The Effect of Nonsurgical Periodontal Therapy
on Hemoglobin A1c Levels in Persons With Type 2 Diabetes and Chronic Periodontitis.
A Randomized Clinical Trial. JAMA. 2013;310(23):2523-2532. doi:10.1001/jama.2013.282431. December 18, 2013 Volume 310, Number 23
Abstract Conclusions and study design: The Diabetes and Periodontal Therapy Trial (DPTT), a 6-month, single-masked, multicenter, randomized clinical trial. Participants had type 2 diabetes, were taking stable doses of medications, had HbA1c levels between 7%and less than 9%, and untreated chronic periodontitis. Five hundred fourteen participants were enrolled between November 2009 and March 2012 from diabetes and dental clinics and
communities affiliated with 5 academic medical centers. The treatment group (n = 257) received scaling and root planing plus chlorhexidine oral rinse at baseline and supportive periodontal therapy at 3 and 6 months.
The control group (n = 257) received no treatment for 6 months.
Results: Enrollment was stopped early because of futility. At 6 months, mean HbA1c levels in the periodontal therapy group increased 0.17%(SD, 1.0), compared with 0.11% (SD, 1.0) in the control group, with no significant difference between groups based on a linear regression model adjusting for clinical site (mean difference, −0.05%[95%CI, −0.23%to 0.12%]; P = .55).
Periodontal measures improved in the treatment group compared with the control group at 6 months, with adjusted between-group differences of 0.28mm(95%CI, 0.18 to 0.37) for probing depth, 0.25mm(95%CI, 0.14 to 0.36) for clinical attachment loss, 13.1%(95%CI, 8.1% to 18.1%) for bleeding on probing, and 0.27 (95%CI, 0.17 to 0.37) for gingival index (P < .001 for all).
Conclusions and Relevance: Nonsurgical periodontal therapy did not improve glycemic control in patients with type 2 diabetes and moderate to advanced chronic periodontitis. These findings do not support the use of nonsurgical periodontal treatment in patients with diabetes for the purpose of lowering levels of HbA1c.
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