title: Effect of nonsurgical periodontal treatment on glycosylated hemoglobin in diabetic patients: a systematic review.
abstract: This review was designed to determine whether non-surgical periodontal treatment is able to reduce serum glycosylated hemoglobin (HbA1c) levels in patients with diabetes mellitus (DM). Several previous reports showed that scaling and root planning (SRP) improve periodontal status in patients with DM, but whether it also improves metabolic control of the disease is unclear. A systematic review was conducted according to the recommendations of the Cochrane Collaboration and PRISMA. A literature search was conducted in October 2012 using three libraries (Cochrane, Web of Knowledge, and Scopus) and the keywords "periodontal disease" and "diabetes mellitus." Only 21 of the articles met the inclusion criteria for this review. A total of 1,454 patients were thus included in this study to evaluate whether periodontal treatment improved serum HbA1c levels. Both the methodological quality and the risk of bias of each study were taken into account using the Jadad scale. Only ten of the included studies had an acceptable-good score of 3-5. Fourteen of the studies reported a significant decrease in serum HbA1c levels (p < 0.05) after periodontal treatment. The remaining seven studies failed to find a significant decrease in serum HbA1c. The findings of this review suggest that the published literature is insufficient and inconclusive to clearly support periodontal treatment as a means to improve serum HbA1c levels in patients with type 1 DM. It also demonstrates the need for homogeneous studies, with larger samples and longer follow-up periods, to properly address this question.
authors: School of Dentistry, Department of Stomatology, University Campus of Bellvitge, University of Barcelona, Pabellón de Gobierno, 2º planta, O8907 L' Hospitalet de Llobregat, Barcelona, Spain. lismauri3@gmail.com.
authors: Elisabet
authors: E
authors: Mauri-Obradors
authors: School of Dentistry, Department of Stomatology, University Campus of Bellvitge, University of Barcelona, Pabellón de Gobierno, 2º planta, O8907 L' Hospitalet de Llobregat, Barcelona, Spain. enjasa19734@gmail.com.
authors: Enric
authors: E
authors: Jané-Salas
authors: School of Dentistry, Department of Stomatology, University Campus of Bellvitge, University of Barcelona, Pabellón de Gobierno, 2º planta, O8907 L' Hospitalet de Llobregat, Barcelona, Spain. marsabater9@gmail.com.
authors: Maria del Mar
authors: Mdel M
authors: Sabater-Recolons
authors: Department Pathology and Experimental Therapeutics, University Campus of Bellvitge, University of Barcelona and IDIBELL, Barcelona, Spain. mvinyas@ub.edu.
authors: Miguel
authors: M
authors: Vinas
authors: School of Dentistry, Department of Stomatology, University Campus of Bellvitge, University of Barcelona, Pabellón de Gobierno, 2º planta, O8907 L' Hospitalet de Llobregat, Barcelona, Spain. jl.lopez@ub.edu.
authors: José
authors: J
authors: López-López
mesh_terms: D055113:Chronic Periodontitis / Q000097:blood* / Q000628:therapy*; D012534:Dental Scaling; D003920:Diabetes Mellitus / Q000097:blood*; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D016745:Root Planing
chemical_list: D006442:Glycated Hemoglobin
keywords: Diabetes mellitus; Glycemic control; Periodontal disease; Periodontal treatment