Evidence map›Paper›PMID 24346989›Full record

Trial reportJAMA2013

The effect of nonsurgical periodontal therapy on hemoglobin A1c levels in persons with type 2 diabetes and chronic periodontitis: a randomized clinical trial.

Steven P Engebretson, Leslie G Hyman, Bryan S Michalowicz, Elinor R Schoenfeld, Marie C Gelato, Wei Hou, Elizabeth R Seaquist, Michael S Reddy, Cora E Lewis, Thomas W Oates and 6 more

2 registry-linked trialsAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JAMA, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 101 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
101citing papers in PubMed, 16 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00997178 phase3completednot on this map

A Multicenter Randomized Single-Masked Clinical Trial Testing the Effect of Non-surgical Periodontal Therapy on Glycosylated Hemoglobin (HbA1c) Levels in Subjects With Type 2 Diabetes and Chronic Periodontitis

TypeinterventionalSponsorStony Brook UniversityRan2009 to 2012Enrolled514ConditionsChronic Periodontitis, Type 2 DiabetesArmsNon-surgical periodontal therapy, Delayed non-surgical periodontal therapy
NCT04830969 phase2completednot on this mapstarted 2016, after this paper: background citation

Impact of Periodontal Therapy on Patients With Diabetes: A Pilot Study

TypeinterventionalSponsorState University of New York at BuffaloRan2016 to 2021Enrolled116ConditionsDiabetes Mellitus, Type II, PeriodontitisArmsChlorhexidine gluconate oral rinse, Scaling & Root Planing, Soft Picks
3 · Its place in the literature

Who cites it

101 citing papers in PubMed, 16 syntheses or guidelines pooled it.

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41 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

16 authors.

Steven P EngebretsonDepartment of Periodontology and Implant Dentistry, New York University, New York, New York.
Leslie G HymanDepartment of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, New York.
Bryan S MichalowiczDepartment of Developmental and Surgical Sciences, University of Minnesota, Minneapolis.
Elinor R SchoenfeldDepartment of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, New York.
Marie C GelatoDepartment of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, New York.
Wei HouDepartment of Preventive Medicine, Stony Brook University School of Medicine, Stony Brook, New York.
Elizabeth R SeaquistDepartment of Medicine, University of Minnesota, Minneapolis.
Michael S ReddyDepartment of Periodontology, University of Alabama at Birmingham.
Cora E LewisDepartment of Medicine, University of Alabama at Birmingham.
Thomas W OatesSchool of Dentistry, University of Texas at San Antonio.
Devjit TripathyDepartment of Medicine, University of Texas-San Antonio Health Science Center.
James A KatancikDepartment of Periodontics, University of Texas at Houston.
Philip R OrlanderDepartment of Internal Medicine, University of Texas-Houston Health Science Center10Department of Endocrinology, University of Texas-Houston Health Science Center.
David W PaquetteStony Brook University School of Dental Medicine, Stony Brook, New York.
Naomi Q HansonDepartment of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis.
Michael Y TsaiDepartment of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis.

Funding

University of Alabama at Birmingham's Diabetes Research CenterP30DK079626 · NIDDK · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI Kirk Michael Habegger · 2013 to 2026
$19.5M
Diabetes and Periodontics Trial - Administrative Center/Study ChairU01DE018902 · NIDCR · STATE UNIVERSITY NEW YORK STONY BROOK · PI ENGEBRETSON, STEVEN P · 2008 to 2012
$11.1M
Diabetes and Periodontics Trial - Coordinating CenterU01DE018886 · NIDCR · STATE UNIVERSITY NEW YORK STONY BROOK · PI HYMAN, LESLIE G · 2008 to 2012
$4.3M
Diabetes and Periodontics Trial R21R21DE017340 · NIDCR · STATE UNIVERSITY NEW YORK STONY BROOK · PI ENGEBRETSON, STEVEN P · 2006 to 2006
$155k
NIDCR NIH HHS R21 DE017340NIDCR NIH HHS U01 DE018886NIDCR NIH HHS U01 DE018902NIDCR NIH HHS UO1 DE018902NIDDK NIH HHS P30 DK079626
6 · The paper itself

Abstract

importanceChronic periodontitis, a destructive inflammatory disorder of the supporting structures of the teeth, is prevalent in patients with diabetes. Limited evidence suggests that periodontal therapy may improve glycemic control.

objectiveTo determine if nonsurgical periodontal treatment reduces levels of glycated hemoglobin (HbA1c) in persons with type 2 diabetes and moderate to advanced chronic periodontitis. DESIGN, SETTING, AND

participantsThe 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.

interventionsThe 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. MAIN OUTCOMES AND MEASURES: Difference in change in HbA1c level from baseline between groups at 6 months. Secondary outcomes included changes in probing pocket depths, clinical attachment loss, bleeding on probing, gingival index, fasting glucose level, and Homeostasis Model Assessment (HOMA2) score.

resultsEnrollment 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 0.28 mm (95% CI, 0.18 to 0.37) for probing depth, 0.25 mm (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.

trial registrationclinicaltrials.gov Identifier: NCT00997178.

Indexed as

Dental ScalingRoot PlaningAgedBlood GlucoseChlorhexidineChronic PeriodontitisDiabetes ComplicationsDiabetes Mellitus, Type 2FemaleGlycated HemoglobinHumansMaleMiddle AgedMouthwashesSingle-Blind MethodTreatment OutcomeBlood GlucoseChlorhexidineGlycated HemoglobinMouthwashes

Identifiers

PMID24346989
PMCPMC4089989

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.