scholarly journals Periodontal Treatment Protocol for Decompensated Diabetes Patients

2021 ◽  
Vol 2 ◽  
Author(s):  
Matías Dallaserra ◽  
Alicia Morales ◽  
Nayib Hussein ◽  
Marcela Rivera ◽  
Franco Cavalla ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Glycated Hemoglobin ◽  
Treatment Guideline ◽  
Infectious Complications ◽  
Periodontal Therapy ◽  
Periodontal Treatment ◽  
Diabetic Patients ◽  
Expert Committee ◽  
Systemic Complications ◽  
The Impact

Background: Decompensated diabetes is associated with a higher prevalence and severity of periodontitis and poorer response to periodontal therapy. It is conceivable that periodontal therapy may cause systemic and local complications in this type of patients. The aim of the present study was to identify and describe the best available evidence for the treatment of periodontitis in decompensated diabetics.Material and methods: An expert committee including participants from different areas gathered to discuss and develop a treatment guideline under the guidance of the Cochrane Associate Center, Faculty of Dentistry, University of Chile. In total, four research questions were prepared. The questions prepared related to decompensated diabetic patients (glycated hemoglobin >8) were, (1) Does the exposure to periodontal treatment increase the risk of infectious or systemic complications? (2) Does the antibiotic treatment or prophylaxis, compared to not giving it, reduce infectious complications? (3) Does the exposure to periodontal treatment, compared to no treatment, reduce the glycated hemoglobin levels (HbA1c)? Last question was related to diabetic patients, (4) Does the exposure to a higher level of HbA1c, compared to stable levels, increase the risk of infectious complications? Based on these questions, a search strategy was developed using MEDLINE and EPISTEMONIKOS. Only systematic reviews were considered.Results: For question 1, the search yielded 12 records in EPISTEMONIKOS and 23 in MEDLINE. None of these studies addressed the question. For question 2, the search yielded 58 records in EPISTEMONIKOS and 11 in MEDLINE. None of these studies addressed the question. For question 3, the search yielded 16 records in EPISTEMONIKOS and 11 in MEDLINE. Thirteen addressed the question. For question 4, the search yielded 7 records in EPISTEMONIKOS and 9 in MEDLINE. One addressed the question.Conclusions: In decompensated diabetic patients, there is lack of scientific information about risk of infectious or systemic complications as a result of periodontal treatment and about the impact of antibiotic treatment or prophylaxis on reduction if infectious complications. A defined HbA1c threshold for dental and periodontal treatment in diabetic patients has yet to be determined. Finally, periodontal treatment does have an impact on HbA1c levels.

Effects of periodontal therapy with topical antibiotics in the glycemic control of diabetic patients: systematic review.

2019 ◽  
Vol 27 (1) ◽  
pp. 31-42
Author(s):  
Gloria Cristina Aranzazu-Moya
Keyword(s):  
Periodontal Disease ◽  
Periodontal Therapy ◽  
Periodontal Treatment ◽  
Diabetic Patients ◽  
Inclusion Criteria ◽  
Topical Antibiotics ◽  
Bias Risk ◽  
Black Scale ◽  
Glycated Hemoglobin A ◽  
Modest Reduction

Background: Periodontal disease is considered as a diabetes complication and has been suggested that periodontal treatment plus antibiotics should reduce glycated hemoglobin A, by reducing local production of pro inflammatory substances. Objective: To evaluate diabetic patients with periodontal disease under periodontal treatment plus topical antibiotics and reduction of  HbA1c, compared to diabetic patients under periodontal treatment without antibiotics. Materials and Methods: Using PUBMED, SCOPUS, WEB OF SCIENCE, EMBASE and Google Scholar data bases, were screened documents from 2008 to 2018. The documents included were the clinical studies, which included non-surgical periodontal treatment plus topical antibiotics, whose outcomes included the HbA1c report. Two independent researchers evaluate title; abstract and bias risk with Downs Black scale and Cochrane tool. Documents with a score higher than 15 on average by the two evaluators were included. Results: Five articles, which find inclusion criteria, were identified. Two documents failed to demonstrate statistically significant effect when compared to non-surgical periodontal therapy alone. Conclusion: In general a modest reduction of HbA1c was identified when using antibiotic therapy.

scholarly journals Effects of Non-Surgical Periodontal Treatment on Reactive Oxygen Metabolites and Glycemic Control in Diabetic Patients with Chronic Periodontitis

Antioxidants ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 1056
Author(s):  
Simone Marconcini ◽  
Enrica Giammarinaro ◽  
Saverio Cosola ◽  
Giacomo Oldoini ◽  
Annamaria Genovesi ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Glycemic Control ◽  
Systemic Inflammation ◽  
Glycated Hemoglobin ◽  
Reactive Oxygen ◽  
Periodontal Treatment ◽  
Diabetic Patients ◽  
Reactive Oxygen Metabolites ◽  
Periodontal Infection ◽  
Oxygen Metabolites

Background: Periodontal infection may contribute to poor glycemic control and systemic inflammation in diabetic patients. The aim of the present study is to evaluate the efficacy of non-surgical periodontal treatment in diabetic patients by measuring oxidative stress outcomes. Methods: Sixty diabetic patients with periodontitis were enrolled, treated with scaling and full-mouth disinfection, and randomly prescribed chlorhexidine mouthwash, antioxidant mouthwash, or ozone therapy. Reactive oxygen metabolites (ROMs), periodontal parameters, and glycated hemoglobin were measured at baseline and then at 1, 3, and 6 months after. Results: At baseline, all patients presented with pathologic levels of plasmatic ROM (388 ± 21.36 U CARR), higher than the normal population. Probing depth, plaque index, and bleeding on probing values showed significant clinical improvements after treatment, accompanied by significant reductions of plasma ROM levels (p < 0.05). At the 6-month evaluation, the mean ROM relapsed to 332 ± 31.76 U CARR. Glycated hemoglobin decreased significantly (∆ = −0.52 units) after treatment. Both the test groups showed longer-lasting improvements of periodontal parameters. Conclusion: In diabetic patients, periodontal treatment was effective at reducing plasma ROM, which is an indicator of systemic oxidative stress and inflammation. The treatment of periodontal infection might facilitate glycemic control and decrease systemic inflammation.

scholarly journals CORRELATION BETWEEN PERIODONTAL INDICES [PLAQUE INDEX (PI), GINGIVAL INDEX (GI)] AND GLYCATED HEMOGLOBIN (HBA1C), IN TYPE 2 DIABETES MELLITUS.

2021 ◽  
pp. 58-60
Author(s):  
Gargi Sharma ◽  
Priyanka Singh ◽  
Guljot singh
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycated Hemoglobin ◽  
Periodontal Therapy ◽  
Plaque Index ◽  
Periodontal Treatment ◽  
Gingival Index ◽  
Periodontal Indices

Objectives:The objective was to find out Correlation between the clinical (periodontal indices) and metabolic changes (glycated hemoglobin) following non-surgical periodontal treatment (pre and post),in diabetic (Type 2) patients. Material and methods: Forty type 2 diabetic patients with generalized chronic periodontitis were selected. Subjects were randomly assigned into two groups. Data collection: st rd Periodontal indices [Plaque index (PI), gingival index (GI)], were recorded at baseline, 1 and 3 st rd months. glycated hemoglobin (HbA1c), was analyzed at baseline, 1 and 3 months following the non surgical periodontal therapy. The treatment group received scaling and root planning whereas the control group received no periodontal treatment. Results:The results showed significant Correlation between periodontal indices and,levels of HbA in Type 2 diabetes 1c mellitus patients. Summary and conclusions: Non surgical periodontal therapy is associated with improved glycemic control in Type 2 diabetes mellitus patients.

Impact of periodontal therapy on systemic markers of inflammation in patients with metabolic syndrome: a randomized clinical trial

2020 ◽  
Author(s):  
Eduardo Montero ◽  
Mercedes López ◽  
Honorato Vidal ◽  
María Martínez ◽  
Jorge Marrero ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Clinical Trial ◽  
Periodontal Therapy ◽  
Periodontal Treatment ◽  
Markers Of Inflammation ◽  
Severe Periodontitis ◽  
Secondary Outcomes ◽  
Hs Crp ◽  
The Impact

Abstract Background Although there is evidence of positive effect of periodontal therapy on systemic inflammation, this response is highly variable among subjects. It was the aim of this clinical investigation to determine the impact of periodontal treatment on systemic markers of inflammation in patients with metabolic syndrome (MetS) and periodontitis. Methods In this parallel-arm, double blind, randomized controlled clinical trial, 63 patients with MetS and severe periodontitis were randomly assigned to receive intensive periodontal treatment (IPT; scaling and root planing plus azithromycin 500 mg, q.d., for three days) or minimal periodontal treatment (MPT; supragingival professional mechanical plaque removal plus a placebo). The primary outcome was the impact of the tested interventions on hs-CRP serum levels at 6 months. As secondary outcomes, differences in the levels of cytokines, markers of prothrombotic states, carbohydrate and lipids metabolism, as well as blood pressure, were measured at 3 and 6 months after therapy. Results The ITT population consisted on 63 subjects randomly assigned to either MPT (n = 31) or IPT (n = 32) groups. At baseline, mean hs-CRP was 3.9 mg/L (standard deviation, SD = 2.9) and 3.9 mg/L (SD = 3.4), respectively, and no significant differences in their cardiometabolic risk profiles were detected between groups. After 6 months, unadjusted mean hs-CRP were 2.9 mg/L (standard error, SE = 0.4) and 4.0 (SE = 0.8), respectively. Adjusting for baseline hs-CRP, sex, age, smoking status and body mass index, hs-CRP was 1.2 mg/L (95% confidence interval, [CI 0.4; 2.0]; p = 0.004) lower in the IPT group than in the MPT group. In the secondary outcomes, significant reductions in IL-1β, TNF-α, HbA1c and blood pressure were observed in the IPT group at 3 months, when compared to the MPT group. Conclusion Effective periodontal treatment significantly reduced hs-CRP after 6 months in patients with MetS and severe periodontitis. Periodontal therapy might be useful to reduce cardiovascular risk in these patients. Trial registration: ClinicalTrials.gov Registration Number: NCT03960216.

scholarly journals Effect of Periodontal Therapy on COPD Outcomes: A Systematic Review

2020 ◽  
Author(s):  
Ioulianos Apessos ◽  
Athanasios Voulgaris ◽  
Michalis Agrafiotis ◽  
Dimitrios Andreadis ◽  
Paschalis Steiropoulos
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Lung Function ◽  
Risk Of Bias ◽  
Periodontal Therapy ◽  
Periodontal Treatment ◽  
Quality Of Evidence ◽  
Copd Patients ◽  
The Impact

Abstract Background: Latest evidence suggests that periodontitis is prevalent among patients with chronic obstructive pulmonary disease (COPD), while recent studies have also reported a potential benefit of periodontal treatment on several COPD outcomes. This systematic review aims to determine the impact of periodontal treatment on exacerbation rate, lung function and quality of life of COPD patients. Methods: A systematic search of electronic databases of PubMed, Scopus, Virtual Health Library, ScienceDirect, Wiley Online Library, Web of Science, ProQuest Dissertation and Theses Global and Google Scholar was conducted. Search restricted to studies involving human subjects and published from January 2000 to March 2020 in English language. Distiller Systematic Review software was used for data management. Risk of bias was assessed using Risk of Bias 2 (RoB2) and Risk of Bias for non-randomized studies of intervention (ROBINS-I) tools. Overall quality of evidence was judged based on Grading of Recommendations Assessment, Development and Evaluation (GRADE) working group methodology.Results: Out of 1442 articles retrieved, 7 full text articles were included in the review. Limited evidence suggests that periodontal treatment in patients with COPD and periodontitis is associated with reduced exacerbation frequency and a slower lung function decline rate, while its effects on quality of life remain unclear. In addition, periodontal treatment in COPD is associated with lower hospitalization rates and reduced all-cause mortality. Overall, the included studies demonstrated high heterogeneity and very low-to-moderate quality of evidence. Conclusions: Although it is reasonable to advise COPD patients not to neglect their dental health, further studies are warranted to determine the role of periodontal therapy on COPD clinical outcomes. Registration: PROSPERO 2020 (CRD42020158481)

scholarly journals Effect of periodontal therapy on COPD outcomes: a systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ioulianos Apessos ◽  
Athanasios Voulgaris ◽  
Michalis Agrafiotis ◽  
Dimitrios Andreadis ◽  
Paschalis Steiropoulos
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Lung Function ◽  
Risk Of Bias ◽  
Periodontal Therapy ◽  
Periodontal Treatment ◽  
Quality Of Evidence ◽  
Copd Patients ◽  
The Impact

Abstract Background Latest evidence suggests that periodontitis is prevalent among patients with chronic obstructive pulmonary disease (COPD), while recent studies have also reported a potential benefit of periodontal treatment on several COPD outcomes. This systematic review aims to determine the impact of periodontal treatment on exacerbation rate, lung function and quality of life of COPD patients. Methods A systematic search of electronic databases of PubMed, Scopus, Virtual Health Library, ScienceDirect, Wiley Online Library, Web of Science, ProQuest Dissertation and Theses Global and Google Scholar was conducted. Search restricted to studies involving human subjects which were published from January 2000 to March 2020 in English language. Distiller Systematic Review software was used for data management. Risk of bias was assessed using Risk of Bias 2 (RoB2) and Risk of Bias for non-randomized studies of intervention (ROBINS-I) tools. Overall quality of evidence was judged based on Grading of Recommendations Assessment, Development and Evaluation working group methodology. Results Out of 1442 articles retrieved, 7 full text articles were included in the review. Limited evidence suggests that periodontal treatment in patients with COPD and periodontitis is associated with reduced exacerbation frequency and a slower lung function decline rate, while its effects on quality of life remain unclear. In addition, periodontal treatment in COPD is associated with lower hospitalization rates and reduced all-cause mortality. Significant methodological differences were noted amongst included studies, while very low-to-moderate overall quality of evidence was demonstrated. Conclusions Although it is reasonable to advise COPD patients not to neglect their dental health, further studies are warranted to determine the role of periodontal therapy on COPD clinical outcomes. Trial Registration: PROSPERO 2020 (CRD42020158481). https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020158481

Impact of Smoking Cessation on Periodontitis: A Systematic Review and Meta-analysis of Prospective Longitudinal Observational and Interventional Studies

2018 ◽  
Vol 21 (12) ◽  
pp. 1600-1608 ◽  
Author(s):  
Fábio R M Leite ◽  
Gustavo G Nascimento ◽  
Stina Baake ◽  
Lisa D Pedersen ◽  
Flemming Scheutz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Smoking Cessation ◽  
Tobacco Smoking ◽  
Meta Analysis ◽  
Periodontal Therapy ◽  
Periodontal Treatment ◽  
Nonsurgical Periodontal Therapy ◽  
Never Smokers ◽  
Prospective Longitudinal ◽  
The Impact

Abstract Aims This systematic review aimed to estimate the effect of tobacco smoking cessation on the risk for periodontitis compared to the risk among never-smokers and to evaluate the effect of tobacco smoking cessation on the clinical outcomes of nonsurgical periodontal treatment. Methods Electronic searches were performed in PubMed, Scopus, and Embase. Search strategy included MeSH and free terms: periodontitis, periodontal diseases, smoking, tobacco use, tobacco, tobacco products, cigarette, pipe, and cigar. Only original prospective longitudinal observational and interventional studies that investigated the association between smoking cessation and periodontitis onset or progression were included. Meta-analyses were conducted to summarize the evidence. Results A total of 2743 articles were identified in electronic searches; out of which only six were included in the meta-analysis. Pooled estimates showed that the risk of periodontitis incidence or progression among those who quit smoking was not significantly different from the risk for never-smokers (risk ratio [RR] = 0.97; 95% confidence interval [CI] = 0.87% to 1.08%). Smokers had approximately 80% higher risk of periodontitis than quitters (RR = 1.79; 95% CI = 1.36% to 2.35%) and never-smokers (RR = 1.82; 95% CI = 1.43% to 2.31%). Periodontal therapy resulted in up to 0.2 mm (95% CI = −0.32% to −0.08%) higher gain in attachment level and extra 0.32 mm (95% CI = 0.07% to 0.52%) reduction in pocket depth among quitters over nonquitters after short follow-up (12–24 months). Conclusions Few studies on the topic were identified. Smoking cessation reduced the risk for periodontitis onset and progression, and improved the outcomes of nonsurgical periodontal therapy. Implications This review provides the first quantitative evidence of the impact of smoking cessation on the risk for periodontitis onset and progression. The findings have demonstrated that the risk for periodontitis becomes comparable to that of never-smokers and that nonsurgical periodontal treatment outcomes improve after smoking cessation. Dental professionals ought to consider smoking cessation interventions as a relevant component of the periodontal therapy.

scholarly journals Effectiveness of Non-Surgical and Surgical Periodontal Therapy in Lowering HbA1c in Diabetic Patients

2021 ◽  
Vol 5 (4) ◽  
Keyword(s):  
Glycemic Control ◽  
Chronic Inflammatory Disease ◽  
Periodontal Therapy ◽  
Diabetic Patients ◽  
Microbial Dysbiosis ◽  
Chronic Hyperglycemia ◽  
Global Pandemic ◽  
Inflammatory State ◽  
The Impact ◽  
Plaque Biofilm

Diabetes is global pandemic disease, a metabolic disorder of multiple etiology that is characterized by chronic hyperglycemia resulting from defects in insulin secretion, insulin action, or both. Periodontitis is a chronic inflammatory disease that is initiated by the accumulation of dental plaque biofilm, within which microbial dysbiosis leads to a chronic, non-resolving and destructive inflammatory response. In the last decades, many studies investigated the impact of periodontal treatment on glycemic control in people with diabetes. The aim of this dissertation is to conduct a review of the published literature to understand the association between periodontal therapy and glycated hemoglobin (HbA1c) values. A search was conducted in PUBMED and of the 277 articles found, only 21 were considered for being more relevant. As has been recognized for some time, the results show a correlation between the two diseases and their link lies in the inflammatory process. In the diabetic patient, this results in higher HbA1c values and a situation that is difficult to control. Being able to control the inflammatory state of the periodontium through oral hygiene protocols and periodontal therapy has several benefits in a complicated clinical picture in situations of poor glycemic control. Non-surgical periodontal therapy proves effective in significantly lowering HbA1c levels in diabetic patients.

Sign in / Sign up

Export Citation Format

Share Document