Periodontal status of diabetics compared with nondiabetics: a meta-analysis.

BACKGROUND This meta-analysis was conducted to assess the association between diabetes mellitus and periodontal diseases by comparing the extent and severity of periodontal diseases between diabetics and nondiabetics. METHODS A literature search was performed using MEDLINE database for published studies from January 1970 through October 2003 with manual search for references in relevant studies. This meta-analysis was based on 18 comparative cross-sectional studies, three prospective cohort studies and baseline data of two clinical trials that compared oral hygiene, gingival and periodontal status between diabetics and nondiabetics. Heterogeneity was obvious among included studies; therefore, the analysis using random-effects model was conducted. RESULTS This study demonstrated that diabetics had significantly worse oral hygiene as measured by the average of plaque index (P1I), higher severity of gingival disease as measured by the average of gingival index (GI) and higher severity of periodontal disease as measured by the average of probing pocket depth (PPD) and clinical attachment loss (CAL). However, diabetics had similar extent of oral hygiene, gingival and periodontal disease as measured by percentages of surfaces or sites with specific scores of P1I, GI, bleeding on probing (BOP), PPD and CAL. CONCLUSIONS Diabetics had a significantly higher severity but the same extent of periodontal disease than nondiabetics.

[1]  R. Genco,et al.  Periodontal disease in non-insulin-dependent diabetes mellitus. , 1991, Journal of periodontology.

[2]  M. Knuuttila,et al.  The onset of diabetes and poor metabolic control increases gingival bleeding in children and adolescents with insulin-dependent diabetes mellitus. , 1996, Journal of clinical periodontology.

[3]  E. Fıratlı,et al.  The relationship between clinical attachment loss and the duration of insulin-dependent diabetes mellitus (IDDM) in children and adolescents. , 1996, Journal of clinical periodontology.

[4]  W. Knowler,et al.  Non-insulin dependent diabetes mellitus and alveolar bone loss progression over 2 years. , 1998, Journal of periodontology.

[5]  M. Ringelberg,et al.  Comparison of Gingival Health and Gingival Crevicular Fluid Flow in Children With and Without Diabetes , 1977, Journal of dental research.

[6]  B. Hacker,et al.  Periodontal disease pathogenesis , 2005 .

[7]  J. Baum,et al.  The dental status of a group of diabetic children , 1981, British Dental Journal.

[8]  E. Fıratlı,et al.  Fructosamine as a possible monitoring parameter in non-insulin dependent diabetes mellitus patients with periodontal disease. , 1993, Journal of periodontology.

[9]  Aileen B. Sedman,et al.  A longitudinal study , 1987 .

[10]  A. B. Novaes,et al.  Manifestations of insulin-dependent diabetes mellitus in the periodontium of young Brazilian patients. , 1991, Journal of periodontology.

[11]  S. Offenbacher.  Periodontal diseases: pathogenesis. , 1996, Annals of periodontology.

[12]  J. de Graaff,et al.  Periodontal condition and microbiology of healthy and diseased periodontal pockets in type 1 diabetes mellitus patients. , 1989, Journal of clinical periodontology.

[13]  M. Becker,et al.  Glycemic control and alveolar bone loss progression in type 2 diabetes. , 1998, Annals of periodontology.

[14]  L. Hedges,et al.  The Handbook of Research Synthesis , 1995 .

[15]  D. Goteiner,et al.  Periodontal and caries experience in children with insulin-dependent diabetes mellitus. , 1986, Journal of the American Dental Association.

[16]  N. Sznajder,et al.  Periodontal findings in diabetic and nondiabetic patients. , 1978, Journal of periodontology.

[17]  R. Genco,et al.  Prevalence of periodontal disease in insulin-dependent diabetes mellitus (juvenile diabetes). , 1982, Journal of the American Dental Association.

[18]  M. Granić,et al.  CPITN assessment of periodontal disease in diabetic patients. , 1988, Journal of periodontology.

[19]  R. Genco,et al.  Periodontal disease and diabetes mellitus: a two-way relationship. , 1998, Annals of periodontology.

[20]  J. Lindhe,et al.  The effect of periodontal therapy in diabetics. Results after 5 years. , 1996, Journal of clinical periodontology.

[21]  T. Watts,et al.  Initial study of periodontal status in non-insulin-dependent diabetics in Mauritius. , 1995, Journal of dentistry.

[22]  T. Tervonen,et al.  Enzyme activity in crevicular fluid in relation to metabolic control of diabetes and other periodontal risk factors. , 1993, Journal of periodontology.

[23]  J. Lindhe,et al.  Prevalence of periodontal disease in young diabetics. , 1987, Journal of clinical periodontology.

[24]  L. Niskanen,et al.  Periodontal findings in elderly patients with non-insulin dependent diabetes mellitus. , 1998, Journal of periodontology.

[25]  Najam Ali Khan,et al.  The relationship between periodontal disease and blood glucose level among type II diabetic patients. , 2001, The journal of contemporary dental practice.

[26]  M. Campbell.  Epidemiology of periodontal disease in the diabetic and the non-diabetic. , 1972, Australian dental journal.

[27]  M. Litaker,et al.  Periodontal disease and type I diabetes mellitus in children and adolescents. , 1995, Journal of clinical periodontology.

[28]  J. Anderson,et al.  Periodontal status of diabetic and non-diabetic men: effects of smoking, glycemic control, and socioeconomic factors. , 1996, Journal of periodontology.

[29]  T. Tervonen,et al.  Adult diabetic and nondiabetic subjects as users of dental services. A longitudinal study. , 1995, Acta odontologica Scandinavica.

[30]  R. Genco,et al.  Host Responses Host Responses in Periodontal Diseases , 1984 .

[31]  T. Tervonen,et al.  Periodontitis and tooth loss: comparing diabetics with the general population. , 1993, Journal of the American Dental Association.

[32]  T. Tervonen,et al.  Immediate response to nonsurgical periodontal treatment in subjects with diabetes mellitus. , 1991, Journal of clinical periodontology.

[33]  A. Hugoson,et al.  Periodontal disease experience in adult long-duration insulin-dependent diabetics. , 1993, Journal of clinical periodontology.

[34]  Novaes Ab,et al.  Periodontal disease progression in type II non-insulin-dependent diabetes mellitus patients (NIDDM). Part I--Probing pocket depth and clinical attachment. , 1996 .

[35]  R. Page,et al.  The host response to the microbial challenge in periodontitis: assembling the players. , 1997, Periodontology 2000.

[36]  T. Tervonen,et al.  Relation of diabetes control to periodontal pocketing and alveolar bone level. , 1986, Oral surgery, oral medicine, and oral pathology.

[37]  T. Tervonen,et al.  Periodontal disease related to diabetic status. A pilot study of the response to periodontal therapy in type 1 diabetes. , 1997, Journal of clinical periodontology.

[38]  W. G. Cochran.  The combination of estimates from different experiments. , 1954 .

[39]  D. Cohen,et al.  Diabetes Mellitus and Periodontal Disease: Two‐Year Longitudinal Observations Part I , 1970 .

[40]  S. Huumonen,et al.  Alveolar bone loss in type 1 diabetic subjects. , 2000, Journal of clinical periodontology.

[41]  W. Lundergan,et al.  Crevicular fluid elastase levels in relation to periodontitis and metabolic control of diabetes. , 2001, Journal of periodontal research.

[42]  E. Fıratlı.  The relationship between clinical periodontal status and insulin-dependent diabetes mellitus. Results after 5 years. , 1997, Journal of periodontology.

[43]  J. Robert,et al.  Periodontal status in insulin-dependent diabetic adolescents. , 1992, Journal of clinical periodontology.

[44]  A. Hugoson,et al.  Periodontal conditions in insulin-dependent diabetics. , 1989, Journal of clinical periodontology.

[45]  W. Knowler,et al.  Type 2 diabetes mellitus and periodontal disease. , 1990, Journal of the American Dental Association.

[46]  R. Genco,et al.  Neutrophil chemotaxis in individuals with advanced periodontal disease and a genetic predisposition to diabetes mellitus. , 1981, Journal of periodontology.