Background: Glycaemic control is a key issue in the care of people with diabetes mellitus (DM). Some studies have suggested a bidirectional relationship between glycaemic control and periodontal disease.

Objectives:  To investigate the relationship between periodontal therapy and glycaemic control in people with diabetes and to identify the appropriate future strategy for this question.

Search strategy:  A comprehensive approach was adopted employing handsearching; searching of electronic databases including the Cochrane Oral Health Group’s Trials Register, CENTRAL, MEDLINE, EMBASE, CINAHL, ZETOC, ISI Web of Knowledge and LILACS; contact with appropriate non-English language healthcare professionals; authors and organizations. The final date for searching for studies was 24 March 2010.

Selection criteria:  This review studied randomized controlled trials of people with Type 1 or 2 diabetes mellitus (DM) with a diagnosis of periodontitis. Suitable interventions included mechanical periodontal therapy with or without adjunctives and oral hygiene education.

Data collection and analysis:  The titles and abstracts of 690 papers were examined by two review authors independently. Ultimately, seven studies were included and 19 excluded after full text scrutiny. All trials were assessed for risk of bias.

Main results:  Three studies had results pooled into a meta-analysis. The effect for the mean percentage difference in HbA1c for scaling/root planing and oral hygiene (+/− antibiotic therapy) versus no treatment/usual treatment after 3–4 months was −0.40% (95% confidence interval (CI) fixed effect −0.78% to −0.01%), representing a statistically significant reduction in HbA1c (P = 0.04) for scaling/root planing.

One study was assessed as being at low risk of bias with the other two at moderate to high risk of bias. A subgroup analysis examined studies without adjunctive antibiotics −0.80% (one study: 95% CI −1.73% to 0.13%; P = 0.09), with adjunctive antibiotics in the test group −0.36% (one study: 95% CI −0.83% to 0.11%; P = 0.14), and with antibiotics in both test and control groups after 3/4 months −0.15% (one study: 95% CI −1.04% to 0.74%; P = 0.74).

Authors’ conclusions:  There is some evidence of improvement in metabolic control in people with diabetes, after treating periodontal disease. There are few studies available and individually these lacked the power to detect a significant effect. Most of the participants in the study had poorly controlled Type 2 DM with little data from randomized trials on the effects on people with Type 1 DM.

/pdf/treatment-of-periodontal-disease-for-glycaemic-control-in-4mp5n5yc65.pdf

Treatment of periodontal disease for glycaemic control in people with diabetes

This paper aims to provide a systematic review of the caries-prevention effect of probiotics in human. The hypothesis was that the administration of probiotic strains might play a role in caries lesion prevention and in the control of caries-related risk factors. The main relevant databases (Medline, Embase) were searched. Quality of the Randomized Clinical Trials (RCTs) was classified using the “Consolidated Standards of Reporting Trials” (CONSORT) checklist and the Impact Factor (IF) value of each journal was recorded. Sixty-six papers were identified, and 23 fulfilled the inclusion criteria. Only three studies had caries lesion development as outcome, all the others reported caries risk factors as interim evaluation. Using the CONSORT Score, the papers were coded as 4 excellent, 9 good and 10 poor. The mean IF value recorded was 1.438. Probiotics may play a role as antagonistic agent on mutans streptococci (MS), acidogenic/aciduric bacteria that contributes to the caries process. In two-thirds of the selected papers, probiotics have demonstrated the capacity to reduce MS counts in saliva and/or plaque in short-term. The effect of probiotics on the development of caries lesion seems encouraging, but to date, RCTs on this topic are insufficient to provide scientific clinical evidence.

https://www.mdpi.com/2072-6643/5/7/2530/pdf

The Use of Probiotic Strains in Caries Prevention: A Systematic Review

Background: It was recently suggested that scaling and root planing (SRP) may help to improve glycemic and metabolic control in patients with chronic periodontitis (CP) and type 2 diabetes mellitus (DM2); however, the effectiveness of SRP in this role remains unclear. This meta-analysis assesses the effectiveness of SRP in improving glycemic and metabolic control in patients with CP and DM2.Methods: A literature search of electronic databases was performed for articles published through May 16, 2012, followed by a manual search of several dental journals. A meta-analysis was conducted according to the recommendations of the Cochrane Collaboration and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Weighted mean differences (MDs) and 95% confidence intervals (CIs) were calculated for glycated hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), total cholesterol (TC), triglycerides (TG), and high- and low-density lipoprotein cholesterol (HDL and LDL, respectively). All out...

Effectiveness of Periodontal Treatment to Improve Metabolic Control in Patients With Chronic Periodontitis and Type 2 Diabetes: A Meta-Analysis of Randomized Clinical Trials

This paper describes the dental health status of Italian 4-year-olds in 2004/2005 and analyzes the association between caries in preschool children and some background characteristics in children and

National pathfinder survey on children's oral health in Italy: pattern and severity of caries disease in 4-year-olds.

Dental caries is a recognized worldwide public health problem. Despite being one of the most effective strategies against dental caries, the excessive use of fluorine may result in a potential risk of developing dental fluorosis especially in children under age of six. The purpose of this work is to analyze a fluorine-free toothpaste containing Biomimetic Hydroxyapatite to assess enamel re-mineralizing and repairing properties. The study was performed in vitro and in vivo, comparing the hydroxyapatite toothpaste with two others toothpaste containing different fluorine concentrations. The coating effect of the micro-structured Hydroxyapatite nanoparticles reintegrates the enamel with a biomimetic film reproducing the structure and the morphology of the biologic Hydroxyapatite of the enamel. As demonstrated, the coating is due to the deposit of a new layer of apatite, which presents fewer particles than the natural enamel, not based on the chemical—physical changes occurring in fluorinated toothpastes. Moreover, it shows resistance to brushing as a consequence of chemical bonds between the synthetic and natural crystals of the enamel. The use of Biomimetic Hydroxyapatite toothpastes has proven to be a valuable prevention measure against dental caries in primary dentition since it prevents the risk of fluorosis.

/pdf/enamel-remineralization-and-repair-results-of-biomimetic-2psgnvrf68.pdf

Enamel remineralization and repair results of Biomimetic Hydroxyapatite toothpaste on deciduous teeth: an effective option to fluoride toothpaste.

No recent data on the experience of caries among Italian 12-year-olds are available. In 2004, an epidemiological survey called 'National Pathfinder among Children's Oral Health in Italy' was promoted and carried out. This study reports the actual oral health status of Italian 12-year-olds according to gender, residence area and geographical distribution. Clinical examinations were carried out from March 2004 to April 2005, according to WHO criteria, and included dental caries (decay at the dentinal lesion level) and Community Periodontal Index (CPI). 5,342 children (2,670 males, 2,672 females) were examined by 7 ad hoc calibrated raters. Dental caries experience was found in 43.1% (95% CI 41.8-44.4%) of the study population. The mean DMFT score was 1.09 (95% CI 0.98-1.21). Significant differences (p < 0.05) were observed among geographical sections for DT, FT and DMFT. An inverse relationship was observed between mean DMFT and gross national product per capita (p < 0.001). Gingival bleeding was observed in 23.8% of children, while 28.7% had calculus. Significant differences in CPI scores among sections were found throughout the sample in both males and females (p < 0.001). Over the past two decades, mean DMFT fell from over 5 to its present level, halving every decade; consequently, the recorded level of dental caries has become aligned with that in other Western European countries. Nevertheless, differences in DMFT values remain between children from different socioeconomic backgrounds.

National Pathfinder survey of 12-year-old Children's Oral Health in Italy.

Linee guida nazionali per la promozione della salute orale e la prevenzione delle patologie orali in età evolutiva

Periodontal disease is the result of a local bacterial \ninfection produced by a pathogenic microflora within \nthe periodontal pocket. Studies evaluating the effect of periodontal therapy \non diabetic patients over 50 are scarce. Therefore, we \ninvestigated the effect of mechanical periodontal \ntherapy on the diabetic control in older adults. Our results demonstrate that mechanical periodontal \ntreatment improve periodontal status of type 2 diabetic \npatients, although the differences at baseline and at 2- \nyear examination are not statistically significant. We \nfocused on patients over 50 because the old age is \nassociated with an increased prevalence of periodontal \ndisease and with an increased insulin resistance \nas well as with an increased incidence and severity of \ndiabetes.

Clinical effects of mechanical periodontal therapy in type 2 diabetic patients

Caries distribution modelling: an application on the data set from the first National Pathfinder survey of Italian 4-year-old Children

Linee guida nazionali per la promozione della salute orale e la prevenzione delle patologie orali in età evolutiva. Ministero del Lavoro della Salute e delle Politiche Sociali.

Mg Cagetti

Papers

National Pathfinder survey of 12-year-old Children's Oral Health in Italy.

Linee guida nazionali per la promozione della salute orale e la prevenzione delle patologie orali in età evolutiva

Clinical effects of mechanical periodontal therapy in type 2 diabetic patients

Caries distribution modelling: an application on the data set from the first National Pathfinder survey of Italian 4-year-old Children

Linee guida nazionali per la promozione della salute orale e la prevenzione delle patologie orali in età evolutiva. Ministero del Lavoro della Salute e delle Politiche Sociali.