The impact of different states of type 2 diabetes when stratified by baseline HbA1c on the periodontal outcomes of non-surgical periodontal treatment: A systematic review and network meta-analysis

IF 1.6 4区医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE International journal of dental hygiene Pub Date : 2024-02-23 DOI:10.1111/idh.12789

Shuai Kang, Zheng-ya Liu, Huan-huan Yuan, Shu-min Wang, Ge-ge Pan, Wei Wei, Yi Jiang, Yu Hou

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Abstract

Background

Type 2 diabetes mellitus (T2DM) has been considered by many studies to have a bidirectional relationship with periodontitis. This systematic review and network meta-analysis aimed to investigate the impact of different states of T2DM when stratified by baseline HbA1c on the clinical outcomes of non-surgical periodontal treatment (NSPT).

Methods

This study followed the Preferred Reporting Items for Meta-Analyses (PRISMA) guidelines and involved an electronic literature search (from inception to the 2nd of January 2023). The study included at least two groups of patients: chronic periodontitis only (No-DM) or periodontitis and well-controlled/poorly controlled type 2 diabetes mellitus (WC/PC-T2DM). Clinical outcomes included probing depth (PD) reduction, bleeding on probing reduction, and clinical attachment level (CAL) gain. Direct and indirect comparisons between groups were assessed by network meta-analysis, thus allowing us to establish a treatment ranking.

Results

Ten prospective cohort studies (11 data sets) were included for qualitative analysis and network meta-analysis. The data included in this study had high consistency; in addition, a funnel plot and Egger's test showed that the articles had low publication bias. Network meta-analysis showed that the effect of NSPT in the No-DM group was significantly better than the WC-T2DM group [weighted mean difference (WMD) = 0.09, 95% confidence interval (CI) (0.01, 0.18)] and the PC-T2DM group [WMD = 0.09, 95% CI (0.01, 0.18)] in terms of CAL gain and better than the PC-T2DM group [WMD = 0.15, 95% CI (0.02, 0.28)] in terms of PD reduction. According to the surface under the cumulative ranking value, the No-DM group had the highest probability of achieving the best outcome following NSPT.

Conclusions

Collectively, our analyses show that T2DM exerts significant effects on the outcomes of NSPT.

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按基线 HbA1c 分层的不同 2 型糖尿病状态对非手术牙周治疗的牙周效果的影响：系统综述与网络荟萃分析。

背景：许多研究认为2型糖尿病（T2DM）与牙周炎有双向关系。本系统综述和网络荟萃分析旨在研究不同状态的 T2DM（按基线 HbA1c 分层）对非手术牙周治疗（NSPT）临床结果的影响：本研究遵循 Meta-Analyses（Meta-Analyses）首选报告项目（Preferred Reporting Items for Meta-Analyses，PRISMA）指南，并进行了电子文献检索（从开始到 2023 年 1 月 2 日）。研究至少包括两组患者：仅有慢性牙周炎（No-DM）或牙周炎和控制良好/控制不佳的2型糖尿病（WC/PC-T2DM）。临床结果包括探诊深度 (PD) 减少、探诊出血减少和临床附着水平 (CAL) 增加。通过网络荟萃分析评估组间的直接和间接比较，从而确定治疗排名：定性分析和网络荟萃分析共纳入了 10 项前瞻性队列研究（11 组数据）。本研究纳入的数据具有高度一致性；此外，漏斗图和 Egger 检验显示，这些文章的发表偏倚较低。网络荟萃分析表明，NSPT在无DM组的CAL增益效果明显优于WC-T2DM组[加权平均差（WMD）=0.09，95%置信区间（CI）（0.01，0.18）]和PC-T2DM组[WMD=0.09，95%CI（0.01，0.18）]，在PD减少方面优于PC-T2DM组[WMD=0.15，95%CI（0.02，0.28）]。根据累积排名值下的表面，No-DM 组在 NSPT 后获得最佳结果的概率最高：总之，我们的分析表明 T2DM 对 NSPT 的疗效有显著影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International journal of dental hygiene DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

4.00

自引率

8.30%

发文量

审稿时长

>12 weeks

期刊介绍： International Journal of Dental Hygiene is the official scientific peer-reviewed journal of the International Federation of Dental Hygienists (IFDH). The journal brings the latest scientific news, high quality commissioned reviews as well as clinical, professional and educational developmental and legislative news to the profession world-wide. Thus, it acts as a forum for exchange of relevant information and enhancement of the profession with the purpose of promoting oral health for patients and communities. The aim of the International Journal of Dental Hygiene is to provide a forum for exchange of scientific knowledge in the field of oral health and dental hygiene. A further aim is to support and facilitate the application of new knowledge into clinical practice. The journal welcomes original research, reviews and case reports as well as clinical, professional, educational and legislative news to the profession world-wide.