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Objective: A meta-analysis of randomized control trials was conducted to evaluatethe effect of periodontal therapy (PT) on metabolic control in patients with diabetes andperiodontal disease.Methods: Studies of periodontal treatment on metabolic control in diabeticpatients were searched from Cochrane Central Register of Controlled Trials(CENTRAL), PubMed, EMBASE database from2000to March2013. Inclusion criteriawere:①Literatures published in English with complete data;②Studies on people withtype1or2diabetes mellitus (DM) with no limits on race, nationality, sex, and age;③Randomized control trials (RCTs) irrespective of their allocation concealment andblinding methods;④Suitable treatment included mechanical periodontal therapy withor without adjunctives and oral hygiene instruction;⑤Glycosylated hemoglobin(HbA1c), blood glucose (BG), lipid profile, and other metabolic indexes were included.Indexes which closely linked to insulin resistance (IR) such as high-sensitivityC-reactive protein (HsCRP), tumor necrosis factor alpha (TNF-α) were included.Duplicate publications, articles only published as abstracts, non-RCTs, and studies withincomplete data were excluded. Two reviewers independently reviewed the titles andabstracts of identified articles first, and then examined the full-text version of selectedarticles to assess relevance to the research topic. The authors were contacted by E-mailto obtain the missing data. The quality of included studies was evaluated by modifiedJADAD scale. The main information included author’s name, year of publication, studyarea, study population, interventions, study duration, the baseline characteristics and thedisease status of patients in the two groups. Data of mean and standard deviation ofHbA1c, fasting BG (FBG), postprandial2h BG (2hPG), total cholesterol (TC),triglycerides (TG), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C), HsCRP, TNF-α were analyzed with RevMan5.0software.Results: Six RCTs involving470type2diabetes patients were retrieved.Meta-analysis suggested that there was significant difference between the PT groupsand the control groups for HbA1c [SMD=-0.46,95%CI:(-0.64,-0.29), P<0.00001],FBG [SMD=-0.88,95%CI:(-1.35,-0.41), P=0.0002],2hPG [SMD=-1.63,95%CI:(-3.15,-0.10), P=0.04], TC [SMD=-0.25,95%CI:(-0.50,-0.01), P=0.05], TG[SMD=-0.28,95%CI:(-0.47,-0.08), P=0.006], HsCRP [SMD=-0.38,95%CI:(-0.60,-0.16), P=0.0006]. But there was no effects of PT on LDL-C [SMD=-0.07,95%CI:(-0.27,0.12), P=0.47], HDL-C [SMD=0.01,95%CI:(-0.18,0.21), P=0.91], and TNF-α[SMD=-0.21,95%CI:(-0.43,0.01), P=0.06].Conclusion: Periodontal therapy could improve metabolic control in diabeticpatients. Further studies of high quality are highly needed.
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