Treatment of periodontal disease in patients with diabetes: a review of clinical and cost-effectiveness

Canadian Agency for Drugs and Technologies in Health
Record ID 32011001166
Authors' recommendations: Three meta-analyses of RCTs and controlled clinical trials reported a statistically significant reduction in HbA1C following treatment of periodontal disease and one meta-analysis of controlled and uncontrolled clinical trials reported no significant difference. The meta-analysis of RCTs was restricted to comparisons of periodontal treatment versus no treatment and, therefore, represents the best available assessment of the effect of periodontal interventions on glycemic control. The statistically significant reduction in HbA1C of -0.4% is less than the commonly cited minimal clinically important differences in HbA1C (range -0.5 to -1.0%);therefore, the effect of periodontal treatment is lower than that observed with other interventions used to control hyperglycemia such as diet, exercise, oral antihyperglycemic agents, or insulins. Furthermore, the individual clinical trials that form the evidence base of these systematic reviews have low statistical power, are heterogeneous, and have poor internal validity. Given these limitations, the findings reported in these reviews may not be generalizable to the broader population of patients with diabetes and periodontal disease. Well-designed RCTs with adequate statistical power and a longer duration of follow-up are required to confirm the results of these systematic reviews.
Project Status: Completed
Year Published: 2010
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Canada
MeSH Terms
  • Cost-Benefit Analysis
  • Diabetes Complications
  • Periodontal Diseases
Organisation Name: Canadian Agency for Drugs and Technologies in Health
Contact Address: 600-865 Carling Avenue, Ottawa, ON K1S 5S8 Canada. Tel: +1 613 226 2553; Fax: +1 613 226 5392;
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Copyright: Canadian Agency for Drugs and Technologies in Health (CADTH)
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