title: Effect of overweight/obesity on response to periodontal treatment: systematic review and a meta-analysis.
abstract: OBJECTIVE
  The objective of this study was to investigate whether the response to periodontal treatment differs among obese, overweight or normal-weight patients.
  
  
  METHODS
  Both randomized and non-randomized studies were identified from searches up to July 2013. Risk of bias was assessed with the Downs-Black checklist, the Cochrane tool and the GRADE framework. Quantitative synthesis was conducted with random-effects meta-analyses in subgroups for systemically healthy and diabetic patients.
  
  
  RESULTS
  A total of 15 studies including 867 patients were included. No significant difference was found for any clinical periodontal parameter between overweight/obese and normal-weight patients. Periodontal treatment in systemically healthy overweight/obese patients was associated with higher decrease in TNFα levels (1 study) and higher decrease in HbA1c levels (1 study) compared to systemically healthy normal-weight patients. Contrary to diabetic normal-weight patients, periodontal treatment in diabetic overweight/obese patients was associated with an increase in adiponectin levels (2 studies) and a decrease in leptin levels (2 studies). However, the quality of existing evidence is low due to inconsistency, imprecision and lack of studies.
  
  
  CONCLUSIONS
  Whereas no difference was found in clinical periodontal parameters, significant differences in inflammatory or metabolic parameters were found between overweight/obese and normal-weight patients, but existing evidence is weak.
authors.affiliation: Department of Orthodontics, School of Dentistry, University of Bonn, Bonn, Germany; Department of Oral Technology, School of Dentistry, University of Bonn, Bonn, Germany; Clinical Research Unit 208, University of Bonn, Bonn, Germany.
authors.forename: Spyridon N
authors.initials: SN
authors.lastname: Papageorgiou
authors.forename: Christoph
authors.initials: C
authors.lastname: Reichert
authors.forename: Andreas
authors.initials: A
authors.lastname: Jäger
authors.forename: James
authors.initials: J
authors.lastname: Deschner
mesh_terms: D052242:Adiponectin / Q000032:analysis; D001835:Body Weight / Q000502:physiology*; D048909:Diabetes Complications / Q000378:metabolism; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D020738:Leptin / Q000032:analysis; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D010510:Periodontal Diseases / Q000628:therapy*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
chemical_list: D052242:Adiponectin; D006442:Glycated Hemoglobin; D020738:Leptin; D014409:Tumor Necrosis Factor-alpha
keywords: meta-analysis; obesity; overweight; periodontal disease; periodontal treatment; periodontitis; systematic review