Sáenz-Ravello Gustavo, Castillo-Riquelme Marianela, Cuadrado Cristóbal, Gamonal Jorge, Baeza Mauricio
Center for Surveillance and Epidemiology of Oral Diseases, Faculty of Dentistry, University of Chile, Santiago, Chile.
Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile.
Community Dent Oral Epidemiol. 2025 Apr;53(2):135-151. doi: 10.1111/cdoe.12999. Epub 2024 Aug 16.
To assess the efficiency of periodontal treatment (PT) in improving diabetes-related outcomes in adults with type 2 diabetes mellitus (T2DM) and periodontitis, providing an updated and comprehensive synthesis from economic evaluations (EE).
Seven databases and one register were independently searched by two reviewers for articles published up to 8 May 2024. Studies that assessed the efficiency of PT versus no treatment or other dental treatments were included. Risk of bias was assessed using the Cochrane RoB 2, ROBINS-I and ECOBIAS tools for the first stage of EE and the CHEERS checklist and NICE quality appraisal tool for overall EE. Qualitative and quantitative syntheses of the articles were conducted and assessed using the GRADE approach.
Eleven studies were included. PT reduces total healthcare costs, including inpatient and outpatient, diabetes-related costs and other drug costs (low to moderate certainty). A total incremental net benefit of USD 12 348 (2022 currency, 95% CI 12 195-12 500) was estimated from three high-quality model-based cost-utility analyses (high certainty).
The inclusion of PT in the comprehensive treatment of patients with T2DM and periodontitis is cost-effective. Future research is required to ensure the transferability of these findings and inform decision makers from different countries.
PROSPERO CRD42023443146.
评估牙周治疗（PT）对改善2型糖尿病（T2DM）合并牙周炎成人患者糖尿病相关结局的有效性，通过经济评估（EE）提供最新的综合分析。
两名研究者独立检索了7个数据库和1个注册库，以查找截至2024年5月8日发表的文章。纳入评估PT与未治疗或其他牙科治疗相比有效性的研究。在EE的第一阶段，使用Cochrane RoB 2、ROBINS-I和ECOBIAS工具评估偏倚风险；对于整体EE，使用CHEERS清单和NICE质量评估工具。使用GRADE方法对文章进行定性和定量综合分析及评估。
纳入11项研究。牙周治疗可降低总医疗成本，包括住院和门诊、糖尿病相关成本及其他药物成本（低至中等确定性）。从三项高质量的基于模型的成本效用分析中估计出总增量净效益为12348美元（2022年货币，95%CI 12195-12500）（高确定性）。
将牙周治疗纳入T2DM合并牙周炎患者的综合治疗具有成本效益。需要进一步研究以确保这些结果的可转移性，并为不同国家的决策者提供信息。
PROSPERO CRD42023443146
