Ata-Ali Fadi, Melo Maria, Cobo Teresa, Nagasawa Magda Aline, Shibli Jamil Awad, Ata-Ali Javier
Department of Surgery and Medical-Surgical Specialities, Area of Orthodontics, University Medical and Dental School, University of Oviedo (Spain), Instituto Asturiano de Odontologia, Oviedo, Spain. E-mail:
Universidad Europea de Valencia, Faculty of Health Sciences. Department of Dentistry, Valencia, Spain; and acultad de Medicina y Odontologia, Universidad de Valencia, Valencia, Spain.
J Int Acad Periodontol. 2020 Oct 1;22(4):205-222.
Periodontal treatment is reported to be associated with an improved periodontal condition in diabetic patients. Therefore, a comprehensive review of meta-analyses was conducted to evaluate whether periodontal treatment can improve glycemic control in patients with type 2 diabetes.
The search on electronic databases included PubMed-Medline, Cochrane Library, Scopus, and LILACS databases. The methodological quality of the systematic reviews was evaluated using AMSTAR, and primary studies were performed in accordance with PRISMA guidelines. The weighted mean difference (WMD) was calculated, nested in a random-effects model with corresponding Z scores, p-values, and 95% confidence intervals.
A total of 11 meta-analyses were included, and a meta-analysis of 11 primary studies comprising a total of 1341 participants was carried out. All the studies evaluated glycosylated hemoglobin (Hb1Ac), and 6 of the 11 publications evaluated fasting plasma glucose (FPG). The AMSTAR scores ranged between 9 and 11, with a median of 10.3. Statistically significant reductions were observed in HbA1c values [-0.32% (3.5 mmol/ mol); 95%CI: -0.50 to -0.15] and FPG values (-11.59 mg/dl; 95%CI: -15.16 to -8.01).
The review of currently available clinical studies concludes that periodontal treatment is associated with improved glycemic control in patients with type 2 diabetes. New guidelines, including periodontal treatment as a routine public health measure to improve glycemic control in diabetic patients, would be of great value.
据报道，牙周治疗与糖尿病患者牙周状况的改善有关。因此，进行了一项荟萃分析的综合评价，以评估牙周治疗是否能改善2型糖尿病患者的血糖控制。
在电子数据库中进行检索，包括PubMed-Medline、Cochrane图书馆、Scopus和LILACS数据库。使用AMSTAR评估系统评价的方法学质量，原始研究按照PRISMA指南进行。计算加权平均差（WMD），纳入随机效应模型，同时给出相应的Z值、p值和95%置信区间。
共纳入11项荟萃分析，并对11项原始研究进行了荟萃分析，共有1341名参与者。所有研究均评估糖化血红蛋白（Hb1Ac），11篇出版物中有6篇评估空腹血糖（FPG）。AMSTAR评分在9至11之间，中位数为10.3。观察到糖化血红蛋白值[-0.32%（3.5 mmol/mol）；95%置信区间：-0.50至-0.15]和空腹血糖值（-11.59 mg/dl；95%置信区间：-15.16至-8.01）有统计学意义的降低。
对现有临床研究的综述得出结论，牙周治疗与2型糖尿病患者血糖控制的改善有关。将牙周治疗作为改善糖尿病患者血糖控制的常规公共卫生措施纳入新指南将具有重要价值。
