title: Effectiveness of periodontal treatment to improve metabolic control in patients with chronic periodontitis and type 2 diabetes: a meta-analysis of randomized clinical trials.
abstract: BACKGROUND
  It was recently suggested that scaling and root planing (SRP) may help to improve glycemic and metabolic control in patients with chronic periodontitis (CP) and type 2 diabetes mellitus (DM2); however, the effectiveness of SRP in this role remains unclear. This meta-analysis assesses the effectiveness of SRP in improving glycemic and metabolic control in patients with CP and DM2.
  
  
  METHODS
  A literature search of electronic databases was performed for articles published through May 16, 2012, followed by a manual search of several dental journals. A meta-analysis was conducted according to the recommendations of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Weighted mean differences (MDs) and 95% confidence intervals (CIs) were calculated for glycated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), total cholesterol (TC), triglycerides (TG), and high- and low-density lipoprotein cholesterol (HDL and LDL, respectively). All outcomes were evaluated as changes from baseline to the end of follow-up. Heterogeneity was assessed with the χ(2)-based Cochran Q test and I(2) statistic. The level of significance was set at P <0.05.
  
  
  RESULTS
  After the study selection process, five randomized clinical trials were included. Results of the meta-analysis indicated that SRP was effective in the reduction of HbA1c (MD = 0.65; 95% CI 0.43 to 0.88; P <0.05) and FPG (MD = 9.04; 95% CI 2.17 to 15.9; P <0.05), but no significant differences were found in the reduction of TC, TG, HDL, or LDL. No evidence of heterogeneity was detected.
  
  
  CONCLUSIONS
  The meta-analysis results seem to support the effectiveness of SRP in the improvement of glycemic control in patients with CP and DM2; however, future studies are needed to confirm these results.
authors.affiliation: Department of Health Sciences, School of Dentistry, University of L'Aquila, L'Aquila, Italy. fabrizio.sgolastra@gmail.com
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Sgolastra
authors.forename: Marco
authors.initials: M
authors.lastname: Severino
authors.forename: Davide
authors.initials: D
authors.lastname: Pietropaoli
authors.forename: Roberto
authors.initials: R
authors.lastname: Gatto
authors.forename: Annalisa
authors.initials: A
authors.lastname: Monaco
mesh_terms: D015982:Bias; D001786:Blood Glucose / Q000032:analysis; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D055113:Chronic Periodontitis / Q000628:therapy*; D003777:Dental Prophylaxis / Q000379:methods; D012534:Dental Scaling / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000517:prevention & control*; D005215:Fasting / Q000097:blood; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D016745:Root Planing / Q000379:methods; D014280:Triglycerides / Q000097:blood
chemical_list: D001786:Blood Glucose; D002784:Cholesterol; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D014280:Triglycerides