Effect of non-surgical periodontal treatment on HbA1c: a meta-analysis of randomized controlled trials
Address for correspondence:
Dr Amy Liew Kia Cheen
Faculty of Dentistry
Universiti Kebangsaan Malaysia
Jalan Raja Muda Abdul Aziz
50300 Kuala Lumpur
A meta-analysis of randomized clinical trials (RCTs) was conducted to evaluate whether non-surgical periodontal treatment can reduce the HbA1c% level in type 2 diabetic patients.
Recent accumulation of RCTs necessitates updating of the findings of previous reviews.
A search of the literature on English publications was conducted in Cochrane CENTRAL, Medline and EMBASE (until 31 March 2012). An RCT was selected if the study population was type 2 diabetic patients (≥16 years old) diagnosed with periodontitis, and compared HbA1c% change with or without non-surgical periodontal treatment for at least three months of the study duration. Weighted mean differences for pooled data and antibiotic use strata were calculated. Heterogeneity and publication bias were explored.
A total of 358 articles were identified but only six were suitable. Compared to the control group, the pooled analysis (n = 422) showed −0.41% (95% CI: −0.73% to −0.09%, p = 0.013) absolute difference in HbA1c% with treatment. Studies without adjunctive antibiotic had HbA1c% change of −0.64% (95% CI: −1.06% to −0.23%, p = 0.002), but we could not conclude on the effect of adjunctive antibiotic use (p = 0.734). Publication bias was significant with Egger's test (p = 0.014) but not with Begg's test (p = 0.06).
The meta-analysis suggested that non-surgical periodontal treatment was associated with a reduction in HbA1c%.