Dataset Information

Long-term effect of non-surgical periodontal treatment on glycaemic control in patients with diabetes with periodontitis: a systematic review and meta-analysis protocol.

ABSTRACT:

Introduction

Non-surgical periodontal therapy consisting of scaling and root planning has been shown to be effective in the improvement of glycaemic control in patients with diabetes with periodontitis for up to 3 months. However, questions remain about this beneficial effect over a longer period of time. This systematic review and meta-analysis aims to determine the long-term effect (at least 6 months from the therapy) of non-surgical periodontal therapy with or without adjuvant on glycaemic control of patients with diabetes with periodontitis.

Methods and analysis

This systematic review will include randomised control trials with a follow-up period of at least 6 months after initial therapy, with measurement of glycated haemoglobin as the primary endpoint. A literature search will be conducted in MEDLINE, CENTRAL, EMBASE, CINAHL, The Cochrane Oral Health Group Trials Register, and the US National Institutes of Health Trials Registry: ClinicalTrials.gov, from inception to 30 June 2020. Selection of studies, data extraction and bias assessment will be conducted independently by two reviewers. A DerSimonian-Laird random-effect meta-analysis will be conducted to pool studies deemed to be homogeneous. A subgroup analysis will be conducted in case of substantial heterogeneity. Egger's test and observation of the funnel plot will be used to assess publication bias. The statistical analysis will be done using R V.4.0.0 software.

Ethics and dissemination

Since primary data are not collected, ethical approval is not required. The final report will be published in a peer-reviewed journal.

Prospero registration number

CRD42020192635.

SUBMITTER: Ndjidda Bakari W

PROVIDER: S-EPMC7903101 | biostudies-literature | 2021 Feb

REPOSITORIES: biostudies-literature

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Publications

Long-term effect of non-surgical periodontal treatment on glycaemic control in patients with diabetes with periodontitis: a systematic review and meta-analysis protocol.

Ndjidda Bakari William W Diallo Ahmad Moustapha AM Danwang Celestin C Nzalie Rolf Nyah Tuku RNT Benoist Henri Michel HM

BMJ open 20210222 2

<h4>Introduction</h4>Non-surgical periodontal therapy consisting of scaling and root planning has been shown to be effective in the improvement of glycaemic control in patients with diabetes with periodontitis for up to 3 months. However, questions remain about this beneficial effect over a longer period of time. This systematic review and meta-analysis aims to determine the long-term effect (at least 6 months from the therapy) of non-surgical periodontal therapy with or without adjuvant on glyc ...[more]

PMID: 33619190

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Project description:BackgroundsTo date, there is still no consensus about the clinical efficacy of non-surgical periodontal therapy in rheumatoid arthritis (RA) patients with periodontitis. Therefore, the aim of this study was to summarize clinical data regarding the efficacy of scaling and root planing (SRP) in patients with RA and periodontitis compared to non-RA periodontitis patients.MethodsWe selected randomized controlled trials (RCTs) that compared periodontal clinical data in RA as compared to non-RA periodontitis patients by searching Embase, PubMed and Cochrane Central Register of Controlled Trials and by manually retrieving from the earliest records to March 8, 2021. The overall effect size of plaque index (PI), gingival index (GI), attachment loss (AL), probing depth (PD) and bleeding on probing (BOP) were calculated by either a fixed or random-effect model, and subgroup analyses were conducted according to the different time points of follow-up. Two investigators extracted the data and assess the accuracy of the obtained results with 95% of Confidence Intervals (CI). Cochrane Collaboration's tool was responsible for the evaluation of the literature quality and the inter-study heterogeneity was evaluated by Q test and I2 statistic. Sensitivity analyses were applied for results with heterogeneity. Publication bias was determined by Begg's test, Egger's test and the trim-and-fill method.ResultsSeven RCTs including 212 patients eventually met the inclusion criteria for the study. As the primary results, the change of PD was not statistically significant and in the secondary results changes of PI, GI, AL and BOP were also not statistically significant in RA patients with periodontitis compared to non-RA periodontitis patients. In subgroup analysis, a larger BOP reduction at 3 months, PI and AL reduction at 6 months were observed in patients with RA and periodontitis group. The results of sensitivity analyses had no significant effect. No evidence of potential publication bias was tested. There were some limitations due to the small number of eligible RCTs.ConclusionsSRP is equally effective in RA as compared to non-RA periodontitis patients. It suggests RA does not affect the clinical efficacy of non-surgical periodontal therapy. These results could serve evidence-based practice.

Project description:AIMS/HYPOTHESIS:We conducted an analysis of data collected during the Veterans Affairs Diabetes Trial (VADT) and the follow-up study (VADT-F) to determine whether intensive (INT) compared with standard (STD) glycaemic control during the VADT resulted in better long-term kidney outcomes. METHODS:VADT randomly assigned 1791 veterans from 20 Veterans Affairs (VA) medical centres who had type 2 diabetes mellitus and a mean HbA1c of 9.4 ± 2% (79.2 mmol/mol) at baseline to receive either INT or STD glucose control for a median of 5.6 years (randomisation December 2000 to May 2003; intervention ending in May 2008). After the trial, participants received routine care through their own physicians within the VA. This is an interim analysis of the VADT-F (June 2008 to December 2013). We collected data using VA and National databases and report renal outcomes based on serum creatinine, eGFR and urine albumin to creatinine ratio (ACR) in 1033 people who provided informed consent to participate in the VADT-F. RESULTS:By the end of the VADT-F, significantly more people who received INT treatment during the VADT maintained an eGFR >60 ml min-1 1.73 m-2 (OR 1.34 [95% CI 1.05, 1.71], p = 0.02). This benefit was most evident in those who were classified as at moderate risk (INT vs STD, RR 1.3, p = 0.03) or high risk (RR 2.3, p = 0.04) of chronic kidney disease on the Kidney Disease Improving Global Outcomes (KDIGO-CKD) at the beginning of VADT. At the end of VADT-F, significantly more people from the INT group improved to a low KDIGO risk category (RR 6.1, p = 0.002). During the VADT-F there were no significant differences between INT and STD for average HbA1c, blood pressure or lipid levels. CONCLUSIONS/INTERPRETATION:After just over 11 years of follow-up, there was a 34% greater odds of maintaining an eGFR of >60 ml min-1 1.73 m-2 and of improving the KDIGO category in individuals with type 2 diabetes who had received INT for a median of 5.6 years. VADT clinical trials.gov number: NCT 00032487.

Project description:BACKGROUND:Non-surgical periodontal therapy (NSPT) known as gold standard treatment in managing periodontitis. The aim of this study was to investigate the response of NSPT in periodontitis subjects who were obese. Clinical parameters of periodontitis, changes in serum resistin and periodontal pathogens in subgingival plaque were compared before and after NSPT in periodontitis subjects who were obese and with normal weight. METHODS:A total of 48 periodontitis subjects (obese, n = 18; normal weight, n = 30) were recruited (hereafter will be referred as participants) to participate into a prospective, before and after clinical trial. Obesity status is defined by body mass index (BMI) criteria (obese: ≥30 kg/ m2; normal weight < 25 kg/m2). Visible Plaque Index (VPI), Gingival Bleeding Index (GBI), Probing Pocket Depth (PPD) and Clinical Attachment Loss (CAL) were recorded; and serum and plaque were collected at baseline and following 12 weeks post-NSPT. Serum resistin level was analyzed using enzyme-linked immune-sorbant assay (ELISA), while detection of periodontal pathogens in dental plaque were carried out using real time PCR (qPCR). RESULTS:Following NSPT, means VPI and GBI showed significant improvement between obese and normal weight groups (p < 0.05), but no difference in means PPD and CAL was observed between groups. Obesity remained as a predictor for VPI and GBI after adjusting for smoking habit. No significant difference was observed in serum resistin level and mean counts for P. gingivalis, T. forsythia, and P. intermedia between obese and normal weight groups following NSPT. CONCLUSIONS:Regardless of obesity status, NSPT has a significant impact on VPI and GBI in periodontitis subjects. However, the impact of NSPT towards serum resistin and periodontal pathogens was non-significant in those with periodontitis. TRIAL REGISTRATION:This study followed the Consolidation Standards of Reporting Trials Statement and retrospectively registered on 26/11/2015 at clinicaltrials.gov (No. NCT02618486).

Dataset Information

Long-term effect of non-surgical periodontal treatment on glycaemic control in patients with diabetes with periodontitis: a systematic review and meta-analysis protocol.

Introduction

Methods and analysis

Ethics and dissemination

Prospero registration number

Publications

Long-term effect of non-surgical periodontal treatment on glycaemic control in patients with diabetes with periodontitis: a systematic review and meta-analysis protocol.

Similar Datasets

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