The efficacy of combining adjuvants with non-surgical periodontal therapy in individuals with type 2 diabetes: A Bayesian network meta-analysis.

Autor: Zanatta FB; Department of Stomatology, Postgraduate Program in Dentistry - Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil., Antoniazzi RP; Department of Stomatology, Postgraduate Program in Dentistry - Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil., Oliveira LM; Department of Stomatology, Postgraduate Program in Dentistry - Periodontics, Universidade Federal de Santa Maria (UFSM), Santa Maria, Rio Grande do Sul, Brazil., Lietzan AD; Department of Comprehensive Oral Health - Periodontology, Adams School of Dentistry, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., Miguez PA; Department of Comprehensive Oral Health - Periodontology, Adams School of Dentistry, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA., Susin C; Department of Comprehensive Oral Health - Periodontology, Adams School of Dentistry, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Jazyk: angličtina
Zdroj: Journal of clinical periodontology [J Clin Periodontol] 2024 May; Vol. 51 (5), pp. 610-630. Date of Electronic Publication: 2024 Feb 11.
DOI: 10.1111/jcpe.13946
Abstrakt: Aim: This Bayesian network meta-analysis of randomized controlled trials assessed the effect of adjuvant periodontal treatment in both periodontal and HbA1c outcomes in adult individuals with type 2 diabetes (T2DM).
Materials and Methods: A systematic search was done up to February 2023 comparing sub-gingival debridement (SD) in combination with local or systemic adjuvant treatment with SD alone for individuals with T2DM. The primary outcomes were changes in absolute HbA1c levels and full-mouth probing depth reported at 3- to 6-month post-treatment.
Results: Seventy-two eligible publications evaluating 27 adjuvant treatments were retrieved. The combination of SD and systemic antibiotic metronidazole or SD and antioxidant alpha lipoic acid provided, respectively, 1.4% (95% credible interval [CrI] 0.48; 2.20) and 2.4% (95% CrI 1.50; 3.30) more significant improvement on HbA1c levels, and 0.89 mm (95% CrI 0.23; 1.50) and 0.92 mm (95% CrI 0.02; 0.92) greater periodontal probing depth reductions. Other adjuvant treatments provided added benefit to the periodontal outcomes without discernible effects on HbA1c.
Conclusions: Adjuvant use of metronidazole or alpha lipoic acid was the best adjunct option to provide clinically meaningful HbA1c levels and probing depth reductions. However, no strong recommendation can be drawn due to the scarcity of studies for each adjuvant treatment and the low certainty of the resultant evidence.
(© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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