title: Evidence that periodontal treatment improves diabetes outcomes: a systematic review and meta-analysis.
abstract: BACKGROUND
  The effect of periodontal therapy on diabetes outcomes has not been established.
  
  
  OBJECTIVE
  This update examines the effect of periodontal treatment on diabetes outcomes.
  
  
  METHODS
  Literature since October 2009 using MEDLINE.
  
  
  METHODS
  Published RCTs including periodontal therapy for diabetic subjects, a metabolic outcome, an untreated control group, and follow-up of 3 months.
  
  
  METHODS
  Pre-defined data fields, including study quality indicators were used.
  
  
  RESULTS
  A search revealed 56 publications of which 9 met inclusion criteria. Mean change of HbA1c from baseline was compared across treatment groups. Pooled analysis was based on random effects models.
  
  
  RESULTS
  A meta-analysis indicated a mean treatment effect of -0.36% HbA1c (CI -0.54, -0.19) compared to no treatment after periodontal therapy (p < 0.0001). Heterogeneity tests revealed only minimal evidence of publication bias (I(2 ) = 9%).
  
  
  CONCLUSIONS
  Small sample size and high risk of bias remain problematic for studies of this type. Periodontal therapy varied considerably.
  
  
  CONCLUSIONS
  The modest reduction in HbA1c observed as a result of periodontal therapy in subjects with type 2 diabetes is consistent with previous systematic reviews. Despite this finding, there is limited confidence in the conclusion due to a lack of multi-centre trials of sufficient sample size are lacking.
authors.affiliation: Department of Periodontology and Implant Dentistry, New York University College of Dentistry, New York, NY 10010, USA. spe2002@nyu.edu
authors.forename: Steven
authors.initials: S
authors.lastname: Engebretson
authors.forename: Thomas
authors.initials: T
authors.lastname: Kocher
mesh_terms: D003924:Diabetes Mellitus, Type 2; D006801:Humans