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
Meta-Analysis
. 2024 Sep 5;28(9):514.
doi: 10.1007/s00784-024-05905-x.

Improvement of post-periodontitis-therapy inflammatory state in diabetics: a meta-analysis of randomized controlled trials

Davi da Silva Barbirato  1   2 , Natasha Soares Nogueira  3 , Taísa Coelho Guimarães  3 , Lenita Zajdenverg  4 , Carmelo Sansone  3
Affiliations
Meta-Analysis

Improvement of post-periodontitis-therapy inflammatory state in diabetics: a meta-analysis of randomized controlled trials

Davi da Silva Barbirato et al. Clin Oral Investig. .

Abstract

Objectives: This systematic review aimed to evaluate the impact of periodontal therapy on systemic biomarkers of inflammation and oxidative stress in patients with type 2 diabetes mellitus (T2DM) and periodontitis.

Materials and methods: An electronic search without restriction on dates or languages was performed in six electronic databases, protocol records and other sources until May 2024. To develop the search strategy, clinical question was formulated using the PICOD method. Eligibility criteria included randomized controlled trials on the effects of periodontitis-therapy on the inflammatory parameters of T2DM patients. Risk of bias and certainty of evidence were assessed by RoB2 and GRADE tools, respectively. The review protocol was registered in PROSPERO platform (CRD42020206295).

Results: Of 1,062 records screened, the authors determined that 14 studies enrolling 1223 participants proved eligible. Moderate-quality evidence suggested a positive effect of periodontitis-therapy on serum levels of c-reactive protein [0.39 (CI95%: 0.27-0.5)], even without the use of antibiotics [0.34 (CI95%: 0.22-0.46)], in T2DM patients. The significant reduction in C-reactive protein (CRP) among smokers in favor of periodontitis-therapy was greatest at six months of follow-up.

Conclusions: Non-surgical periodontal therapy improved short-term biomarkers of systemic inflammation in T2DM patients, with moderate evidence of improvement in serum levels of high sensitivity-CRP.

Clinical relevance: Systemic inflammation in T2DM patients can be reduced after non-surgical periodontal therapy, which also has the potential to reduce the risk of other important systemic outcomes, such as cardiovascular disease.

Keywords: Diabetes mellitus; Meta-analysis [Publication Type]; Periodontitis; Subgingival instrumentation; Systematic review [Publication Type]; Therapy [Subheading].

PubMed Disclaimer

References

    1. Donath MY, Shoelson SE (2011) Type 2 diabetes as an inflammatory disease. Nat Rev Immunol 11(2):98–107. https://doi.org/10.1038/nri2925 - PubMed
    1. Löe H (1993) Periodontal disease. The sixth complication of diabetes mellitus. Diabetes Care 16(1):329–334 - PubMed
    1. Hajishengallis G, Darveau RP, Curtis MA (2012) The keystone-pathogen hypothesis. Nat Rev Microbiol 10(10):717–725. https://doi.org/10.1038/nrmicro2873 - PubMed - PMC
    1. D’Aiuto F, Gkranias N, Bhowruth D, Khan T, Orlandi M, Suvan J, Masi S, Tsakos G, Hurel S, Hingorani AD, Donos N, Deanfield JE, TASTE Group (2018) Systemic effects of periodontitis treatment in patients with type 2 diabetes: a 12 month, single-centre, investigator-masked, randomised trial. Lancet Diabetes Endocrinol 6(12):954–965. https://doi.org/10.1016/S2213-8587(18)30038-X
    1. Taylor JJ, Preshaw PM, Lalla E (2013) A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes. J Periodontol 84(4 Suppl):S113–S134. https://doi.org/10.1902/jop.2013.134005 - PubMed

LinkOut - more resources