; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010518:Periodontitis / Q000150:complications / Q000378:metabolism* / Q000473:pathology* / Q000517:prevention & control; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects; D016388:Tooth Loss / Q000209:etiology; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin