Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Apr 14;4(4):CD004714.
doi: 10.1002/14651858.CD004714.pub4.

Treatment of periodontitis for glycaemic control in people with diabetes mellitus

Terry C Simpson  1 , Janet E Clarkson  2   3 , Helen V Worthington  3 , Laura MacDonald  3 , Jo C Weldon  4 , Ian Needleman  5 , Zipporah Iheozor-Ejiofor  6 , Sarah H Wild  7 , Ambrina Qureshi  8 , Andrew Walker  9 , Veena A Patel  10 , Dwayne Boyers  11 , Joshua Twigg  12
Affiliations

Treatment of periodontitis for glycaemic control in people with diabetes mellitus

Terry C Simpson et al. Cochrane Database Syst Rev. .

Abstract

Background: Glycaemic control is a key component in diabetes mellitus (diabetes) management. Periodontitis is the inflammation and destruction of the underlying supporting tissues of the teeth. Some studies have suggested a bidirectional relationship between glycaemic control and periodontitis. Treatment for periodontitis involves subgingival instrumentation, which is the professional removal of plaque, calculus, and debris from below the gumline using hand or ultrasonic instruments. This is known variously as scaling and root planing, mechanical debridement, or non-surgical periodontal treatment. Subgingival instrumentation is sometimes accompanied by local or systemic antimicrobials, and occasionally by surgical intervention to cut away gum tissue when periodontitis is severe. This review is part one of an update of a review published in 2010 and first updated in 2015, and evaluates periodontal treatment versus no intervention or usual care. OBJECTIVES: To investigate the effects of periodontal treatment on glycaemic control in people with diabetes mellitus and periodontitis.

Search methods: An information specialist searched six bibliographic databases up to 7 September 2021 and additional search methods were used to identify published, unpublished, and ongoing studies. SELECTION CRITERIA: We searched for randomised controlled trials (RCTs) of people with type 1 or type 2 diabetes mellitus and a diagnosis of periodontitis that compared subgingival instrumentation (sometimes with surgical treatment or adjunctive antimicrobial therapy or both) to no active intervention or 'usual care' (oral hygiene instruction, education or support interventions, and/or supragingival scaling (also known as PMPR, professional mechanical plaque removal)). To be included, the RCTs had to have lasted at least 3 months and have measured HbA1c (glycated haemoglobin).

Data collection and analysis: At least two review authors independently examined the titles and abstracts retrieved by the search, selected the included trials, extracted data from included trials, and assessed included trials for risk of bias. Where necessary and possible, we attempted to contact study authors. Our primary outcome was blood glucose levels measured as glycated (glycosylated) haemoglobin assay (HbA1c), which can be reported as a percentage of total haemoglobin or as millimoles per mole (mmol/mol). Our secondary outcomes included adverse effects, periodontal indices (bleeding on probing, clinical attachment level, gingival index, plaque index, and probing pocket depth), quality of life, cost implications, and diabetic complications.

Main results: We included 35 studies, which randomised 3249 participants to periodontal treatment or control. All studies used a parallel-RCT design and followed up participants for between 3 and 12 months. The studies focused on people with type 2 diabetes, other than one study that included participants with type 1 or type 2 diabetes. Most studies were mixed in terms of whether metabolic control of participants at baseline was good, fair, or poor. Most studies were carried out in secondary care. We assessed two studies as being at low risk of bias, 14 studies at high risk of bias, and the risk of bias in 19 studies was unclear. We undertook a sensitivity analysis for our primary outcome based on studies at low risk of bias and this supported the main findings. Moderate-certainty evidence from 30 studies (2443 analysed participants) showed an absolute reduction in HbA1c of 0.43% (4.7 mmol/mol) 3 to 4 months after treatment of periodontitis (95% confidence interval (CI) -0.59% to -0.28%; -6.4 mmol/mol to -3.0 mmol/mol). Similarly, after 6 months, we found an absolute reduction in HbA1c of 0.30% (3.3 mmol/mol) (95% CI -0.52% to -0.08%; -5.7 mmol/mol to -0.9 mmol/mol; 12 studies, 1457 participants), and after 12 months, an absolute reduction of 0.50% (5.4 mmol/mol) (95% CI -0.55% to -0.45%; -6.0 mmol/mol to -4.9 mmol/mol; 1 study, 264 participants). Studies that measured adverse effects generally reported that no or only mild harms occurred, and any serious adverse events were similar in intervention and control arms. However, adverse effects of periodontal treatments were not evaluated in most studies.

Authors' conclusions: Our 2022 update of this review has doubled the number of included studies and participants, which has led to a change in our conclusions about the primary outcome of glycaemic control and in our level of certainty in this conclusion. We now have moderate-certainty evidence that periodontal treatment using subgingival instrumentation improves glycaemic control in people with both periodontitis and diabetes by a clinically significant amount when compared to no treatment or usual care. Further trials evaluating periodontal treatment versus no treatment/usual care are unlikely to change the overall conclusion reached in this review.

PubMed Disclaimer

Conflict of interest statement

  1. Terry C Simpson: none known.

  2. Janet E Clarkson: none known. I am joint Co‐ordinating Editor of Cochrane Oral Health and Director of the Scottish Dental Clinical Effectiveness Programme. I was not involved in conducting the editorial process for the review.

  3. Helen V Worthington: none known. I am an Editor with Cochrane Oral Health, and was previously Co‐ordinating Editor. I was not involved in conducting the editorial process for the review.

  4. Laura MacDonald: none known. I am a Managing Editor with Cocrane Oral Health. I was not involved in conducting the editorial process for the review.

  5. Jo C Weldon: none known. I was previously a salaried member of staff with Cochrane Oral Health.

  6. Ian Needleman: I am involved in research investigating the patient perspective on the periodontitis‐diabetes link. I am also a project member with NHS England regarding the commissioning standard guideline for oral health care in people with diabetes as well as clinical practice guideline groups for periodontal health with the European Federation of Periodontology and British Society of Periodontology. I lead the British Society of Periodontology Patient Forum and am an advisory group member of the UCL Centre for Co‐Production in Health Research. I have received funding for research and consultancy from oral healthcare industry (GlaxoSmithKline, Procter and Gamble, BrickBuilt Technologies) not related to the topic of this systematic review. I am an Editor with Cochrane Oral Health. I was not involved in conducting the editorial process for the review.

  7. Sarah H Wild: I received an honorarium paid into my research account from Gilead for attending an advisory board on the epidemiology of non‐alcoholic fatty liver disease in January 2020, and I attend meetings of the Scottish Study Group for Diabetes in the Young for which registration/accommodation/subsistence are subsidised by an unrestricted educational grant from Novo Nordisk.

  8. Zipporah Iheozor‐Ejiofor: none known. I am an Editor with Cochrane Oral Health and was previously a salaried member of staff. I was not involved in conducting the editorial process for the review.

  9. Ambrina Qureshi: I was principal investigator for a study included in the review, which was funded by the National Research Program for Universities, Higher Education Commission, Islamabad, Pakistan.

  10. Andrew Walker: none known.

  11. Veena A Patel: none known.

  12. Dwayne Boyers: none known.

  13. Joshua Twigg: none known.

Figures

1
1
Study selection process.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
3
3
Forest plot of comparison: 1 Periodontal treatment versus no active intervention/usual care, outcome: 1.1 HbA1c at 3‐4 months.
4
4
Funnel plot of comparison: 1 Periodontal therapy versus no active intervention/usual care, outcome: 1.1 HbA1c at 3‐4 months.
5
5
Forest plot of comparison: 1 Periodontal treatment versus no active intervention/usual care, outcome: 1.2 HbA1c at 6 months.
6
6
Forest plot of comparison: 1 Periodontal treatment versus no active intervention/usual care, outcome: 1.3 HbA1c at 12 months.
1.1
1.1. Analysis
Comparison 1: Periodontal treatment versus no active intervention/usual care, Outcome 1: HbA1c at 3‐4 months
1.2
1.2. Analysis
Comparison 1: Periodontal treatment versus no active intervention/usual care, Outcome 2: HbA1c at 6 months
1.3
1.3. Analysis
Comparison 1: Periodontal treatment versus no active intervention/usual care, Outcome 3: HbA1c at 12 months
1.4
1.4. Analysis
Comparison 1: Periodontal treatment versus no active intervention/usual care, Outcome 4: CAL at 3‐4 months
1.5
1.5. Analysis
Comparison 1: Periodontal treatment versus no active intervention/usual care, Outcome 5: CAL at 6 months
1.6
1.6. Analysis
Comparison 1: Periodontal treatment versus no active intervention/usual care, Outcome 6: PPD at 3‐4 months
1.7
1.7. Analysis
Comparison 1: Periodontal treatment versus no active intervention/usual care, Outcome 7: PPD at 6 months
1.8
1.8. Analysis
Comparison 1: Periodontal treatment versus no active intervention/usual care, Outcome 8: PPD at 12 months
1.9
1.9. Analysis
Comparison 1: Periodontal treatment versus no active intervention/usual care, Outcome 9: BOP at 3‐4 months
1.10
1.10. Analysis
Comparison 1: Periodontal treatment versus no active intervention/usual care, Outcome 10: BOP at 6 months
1.11
1.11. Analysis
Comparison 1: Periodontal treatment versus no active intervention/usual care, Outcome 11: PI at 3‐4 months
1.12
1.12. Analysis
Comparison 1: Periodontal treatment versus no active intervention/usual care, Outcome 12: PI at 6 months
1.13
1.13. Analysis
Comparison 1: Periodontal treatment versus no active intervention/usual care, Outcome 13: PI at 12 months
1.14
1.14. Analysis
Comparison 1: Periodontal treatment versus no active intervention/usual care, Outcome 14: GI at 3‐4 months
1.15
1.15. Analysis
Comparison 1: Periodontal treatment versus no active intervention/usual care, Outcome 15: GI at 6 months
1.16
1.16. Analysis
Comparison 1: Periodontal treatment versus no active intervention/usual care, Outcome 16: GI at 12 months
See this image and copyright information in PMC

Update of

Comment in

References

References to studies included in this review

Artese 2015 {published data only}
    1. Artese HPC, Longo PL, Gomes GH, Mayer MPA, Romito GA.Supragingival biofilm control and systemic inflammation in patients with type 2 diabetes mellitus. Brazilian Oral Research (online) 2015;29(1):1-7. - PubMed
Bukleta 2018 {published data only}
    1. Bukleta D, Krasniqi S, Beretta G, Daci A, Nila A, Komoni T, et al.Impact of combined non-surgical and surgical periodontal treatment in patients with type 2 diabetes mellitus - a preliminary report randomized clinical study. Biomedical Research 2018;29(3):633-9. [PMID: ISSN 0790-938X]
    1. Daci A.Re: Fw: COHG_0091_contact with authors [personal communication]. Email to: TC Simpson 13 September 2021.
    1. NCT02874963.FM-SRP and tooth extraction improve type 2 diabetes mellitus in periodontitis. clinicaltrials.gov/ct2/show/NCT02874963 (first received 22 August 2016).
Calbacho 2004 {published and unpublished data}
    1. Calbacho V, Carrasco E, Wilckens M, Barboza P, Grant C, Aguirre M, et al.Evaluation of influence of conventional therapy in diabetics type 2. Journal of Dental Research 2004;84(Spec Issue B Chilean section):65739.
Chen 2012 {published data only}
    1. Chen L, Luo G, Xuan D, Wei B, Liu F, Li J, et al.Effects of non-surgical periodontal treatment on clinical response, serum inflammatory parameters, and metabolic control in patients with type 2 diabetes: a randomized study. Journal of Periodontology 2012;83(4):435-43. - PubMed
    1. Chen L, Wei B, Li J, Liu F, Xuan D, Xie B, et al.Association of periodontal parameters with metabolic level and systemic inflammatory markers in patients with type 2 diabetes. Journal of Periodontology 2010;81(3):364-71. - PubMed
D'Aiuto 2018 {published data only}
    1. Correction to Lancet Diabetes Endocrinol 2018; 6: 954-65. Lancet Diabetes Endocrinol. 2019 Mar;7(3):e3. doi: 10.1016/S2213-8587(19)30036-1. Erratum for: Lancet Diabetes Endocrinol. 2018 Dec;6(12):954-65. PMID: 30782470. Lancet Diabetes & Endocrinology. - PubMed
    1. D'Aiuto F, Gkranias N, Bhowruth D, Khan T, Orlandi M, Suvan J, et al.Systemic effects of periodontitis treatment in patients with type 2 diabetes: a 12 month, single-centre, investigator-masked, randomised trial. Lancet Diabetes & Endocrinology 2018;6(12):954-65. [DOI: 10.1016/S2213-8587(18)30038-X] - DOI - PubMed
    1. ISRCTN83229304.Periodontitis and type 2 diabetes mellitus. www.isrctn.com/ISRCTN83229304 (first received 18 June 2010).
    1. Masi S, Orlandi M, Parkar M, Bhowruth D, Kingston I, O'Rourke C, et al.Mitochondrial oxidative stress, endothelial function and metabolic control in patients with type II diabetes and periodontitis: a randomised controlled clinical trial. International Journal of Cardiology 2018;271:263-8. - PMC - PubMed
Das 2019 {published data only}
    1. Das AC, Das SJ, Panda S, Sharma D, Taschieri S, Fabbro MD.Adjunctive effect of doxycycline with conventional periodontal therapy on glycemic level for chronic periodontitis with type 2 diabetes mellitus subjects. Journal of Contempory Dental Practice 2019;20(12):1417-23. [PMID: ] - PubMed
El‐Makaky 2020 {published data only}
    1. El-Makaky Y.The effects of non-surgical periodontal therapy on glycemic control in diabetic patients: a randomized controlled trial. Oral Diseases 2020;26(4):822-9. [DOI: 10.1111/odi.13256] - DOI - PubMed
Engebretson 2013 {published data only}
    1. Engebretson S, Gelato M, Hyman L, Michalowicz BS, Schoenfeld E.Design features of the Diabetes and Periodontal Therapy Trial (DPTT): a multicenter randomized single-masked clinical trial testing the effect of nonsurgical periodontal therapy on glycosylated hemoglobin (HbA1c) levels in subjects with type 2 diabetes and chronic periodontitis. Contemporary Clinical Trials 2013;36(2):515-26. - PMC - PubMed
    1. Engebretson S, Michaelowicz B, Seaquist ER, Reddy M, Lewis CE, Oates T, et al.The Diabetes and Periodontal Therapy Trial (DPTT). Journal of Dental Research 2012;91(Suppl A (AADR 41st Annual Meeting; Tampa, Florida)):Abstract No 568.
    1. Engebretson SP, Hyman LG, Michalowicz BS, Schoenfeld ER, Gelato MC, Hou W, et al.The effect of nonsurgical periodontal therapy on hemoglobin A1c levels in persons with type 2 diabetes and chronic periodontitis: a randomized clinical trial. JAMA 2013;310(23):2523-32. - PMC - PubMed
    1. Geisinger ML, Michalowicz BS, Hou W, Schoenfeld E, Gelato M, Engebretson SP, et al.Systemic inflammatory biomarkers and their association with periodontal and diabetes-related factors in the diabetes and periodontal therapy trial, a randomized controlled trial. Journal of Periodontology 2016;87(8):900-13. [DOI: 10.1902/jop.2016.150727] [PMID: ] - DOI - PubMed
    1. Michalowicz BS, Hyman L, Hou W, Oates TW Jr, Reddy M, Paquette DW, et al.Factors associated with the clinical response to nonsurgical periodontal therapy in people with type 2 diabetes mellitus. Journal of the American Dental Association 2014;145(12):1227-39. - PubMed
Felipe 2015 {published data only}
    1. Felipe MEMC.Effect of non-surgical periodontal treatment on glycemic control, inflammatory mediators and adipokines in patients with type 2 diabetes and severe chronic periodontitis [Thesis] [Efeito do tratamento periodontal não-cirúrgico sobre o controle glicêmico, mediadores inflamatórios e adipocinas em pacientes com diabetes mellitus tipo 2 e periodontite crônica severa ]. pesquisa.bvsalud.org/portal/resource/pt/biblio-910208 (accessed 1 September 2021).
Gay 2014 {published data only}
    1. Gay IC, Tran DT, Cavender AC, Weltman R, Chang J, Luckenbach E, et al.The effect of periodontal therapy on glycaemic control in a Hispanic population with type 2 diabetes: a randomized controlled trial. Journal of Clinical Periodontology 2014;41(7):673-80. - PMC - PubMed
    1. NCT01128374.The effect of non-surgical periodontal therapy on glycemic control and bacterial levels in a Mexican-American population with type 2 diabetes. clinicaltrials.gov/ct2/show/NCT01128374 (first received 21 May 2010).
Jones 2007 {published and unpublished data}
    1. Jones JA, Miller DR, Wehler CJ, Rich S, Krall E, Christiansen CL, et al.Study design, recruitment, and baseline characteristics: the Department of Veterans Affairs Dental Diabetes Study. Journal of Clinical Periodontology 2007;34(1):40-5. [PMID: ] - PubMed
    1. Jones JA, Miller DR, Wehler CJ, Rich SE, Krall-Kaye EA, McCoy LC, et al.Does periodontal care improve glycemic control? The Department of Veterans Affairs Dental Diabetes Study. Journal of Clinical Periodontology 2007;34(1):46-52. - PubMed
    1. McCoy LC, Wehler CJ, Rich SE, Garcia RI, Miller DR, Jones JA.Adverse events associated with chlorhexidine use: results from the Department of Veterans Affairs Dental Diabetes Study. Journal of the American Dental Association 2008;139(2):178-83. [PMID: ] - PubMed
Kapellas 2017 {published data only}
    1. Kapellas K, Mejia G, Bartold PM, Skilton MR, Maple-Brown LJ, Slade GD, et al.Periodontal therapy and glycaemic control among individuals with type 2 diabetes: reflections from the PerioCardio study. International Journal of Dental Hygiene 2017;15(4):e42-e51. [DOI: 10.1111/idh.12234] [PMID: ] - DOI - PubMed
Katagiri 2009 {published and unpublished data}
    1. Katagiri S, Nitta H, Nagasawa T, Uchimura I, Izumiyama H, Inagaki K, et al.Multi-center intervention study on glycohemoglobin (HbA1c) and serum, high-sensitivity CRP (hs-CRP) after local anti-infectious periodontal treatment in type 2 diabetic patients with periodontal disease. Diabetes Research and Clinical Practice 2009;83(3):308-15. - PubMed
Kaur 2015 {published data only}
    1. Kaur Khanuja P.Reply to queries [personal communication]. Email to: TC Simpson 15 September 2021.
    1. Kaur PK, Narula SC, Rajput R, K Sharma R, Tewari S.Periodontal and glycemic effects of nonsurgical periodontal therapy in patients with type 2 diabetes stratified by baseline HbA1c. Journal of Oral Science 2015;57(3):201-11. [DOI: 10.2334/josnusd.57.201] [PMID: ] - DOI - PubMed
Kiran 2005 {published and unpublished data}
    1. Kiran M, Arpak N, Unsal E, Erdogan MF.The effect of improved periodontal health on metabolic control in type 2 diabetes mellitus. Journal of Clinical Periodontology 2005;32(3):266-72. - PubMed
Koromantzos 2011 {published and unpublished data}
    1. Koromantzos PA, Makrilakis K, Dereka X, Katsilambros N, Vrotsos IA, Madianos PN.A randomized, controlled trial on the effect of non-surgical periodontal therapy in patients with type 2 diabetes. Part I: effect on periodontal status and glycaemic control. Journal of Clinical Periodontology 2011;38(2):142-7. - PubMed
    1. Koromantzos PA, Makrilakis K, Dereka X, Offenbacher S, Katsilambros N, Vrotsos IA, et al.Effect of non-surgical periodontal therapy on C-reactive protein, oxidative stress, and matrix metalloproteinase (MMP)-9 and MMP-2 levels in patients with type 2 diabetes: a randomized controlled study. Journal of Periodontology 2012;83(1):3-10. - PubMed
Kothiwale 2013 {published and unpublished data}
    1. Kothiwale SV, Kothiwale VA, Bhargava PV.Effect of non-invasive periodontal therapy on glycaemic control in type 2 diabetes mellitus patients - a randomized control trial. Diabetes 2013;62(Suppl 1):Abstract No A229.
Lee 2020 {published data only}
    1. Lee JY, Choi YY, Choi Y, Jin BH.Efficacy of non-surgical treatment accompanied by professional toothbrushing in the treatment of chronic periodontitis in patients with type 2 diabetes mellitus: a randomized controlled clinical trial. Journal of Periodontal Implant Science 2020;50(2):83-96. [DOI: 10.5051/jpis.2020.50.2.83] [PMID: ] - DOI - PMC - PubMed
Li 2011 {published data only}
    1. Li Z, Sha YQ, Zhang BX, Zhu L, Kang J.[Effect of community periodontal care intervention on periodontal health and glycemic control in type 2 diabetic patients with chronic periodontitis]. [Chinese]. Beijing da Xue Xue Bao (Yi Xue Ban/Journal of Peking University. Health Sciences) 2011;43(2):285-9. - PubMed
Mauri‐Obradors 2018 {published data only}
    1. Mauri E, López J.FW: COHG 0091_contact with authors [personal communication]. Email to: T Simpson 30 September 2021.
    1. Mauri-Obradors E, Merlos A, Estrugo-Devesa A, Jané-Salas E, López-López J, Viñas M.Benefits of non-surgical periodontal treatment in patients with type 2 diabetes mellitus and chronic periodontitis: a randomized controlled trial. Journal of Clinical Periodontology 2018;45(3):345-53. [DOI: 10.1111/jcpe.12858] [PMID: ] - DOI - PubMed
Mizuno 2017 {published data only}
    1. Mizuno H, Ekuni D, Maruyama T, Kataoka K, Yoneda T, Fukuhara D, et al.The effects of non-surgical periodontal treatment on glycemic control, oxidative stress balance and quality of life in patients with type 2 diabetes: a randomized clinical trial. PLOS One 2017;12(11):e0188171. [DOI: 10.1371/journal.pone.0188171] [PMCID: PMC5689834] [PMID: ] - DOI - PMC - PubMed
Moeintaghavi 2012 {published data only}
    1. Moeintaghavi A, Arab HR, Bozorgnia Y, Kianoush K, Alizadeh M.Non-surgical periodontal therapy affects metabolic control in diabetics: a randomized controlled clinical trial. Australian Dental Journal 2012;57(1):31-7. - PubMed
    1. NCT01252082.Non-surgical periodontal therapy effects [sic] metabolic control in diabetics. clinicaltrials.gov/ct2/show/NCT01252082 (first received 2 December 2010).
Qureshi 2021 {published data only}
    1. NCT03343366.Glycemic control in T2DM through non-surgical periodontal therapy. clinicaltrials.gov/ct2/show/NCT03343366 (first received 17 November 2017).
    1. Qureshi A, Bokhari SAH, Haque Z, Baloch AA, Zaheer S.Clinical efficacy of scaling and root planing with and without metronidazole on glycemic control: three-arm randomized controlled trial. BMC Oral Health 2021;21:253. [DOI: 10.1186/s12903-021-01620-1] - DOI - PMC - PubMed
Raman 2014 {published data only}
    1. NCT01951547 .The periodontal disease and diabetes mellitus interrelationship among adult Malaysians. clinicaltrials.gov/ct2/show/NCT01951547 (first received 26 September 2013).
    1. Raman RP, Taiyeb-Ali TB, Chan SP, Chinna K, Vaithilingam RD.Effect of nonsurgical periodontal therapy versus oral hygiene instructions on Type 2 diabetes subjects with chronic periodontitis: a randomised clinical trial. BMC Oral Health 2014;14(1):2-19. - PMC - PubMed
Rapone 2021 {published data only}
    1. Rapone B, Ferrara E, Corsalini M, Qorri E, Converti I, Lorusso F, et al.Inflammatory status and glycemic control level of patients with type 2 diabetes and periodontitis: a randomized clinical trial. International Journal of Environmental Research and Public Health 2021;18(6):3018. [DOI: 10.3390/ijerph18063018] [PMID: ] - DOI - PMC - PubMed
Rodrigues 2015 {published data only}
    1. Rodrigues RMJ.Effect of periodontal therapy on serum osteocalcin levels in patients with type 2 diabetes and severe chronic periodontitis [Thesis] [Efeito do tratamento periodontal nos niveis de osteocalcina serica em pacientes com diabetes tipo 2 e periodontite cronica severa]. www.bdtd.uerj.br:8443/bitstream/1/14058/1/TESE_FINAL_ROSA_MARIA_JARDIM_R... (accessed 6 September 2021).
Singh 2008 {published data only}
    1. Singh S, Kumar V, Kumar S, Subbappa A.The effect of periodontal therapy on the improvement of glycaemic control in patients with type 2 diabetes mellitus: a randomized controlled clinical trial. International Journal of Diabetes in Developing Countries 2008;28(2):38-44. - PMC - PubMed
Sun 2011 {published data only}
    1. Sun WL, Chen LL, Zhang SZ, Wu YM, Ren YZ, Qin GM.Inflammatory cytokines, adiponectin, insulin resistance and metabolic control after periodontal intervention in patients with type 2 diabetes and chronic periodontitis. Internal Medicine 2011;50(15):1569-74. - PubMed
Telgi 2013 {published data only}
    1. Telgi RL, Tandon V, Tangade PS, Tirth A, Kumar S, Yadav V.Efficacy of nonsurgical periodontal therapy on glycaemic control in type II diabetic patients: a randomized controlled clinical trial. Journal of Periodontal & Implant Science 2013;43(4):177-82. [DOI: 10.5051/jpis.2013.43.4.177] - DOI - PMC - PubMed
Tsobgny‐Tsague 2018 {published data only}
    1. Tsobgny-Tsague NF, Lontchi-Yimagou E, Nana ARN, Tankeu AT, Katte JC, Dehayem MY, et al.Effects of nonsurgical periodontal treatment on glycated haemoglobin on type 2 diabetes patients (PARODIA 1 study): a randomized controlled trial in a sub-Saharan Africa population. BMC Oral Health 2018;18(1):28. [DOI: 10.1186/s12903-018-0479-5] [PMID: ] - DOI - PMC - PubMed
Vergnes 2018 {published data only}
    1. Vergnes JN, Arrivé E, Gourdy P, Hanaire H, Rigalleau V, Gin H, et al.Periodontal treatment to improve glycaemic control in diabetic patients: study protocol of the randomized, controlled DIAPERIO trial. Trials 2009;10:65. - PMC - PubMed
    1. Vergnes JN, Canceill T, Vinel A, Laurencin-Dalicieux S, Maupas-Schwalm F, Blasco-Baqué V, et al.The effects of periodontal treatment on diabetic patients: The DIAPERIO randomized controlled trial. Journal of Clinical Periodontology 2018;45(10):1150-63. [DOI: 10.1111/jcpe.13003] [PMID: ] - DOI - PubMed
Wang S 2017 {published data only}
    1. Wang S, Liu J, Zhang J, Lin J, Yang S, Yao J, et al.Glycemic control and adipokines after periodontal therapy in patients with Type 2 diabetes and chronic periodontitis. Brazilian Oral Research 2017;31:e90. [DOI: 10.1590/1807-3107BOR-2017.vol31.0090] [PMID: ] - DOI - PubMed
Wang Y 2017 {published data only}
    1. Wang Y, Liu HN, Zhen Z, Yiu KH, Tse HF, Pelekos G, et al.Periodontal treatment modulates gene expression of endothelial progenitor cells in diabetic patients. Journal of Clinical Periodontology 2017;44(12):1253-63. - PubMed
Yun 2007 {published and unpublished data}
    1. Yun F, Firkova EI, Jun-Qi L, Xun H.Effect of non-surgical periodontal therapy on patients with type 2 diabetes mellitus. Folia Medica 2007;49(1-2):32-6. - PubMed
Zhang 2013 {published data only}
    1. Zhang H, Li C, Shang S, Luo Z.Scaling and root planing with enhanced root planing on healthcare for type 2 diabetes mellitus: a randomized controlled clinical trial. Journal of Dental Sciences 2013;8(3):272-80.

References to studies excluded from this review

Albrecht 1988 {published data only}
    1. Albrecht M, Banoczy J, Gyenes V, Ember G, Rigo O, Valkovics M, et al.Treatment of gingivitis and periodontal diseases with insadol in diabetics. Fogorvosi Szemle 1988;81:65-71. - PubMed
Botero 2013 {published data only}
    1. Botero JE, Yepes FL, Ochoa SP, Hincapie JP, Roldan N, Ospina CA, et al.Effects of periodontal non-surgical therapy plus azithromycin on glycemic control in patients with diabetes: a randomized clinical trial. Journal of Periodontal Research 2013;48(6):706-12. - PubMed
    1. Hincapié JP, Castrillón CA, Yepes FL, Roldan N, Becerra MA, Moreno SM, et al.Microbiological effects of periodontal therapy plus azithromycin in patients with diabetes: results from a randomized clinical trial. Acta Odontológica Latinoamericana 2014;27(2):89-95. - PubMed
Chee 2006 {published data only}
    1. Chee HK, Lim LP, Tay F, Thai AC, Sum CF.Non-surgical periodontal therapy and serum lipid levels in patients with diabetes mellitus. Annals of the Royal Australasian College of Dental Surgeons 2006;18:46. - PubMed
    1. Chee HK, Lim LP, Tay F, Thai AC, Sum CF.Non-surgical periodontal treatment and lipid levels in diabetic patients. Annals of the Royal Australasian College of Dental Surgeons 2008;19:183. - PubMed
ChiCTR2000030393 {published data only}
    1. ChiCTR2000030393.Study for the effect of periodontal basic treatment on the microflora of patients with chronic periodontitis and diabetes mellitus. www.chictr.org.cn/showproj.aspx?proj=50096 (first received 1 March 2020).
Elsadek 2020 {published data only}
    1. Elsadek MF, Ahmed BM, Alkhawtani DM, Zia Siddiqui A.A comparative clinical, microbiological and glycemic analysis of photodynamic therapy and Lactobacillus reuteri in the treatment of chronic periodontitis in type-2 diabetes mellitus patients. Photodiagnosis and Photodynamic Therapy 2020;29:101629. [DOI: 10.1016/j.pdpdt.2019.101629] [PMID: ] - DOI - PubMed
Goel 2017 {published data only}
    1. Goel K, Pradhan S, Bhattarai MD.Effects of nonsurgical periodontal therapy in patients with moderately controlled type 2 diabetes mellitus and chronic periodontitis in Nepalese population. Clinical Cosmetic and Investigative Dentistry 2017;9:73-80. [DOI: 10.2147/CCIDE.S138338] - DOI - PMC - PubMed
Khader 2010 {published data only}
    1. Khader YS, Al Habashneh R, Al Malalheh M, Bataineh A.The effect of full-mouth tooth extraction on glycemic control among patients with type 2 diabetes requiring extraction of all remaining teeth: a randomized clinical trial. Journal of Periodontal Research 2010;45(6):741-7. - PubMed
Mammen 2017 {published data only}
    1. Chandni R, Mammen J, Joseraj MG, Joseph R.Effect of nonsurgical periodontal therapy on insulin resistance in patients with type 2 diabetes mellitus and chronic periodontitis. In: 75th Scientific Sessions of the American Diabetes Association; 2015 June 5-9; Boston (MA). 2015.
    1. Mammen J, Vadakkekuttical RJ, George JM, Kaziyarakath JA, Radhakrishnan CE.Effect of non-surgical periodontal therapy on insulin resistance in patients with type II diabetes mellitus and chronic periodontitis, as assessed by C-peptide and the Homeostasis Assessment Index. Journal of Investigative and Clinical Dentistry 2017;8(3):e12221. [DOI: 10.1111/jicd.12221] [PMID: ] - DOI - PubMed
NCT01255254 {published data only}
    1. NCT01255254.The effect of oral hygiene and full mouth scaling on metabolic control in patients with Type II diabetes. clinicaltrials.gov/show/NCT01255254 (first received 7 December 2010).
Peña Sisto 2018 {published data only}
    1. Peña Sisto M, Calzado de Silva MC, Suárez Avalo W, Peña Sisto L, González Heredia E.Effectiveness of the periodontal treatment in the metabolic control of patients with diabetes mellitus [Efectividad del tratamiento periodontal en el control metabólico de pacientes con diabetes mellitus]. Medisan 2018;22(3):240-7.
Phetnin 2020 {published data only}
    1. Phetnin N, Vichayanrat T, Anunmana C.Effectiveness of the diabetic and oral care program for senior in older patients with diabetes in Muang District, Nakhon Ratchasima Province. In: 5th RSU National and International Research Conference on Science and Technology, Social Science, and Humanities; 2020 May 1; online conference. 2020. [DOI: 10.14458/RSU.res.2020.92] - DOI
    1. TCTR20200423005.Effectiveness of the diabetic and oral care program for senior in Thai older people with type 2 diabetes mellitus: a randomized control trial. trialsearch.who.int/?TrialID=TCTR20200423005 (accessed 15 September 2021).

References to ongoing studies

ACTRN12605000260628 {published and unpublished data}
    1. ACTRN12605000260628.Assessment of diabetes after periodontal treatment. www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12605000260628 (first received 18 August 2005).
NCT01291875 {published data only}
    1. NCT01291875.Periodontal treatment and metabolic control in Type 2 diabetic patients. clinicaltrials.gov/ct2/show/NCT01291875 (first received 9 February 2011).
NCT01901926 {published data only}
    1. NCT01901926.Impact of non surgical periodontal treatment on glycemic control in Type II diabetics. clinicaltrials.gov/ct2/show/NCT01901926 (first received 17 July 2013).
U1111‐1124‐3635 {published data only}
    1. U1111-1124-3635.Influence of periodontal treatment in periodontitis and diabetes control. www.ensaiosclinicos.gov.br/rg/RBR-8dfrpt/ (first received 1 February 2012).

Additional references

Abusleme 2021
    1. Abusleme L, Hoare A, Hong B-Y, Diaz PI.Microbial signatures of health, gingivitis and periodontitis. Periodontology 2000 2021;86:57-78. - PubMed
Baeza 2020
    1. Baeza M, Morales A, Cisterna C, Cavalla F, Jara G, Isamitt Y, et al.Effect of periodontal treatment in patients with periodontitis and diabetes: systematic review and meta-analysis. Journal of Applied Oral Science 2020;28:e20190248. - PMC - PubMed
Begg 1994
    1. Begg CB, Mazumdar M.Operating characteristics of a rank correlation test for publication bias. Biometrics 1994;50(4):1088-101. - PubMed
Berlin 1997
    1. Berlin JA.Does blinding of readers affect the results of meta-analyses? University of Pennsylvania Meta-analysis Blinding Study Group. Lancet 1997;350(9072):185-6. - PubMed
Buchwald 2013
    1. Buchwald S, Kocher T, Biffar R, Harb A, Holtfreter B, Meisel P.Tooth loss and periodontitis by socio-economic status and inflammation in a longitudinal population-based study. Journal of Clinical Periodontology 2013;40(3):203-11. - PubMed
Bunn 1981
    1. Bunn HF.Evaluation of glycosylated hemoglobin diabetic patients. Diabetes 1981;30(7):613-7. - PubMed
Cao 2019
    1. Cao R, Li Q, Wu Q, Yao M, Chen Y, Zhou H.Effect of non-surgical periodontal therapy on glycemic control of type 2 diabetes mellitus: a systematic review and Bayesian network meta-analysis. BMC Oral Health 2019;19(176):1-14. [DOI: 10.1186/s12903-019-0829-y] - DOI - PMC - PubMed
Caton 2018
    1. Caton JG, Armitage G, Berglundh T, Chapple ILC, Jepsen S, Kornman KS, et al.A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. Journal of Clinical Periodontology 2018;45(Suppl 20):S1-8. [DOI: 10.1111/jcpe.12935] - DOI - PubMed
Chapple 2018
    1. Chapple ILC, Mealey BL, Van Dyke TEV, Bartold PM, Dommisch H, Eickholz P, et al.Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Journal of Clinical Periodontology 2018;45(Suppl 20):S68-77. - PubMed
Chen 2021
    1. Chen YF, Zhan Q, Wu CZ, Yuan YH, Chen W, Yu FY, et al.Baseline HbA1c level influences the effect of periodontal therapy on glycemic control in people with type 2 diabetes and periodontitis: a systematic review on randomized controlled trials. Diabetes Therapy 2021;12:1249-78. [DOI: 10.1007/s13300-021-01000-6] - DOI - PMC - PubMed
Choi 2020
    1. Choi S, Sima C, Pandya A.Impact of treating oral disease on preventing vascular diseases: a model-based cost-effectiveness analysis of periodontal treatment among patients with type 2 diabetes. Diabetes Care 2020;43:563-71. - PubMed
D'Aiuto 2017
    1. D’Aiuto F, Gable D, Syed Z, Allen Y, Wanyonyi KL, White S.Evidence summary: the relationship between oral diseases and diabetes . British Dental Journal 2017;222(12):944-8. [DOI: 10.1038/sj.bdj.2017.544] - DOI - PubMed
Darré 2008
    1. Darré L, Vergnes JN, Gourdy P, Sixou M.Efficacy of periodontal treatment on glycaemic control in diabetic patients: a meta-analysis of interventional studies. Diabetes & Metabolism 2008;34(5):497-506. - PubMed
DCCT 1993
    1. Diabetes Control and Complications Trial Research Group (DCCT).The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. New England Journal of Medicine 1993;329(14):977-86. - PubMed
Egger 1997
    1. Egger M, Davey-Smith G, Schneider M, Minder C.Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315(7109):629-34. - PMC - PubMed
Eke 2012
    1. Eke PI, Page RC, Wei L, Thornton-Evans G, Genco RJ.Update of the case definitions for population based surveillance of periodontitis. Journal of Periodontology 2012;83:1449-54. - PMC - PubMed
Engebretson 2013a
    1. Engebretson S, Kocher T.Evidence that periodontal treatment improves diabetes outcomes: a systematic review and meta-analysis. Journal of Clinical Periodontology 2013;40(Suppl 14):S153-63. - PubMed
Firatli 1997
    1. Firatli E.The relationship between clinical periodontal status and insulin dependent diabetes mellitus. Results after 5 years. Journal of Periodontology 1997;68(2):136-40. - PubMed
Florkowski 2003
    1. Florkowski C.HbA1c standardisation issues: should New Zealand follow the DCCT or the IFCC position? New Zealand Medical Journal 2003;116(1171):U395. - PubMed
Franco 2012
    1. Franco RS.Measurement of red cell lifespan and aging. Transfusion Medicine and Hemotherapy 2012;39(5):302-7. - PMC - PubMed
Goldstein 2004
    1. Goldstein DE, Little RR, Lorenz RA, Malone JI, Nathan D, Peterson CM, et al.Tests of glycaemia in diabetes. Diabetes Care 2004;27(7):1761-73. - PubMed
GRADEpro GDT [Computer program]
    1. GRADEpro GDT.Version accessed 20 December 2021. Hamilton (ON): McMaster University (developed by Evidence Prime), 2021. Available at gradepro.org.
Grossi 1998
    1. Grossi SG, Genco RJ.Periodontal disease and diabetes mellitus: a two-way relationship. Annals of Periodontology 1998;3(1):51-61. - PubMed
Hajishengallis 2021
    1. Hajishengallis G, Chavakis T.Local and systemic mechanisms linking periodontal disease and inflammatory comorbidities. Nature Reviews Immunology 2021;21:426-40. [DOI: 10.1038/s41577-020-00488-6] - DOI - PMC - PubMed
Hanas 2010
    1. Hanas R, John G, International HBA1c Consensus Committee.2010 consensus statement on the worldwide standardization of the hemoglobin A1C measurement. Diabetes Care 2010;33(8):1903-4. - PMC - PubMed
Hex 2012
    1. Hex N, Bartlett C, Wright D, Taylor M, Varley D.Estimating the current and future costs of type 1 and type 2 diabetes in the UK, including direct health costs and indirect societal and productivity costs. Diabetic Medicine 2012;29(7):855-62. - PubMed
Higgins 2011
    1. Higgins JP, Green S, editor(s).Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from training.cochrane.org/handbook.
Higgins 2019
    1. Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s).Cochrane Handbook for Systematic Reviews of Interventions. 2nd edition. Chichester (UK): John Wiley & Sons, 2019.
International Diabetes Federation 2013
    1. International Diabetes Federation.IDF Diabetes Atlas. 6th edition. Brussels (Belgium): International Diabetes Federation, 2013. [ISBN 2-930229-85-3]
International Diabetes Federation 2021
    1. International Diabetes Federation.The IDF Diabetes Atlas 10th Edition; 2021. Available at www.diabetesatlas.org.
Jain 2019
    1. Jain A, Gupta J, Bansal D, Sood S, Gupta S, Jain A.Effect of scaling and root planing as monotherapy on glycemic control in patients of Type 2 diabetes with chronic periodontitis: a systematic review and meta-analysis. Journal of the Indian Society of Periodontology 2019;23:303-10. [DOI: 10.4103/jisp.jisp_417_18] - DOI - PMC - PubMed
Jepsen 2018
    1. Jepsen S, Caton JG, Albandar JM, Bissada NF, Bouchard P, Cortellini P, et al.Periodontal manifestations of systemic diseases and developmental and acquired conditions: consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Journal of Periodontology 2018;89(Suppl 1):S237-48. - PubMed
Karnchanasorn 2016
    1. Karnchanasorn R, Huang J, Ou H-Y, Feng W, Chuang L-M, Chiu KC, et al.Comparison of the current diagnostic criterion of HbA1c with fasting and 2-hour plasma glucose concentration. Journal of Diabetes Research 2016;2016:6195494. [DOI: 10.1155/2016/6195494] - DOI - PMC - PubMed
Khaw 2001
    1. Khaw KT, Wareham N, Luben R, Bingham S, Oakes S, Welch A, et al.Glycated haemoglobin, diabetes, and mortality in men in Norfolk cohort of european prospective investigation of cancer and nutrition (EPIC-Norfolk). BMJ 2001;322(7277):15-8. - PMC - PubMed
Kornman 2014
    1. Kornman KS.Commentary: Periodontitis severity and progression are modified by various host and environmental factors. Journal of Periodontology 2014;85(12):1642-5. - PubMed
Lefebvre 2020
    1. Lefebvre C, Glanville J, Briscoe S, Littlewood A, Marshall C, Metzendorf M-I, et al.Technical Supplement to Chapter 4: Searching for and selecting studies. In: Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, et al, editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 6.1 (updated September 2020). Cochrane, 2020. Available from www.training.cochrane.org/handbook.
Li 2009
    1. Li X, Tse HF, Yiu KH, Jia N, Chen H, Li LS, et al.Increased levels of circulating endothelial progenitor cells in subjects with moderate to severe chronic periodontitis. Journal of Clinical Periodontology 2009;36(11):933-9. - PubMed
McCambridge 2014
    1. McCambridge J, Witton J, Elbourne DR.Systematic review of the Hawthorne effect: new concepts are needed to study research participation effects. Journal of Clinical Epidemiology 2014;67(3):267-77. - PMC - PubMed
Monami 2008
    1. Monami M, Lamanna C, Marchionni N, Mannucci E.Comparison of different drugs as add-on treatments to metformin in type 2 diabetes: a meta-analysis. Diabetes Research and Clinical Practice 2008;79(2):196-203. [DOI: 10.1016/j.diabres.2007.08.024] - DOI - PubMed
Nasseh 2017
    1. Nasseh K, Vujicic M, Glick M.The relationship between periodontal interventions and healthcare costs and utilization. Evidence from an integrated dental, medical, and pharmacy commercial claims database. Health Economics 2017;26:519-27. - PMC - PubMed
NHS 2019
    1. NHS England and NHS Improvement.Commissioning standard: dental care for people with diabetes. www.england.nhs.uk/publication/commissioning-standard-dental-care-for-pe... (accessed 11 January 2022).
Page 1998
    1. Page RC.The pathobiology of periodontal diseases may affect systemic diseases: inversion of a paradigm. Annals of Periodontology 1998;3(1):108-20. - PubMed
Papapanou 1996
    1. Papapanou PN.Periodontal diseases: epidemiology. Annals of Periodontology 1996;1(1):1-36. - PubMed
Papapanou 2018
    1. Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, et al.Periodontitis: consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. Journal of Periodontology 2018;89(Suppl 1):S173-82. - PubMed
Peter 2007
    1. Peter S.Essentials Of Preventive and Community Dentistry. 3rd edition. New Delhi: Arya (Medi) Publishing House, 2007.
Preshaw 2012
    1. Preshaw PM, Alba AL, Herrera D, Jepsen S, Konstantinidis A, Makrilakis K, et al.Periodontitis and diabetes: a two-way relationship. Diabetologia 2012;55(1):21-31. - PMC - PubMed
Preshaw 2020
    1. Preshaw PM, Taylor JT, Jaedicke KM, De Jager M, Bikker JW, Selten W, et al.Treatment of periodontitis reduces systemic inflammation in type 2 diabetes. Journal of Clinical Periodontology 2020;47(6):737-46. [DOI: 10.1111/jcpe.13274] - DOI - PubMed
Rabi 2006
    1. Rabi DM, Edwards AL, Southern DA, Svenson LW, Sargious PM, Norton P, et al.Association of socio-economic status with diabetes prevalence and utilization of diabetes care services. BMC Health Services Research 2006;3(6):124. - PMC - PubMed
Raval 2021
    1. Raval P, Moreno F, Needleman I.Patient involvement to explore research prioritisation and self-care management in people with periodontitis and diabetes. British Dental Journal 2021;8:1-7. [DOI: 10.1038/s41415-021-3175-9] - DOI - PubMed
Review Manager 2020 [Computer program]
    1. Review Manager 5 (RevMan 5).Version 5.4. The Cochrane Collaboration, 2020.
Rodrigues 2003
    1. Rodrigues DC, Taba MJ, Novaes AB, Souza SL, Grisi MF.Effect of non-surgical periodontal therapy on glycemic control in patients with type 2 diabetes mellitus. Journal of Periodontology 2003;74:1361–7. - PubMed
Sandberg 2000
    1. Sandberg GE, Sundberg HE, Fjellstrom CA, Wikblad KF.Type 2 diabetes and oral health: a comparison between diabetic and non-diabetic subjects. Diabetes Reseach and Clinical Practice 2000;50(1):27-34. - PubMed
Sanz 2018
    1. Sanz M, Ceriello A, Buysschaert M, Chapple I, Demmer RT, Graziani F, et al.Scientific evidence on the links between periodontal diseases and diabetes: consensus report and guidelines of the Joint Workshop on Periodontal Diseases and Diabetes by the International Diabetes Federation and the European Federation of Periodontology. Journal of Clinical Periodontology 2018;45:138-45. [DOI: 10.1111/jcpe.12808] - DOI - PubMed
Sanz 2020
    1. Sanz M, Herrera D, Kebschull M, Chapelle I, Jepsen S, Beglundh T, et al.Treatment of stage I–III periodontitis - The EFP S3 level clinical practice guideline. Journal of Clinical Periodontology 2020;47(Suppl 22):4-60. - PMC - PubMed
Schenkein 2020
    1. Schenkein HA, Papapanou PN, Genco R, Sanz M.Mechanisms underlying the association between periodontitis and atherosclerotic disease. Periodontology 2000 2020;83:90-106. - PubMed
Seppälä 1993
    1. Seppälä B, Seppälä M, Ainamo J.A longitudinal study on insulin-dependent diabetes mellitus and periodontal disease. Journal of Clinical Periodontology 1993;20(3):161-5. - PubMed
Seuring 2015
    1. Seuring T, Archangelidi O, Suhrcke M.The economic costs of type 2 diabetes: a global systematic review. PharmacoEconomics 2015;33(8):811-31. - PMC - PubMed
Sgolastra 2013
    1. Sgolastra F, Severino M, Pietropaoli D, Gatto R, Monaco A.Effectiveness of periodontal treatment to improve metabolic control in patients with chronic periodontitis and type 2 diabetes: a meta-analysis of randomized clinical trials. Journal of Periodontology 2013;84(7):958-73. - PubMed
SIGN 2022
    1. Scottish Intercollegiate Guidelines Network.Search filters: economic studies. www.sign.ac.uk/what-we-do/methodology/search-filters/ (accessed 23 March 2022).
Smits 2020
    1. Smits K, Listl S, Plachokova A, Van der Galien O, Kalmus O.Effect of periodontal treatment on diabetes-related healthcare costs: a retrospective study. BMJ Open Diabetes Research & Care 2020;8(1):e001666. [DOI: 10.1136/bmjdrc-2020-001666] - DOI - PMC - PubMed
Soloweij‐Wedderburn 2017
    1. Soloweij-Wedderburn J, Ide M, Pennington M.Cost-effectiveness of non-surgical periodontal therapy for patients with type 2 diabetes in the UK. Journal of Clinical Periodontology 2017;44:700-7. - PubMed
Stewart 2001
    1. Stewart JE, Wager KA, Friedlander AH, Zadeh HH.The effect of periodontal treatment on glycaemic control in patients with type 2 diabetes mellitus. Journal of Clinical Periodontology 2001;28(4):306-10. - PubMed
Stratton 2000
    1. Stratton IM, Adler AI, Neil HA, Mathews DR, Manley SE, Cull CA, et al.Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000;321(7258):405-12. - PMC - PubMed
Sun 2021
    1. Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al.IDF Diabetes Atlas: global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Research and Clinical Practice 2021;183:109119. [DOI: 10.1016/j.diabres.2021.109119] - DOI - PMC - PubMed
Taylor 2001
    1. Taylor GW.Bidirectional interrelationships between diabetes and periodontal diseases: an epidemiological perspective. Annals of Periodontology 2001;6(1):99-112. - PubMed
Teshome 2017
    1. Teshome A, Yitayeh A.The effect of periodontal therapy on glycemic control and fasting plasma glucose level in type 2 diabetic patients: systematic review and meta-analysis. BMC Oral Health 2017;17(31):1-11. [DOI: 10.1186/s12903-016-0249-1] - DOI - PMC - PubMed
Tonetti  2018
    1. Tonetti M, Greenwell H, Kornman KS.Staging and grading of periodontitis: framework and proposal of a new classification and case definition. Journal of Clinical Periodontology 2018;45(Suppl 20):S149-61. - PubMed
UKPDS 1998
    1. United Kingdom Prospective Diabetes Study 33 (UKPDS).Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes. Lancet 1998;352(9131):837-53. - PubMed
WHO 2013
    1. World Health Organization.Global action plan for the prevention and control of noncommunicable diseases (NCDs) 2013-2020; November 2013. Available at www.who.int/nmh/events/ncd_action_plan/en/.
WHO 2014
    1. World Health Organization.Global status report on noncommunicable diseases 2014. Available at apps.who.int/iris/bitstream/handle/10665/148114/9789241564854_eng.pdf.
WHO 2015
    1. World Health Organization.Diabetes: fact sheet N° 312; January 2015. Available at www.who.int/mediacentre/factsheets/fs312/en/.
WHO 2021
    1. World Health Organization.Diabetes fact sheet; November 2021. Available at www.who.int/news-room/fact-sheets/detail/diabetes.
Worthington 2015
    1. Worthington H, Clarkson J, Weldon J.Priority oral health research identification for clinical decision-making. Evidence-based Dentistry 2015;16(3):69-71. - PubMed
Yap 2019
    1. Yap KCH, Pulikkotil SJ.Systemic doxycycline as an adjunct to scaling and root planing in diabetic patients with periodontitis: a systematic review and meta-analysis. BMC Oral Health 2019;19:209. [DOI: 10.1186/s12903-019-0873-7] - DOI - PMC - PubMed

References to other published versions of this review

Simpson 2004
    1. Simpson T, Needleman I, Wild SH, Moles DR, Mills EJ.Treatment of periodontal disease for glycaemic control in people with diabetes. Cochrane Database of Systematic Reviews 2004, Issue 2. Art. No: CD004714. [DOI: 10.1002/14651858.CD004714] - DOI - PubMed
Simpson 2010
    1. Simpson TC, Needleman I, Wild SH, Moles DR, Mills EJ.Treatment of periodontal disease for glycaemic control in people with diabetes. Cochrane Database of Systematic Reviews 2010, Issue 5. Art. No: CD004714. [DOI: 10.1002/14651858.CD004714.pub2] - DOI - PubMed
Simpson 2015
    1. Simpson TC, Weldon JC, Worthington HV, Needleman I, Wild SH, Moles DR, et al.Treatment of periodontal disease for glycaemic control in people with diabetes mellitus. Cochrane Database of Systematic Reviews 2015, Issue 11. Art. No: CD004714. [DOI: 10.1002/14651858.CD004714.pub3] - DOI - PMC - PubMed

Publication types

Substances