Periodontal Treatment Protocol for Decompensated Diabetes Patients.

Autor:	Dallaserra M; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Chile, Santiago, Chile.; Cochrane Associate Center, Faculty of Dentistry, University of Chile, Santiago, Chile., Morales A; Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, University of Chile, Santiago, Chile.; Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile., Hussein N; Centro de Salud Familiar Dr. Francisco Boris Soler, Melipilla, Chile., Rivera M; Departamento de Atención de las Personas, División de Atención Primaria, Subsecretaría de Redes Asistenciales del Ministerio de Salud, Santiago, Chile., Cavalla F; Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, University of Chile, Santiago, Chile.; Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile., Baeza M; Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, University of Chile, Santiago, Chile.; Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile., Strauss FJ; Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile.; Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.; Department of Oral Biology, Medical University of Vienna, Vienna, Austria., Yoma Y; Referencia Técnica Odontológica, Departamento de Gestión Clínica, Servicio de Salud Metropolitano Occidente, Santiago, Chile., Suazo C; Programa Odontológico, Cesfam Steeger, Corporación Municipal Desarrollo Social de Cerro Navia, Santiago, Chile., Jara G; Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, University of Chile, Santiago, Chile., Contreras J; Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile., Villanueva J; Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Chile, Santiago, Chile.; Cochrane Associate Center, Faculty of Dentistry, University of Chile, Santiago, Chile.; Servicio de Cirugía Maxilofacial, Hospital Clínico San Borja Arriarán, Santiago, Chile., Valenzuela-Villarroel F; Faculty of Medicine, University of Chile, Santiago, Chile., Gamonal J; Center for Epidemiology and Surveillance of Oral Diseases (CESOD), Faculty of Dentistry, University of Chile, Santiago, Chile.; Department of Conservative Dentistry, Faculty of Dentistry, University of Chile, Santiago, Chile.
Jazyk:	angličtina
Zdroj:	Frontiers in oral health [Front Oral Health] 2021 Apr 16; Vol. 2, pp. 666713. Date of Electronic Publication: 2021 Apr 16 (Print Publication: 2021).
DOI:	10.3389/froh.2021.666713
Abstrakt:	Background: Decompensated diabetes is associated with a higher prevalence and severity of periodontitis and poorer response to periodontal therapy. It is conceivable that periodontal therapy may cause systemic and local complications in this type of patients. The aim of the present study was to identify and describe the best available evidence for the treatment of periodontitis in decompensated diabetics. Material and methods: An expert committee including participants from different areas gathered to discuss and develop a treatment guideline under the guidance of the Cochrane Associate Center, Faculty of Dentistry, University of Chile. In total, four research questions were prepared. The questions prepared related to decompensated diabetic patients (glycated hemoglobin >8) were, (1) Does the exposure to periodontal treatment increase the risk of infectious or systemic complications? (2) Does the antibiotic treatment or prophylaxis, compared to not giving it, reduce infectious complications? (3) Does the exposure to periodontal treatment, compared to no treatment, reduce the glycated hemoglobin levels (HbA1c)? Last question was related to diabetic patients, (4) Does the exposure to a higher level of HbA1c, compared to stable levels, increase the risk of infectious complications? Based on these questions, a search strategy was developed using MEDLINE and EPISTEMONIKOS. Only systematic reviews were considered. Results: For question 1, the search yielded 12 records in EPISTEMONIKOS and 23 in MEDLINE. None of these studies addressed the question. For question 2, the search yielded 58 records in EPISTEMONIKOS and 11 in MEDLINE. None of these studies addressed the question. For question 3, the search yielded 16 records in EPISTEMONIKOS and 11 in MEDLINE. Thirteen addressed the question. For question 4, the search yielded 7 records in EPISTEMONIKOS and 9 in MEDLINE. One addressed the question. Conclusions: In decompensated diabetic patients, there is lack of scientific information about risk of infectious or systemic complications as a result of periodontal treatment and about the impact of antibiotic treatment or prophylaxis on reduction if infectious complications. A defined HbA1c threshold for dental and periodontal treatment in diabetic patients has yet to be determined. Finally, periodontal treatment does have an impact on HbA1c levels. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2021 Dallaserra, Morales, Hussein, Rivera, Cavalla, Baeza, Strauss, Yoma, Suazo, Jara, Contreras, Villanueva, Valenzuela-Villarroel and Gamonal.)
Databáze:	MEDLINE
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