Non-Cochrane · intervention · PM41450397
Impact of Periodontal Interventions on Glycemic Indices and Periodontal Status Among Adults With Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.
Delgado Castromonte Heliette Emperatriz E, Jaramillo Arturo P, Vera Wellinger, et al. · Cureus · 2025 · PubMed · doi:10.7759/cureus.97692
Findings
5 findings
| Population | ||||
|---|---|---|---|---|
| Adults with type 2 diabetes mellitus and periodontitis | Periodontal intervention (non-surgical periodontal therapy alone or with adjuncts or self-management programs) | No active periodontal treatment (hygiene advice only, delayed or routine care) | HbA1c change (%) about 3 months | MD -0.40 [-0.72, -0.09] GRADE not reported 7 studies · 735 participants |
| Adults (>=18 years) with type 2 diabetes mellitus and periodontitis | Non-surgical periodontal therapy (scaling and root planing with oral-hygiene instruction), alone or with adjuncts or self-management programs | No active periodontal treatment (delayed or minimal care, hygiene advice only, routine care) | HbA1c change (%) about 3 months · Outpatient and community settings · Fixed-effect model (Figure 2 caption) Unresolved: the two extractors disagree on this row. | MD -0.38 [-0.52, -0.25] GRADE not reported Studies not reported |
| Adults with type 2 diabetes mellitus and periodontitis | Periodontal intervention (non-surgical periodontal therapy alone or with adjuncts or self-management programs) | No active periodontal treatment (hygiene advice only, delayed or routine care) | HbA1c change (%) 3 to 6 months (all trials, earliest post-treatment visit) | MD -0.36 [-0.60, -0.11] Moderate Downgraded: risk of bias 10 studies · 960 participants |
| Adults with type 2 diabetes mellitus and periodontitis | Periodontal intervention (non-surgical periodontal therapy alone or with adjuncts or self-management programs) | No active periodontal treatment (hygiene advice only, delayed or routine care) | Fasting plasma glucose (mg/dL) about 3 to 6 months | MD -6.22 [-10.94, -1.49] Moderate Downgraded: risk of bias 6 studies · 466 participants |
| Adults with type 2 diabetes mellitus and periodontitis | Periodontal intervention (non-surgical periodontal therapy alone or with adjuncts or self-management programs) | No active periodontal treatment (hygiene advice only, delayed or routine care) | Periodontal parameters (probing depth, clinical attachment level, bleeding on probing, plaque) 3 to 6 months | Consistently improved vs control; forest plots all favor intervention; Moderate Moderate Downgraded: risk of bias Studies not reported |
Included primary studies 10
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Al-Abbadi 2025 Non-surgical periodontal therapy with and without hyaluronic acid gel in type 2 diabetic stage-II periodontitis patients: a randomized… PMID:40665270 | 2025 | this review only | not stated | not extracted yet |
| Bian 2021 Application value of combination therapy of periodontal curettage and root planing on moderate-to-severe chronic periodontitis in patients… PMID:33832490 | 2021 | this review only | not stated | not extracted yet |
| Brinar 2023 The effect of antimicrobial photodynamic therapy on periodontal disease and glycemic control in patients with type 2 diabetes mellitus. PMID:37672083 | 2023 | this review only | not stated | not extracted yet |
| Gomez-Sandoval 2020 Efficacy of clindamycin compared with amoxicillin-metronidazole after a 7-day regimen in the treatment of periodontitis in patients with… PMID:31958293 | 2020 | this review only | not stated | not extracted yet |
| Mizuno 2017 The effects of non-surgical periodontal treatment on glycemic control, oxidative stress balance and quality of life in patients with type… PMID:29145468 | 2017 | this review only | not stated | not extracted yet |
| Qureshi 2021 Clinical efficacy of scaling and root planing with and without metronidazole on glycemic control: three-arm randomized controlled trial. PMID:33980234 | 2021 | this review only | not stated | not extracted yet |
| Rapone 2021 Inflammatory Status and Glycemic Control Level of Patients with Type 2 Diabetes and Periodontitis: A Randomized Clinical Trial. PMID:33804123 | 2021 | this review only | not stated | not extracted yet |
| Tsobgny-Tsague 2018 Effects of nonsurgical periodontal treatment on glycated haemoglobin on type 2 diabetes patients (PARODIA 1 study): a randomized… PMID:29482543 | 2018 | this review only | not stated | not extracted yet |
| Wernicke 2021 Influence of physical activity on periodontal health in patients with type 2 diabetes mellitus. A blinded, randomized, controlled trial. PMID:33796948 | 2021 | this review only | not stated | not extracted yet |
| Zhang 2025 Community interventions improve diabetes management and oral health in type 2 diabetes patients with chronic periodontitis. PMID:40628879 | 2025 | this review only | not stated | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Adults (>=18 years) with type 2 diabetes mellitus and periodontitis | Adults with T2DM and periodontitis (10 studies, >1500 participants reported) |
| Intervention | NSPT (scaling and root planing with oral-hygiene instruction) alone or with adjuncts (systemic/topical antimicrobials, aPDT, hyaluronic acid) or self-management programs | NSPT with or without adjuncts (povidone-iodine, systemic antibiotics, aPDT, hyaluronic acid), physical activity, education and self-management programs (n=10) |
| Comparison | No active periodontal treatment (delayed or minimal care, routine care, pre-intervention status) | Hygiene advice only, delayed treatment, routine care (n=10) |
| Outcomes | HbA1c (primary); fasting plasma glucose; probing depth, clinical attachment level, bleeding on probing, plaque indices; CRP, oxidative stress, quality of life | HbA1c (n=10 pooled); fasting plasma glucose (n=6 pooled); periodontal parameters (narrative, GRADE only) |
| Study designs | Randomized and non-randomized comparative studies; parallel-group trials and single-group pre-post studies | 9 RCTs/cluster RCTs and 1 comparative prospective study (n=10) |
| Timing | Earliest post-treatment visit within 3 to 6 months; subgroup of longer follow-up (6 months or more) | 3 to 6 months |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | No | No | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | No | yes |
| 5Study selection in duplicate | No | No | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: Partial Yes | NRSI: Partial Yes · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: No | NRSI: No · RCT: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |