It is remarkable that the prestigious Journal of Clinical Periodontology, founded by Hans Mühlemann and edited for decades by Jan Lindhe, is going to publish a commercial for a Quintessence Publishing and Sunstar production, part of a Quintpub series of DVDs (all called Cell-to-Cell Communication) of short (each runs for about 15 minutes) animated (“3D”) movies. The first installations in this series had been about inflammatory reactions in the periodontium (I had critically reported on its educational value here), periodontal regeneration and osseointegration.
Members of the American Academy of Periodontology have been alerted yesterday evening by the publication of a large (more than 500 patients were enrolled) phase 3, single-masked, multicenter, randomized, 6-month intervention study on moderate to severe chronic periodontitis patients with diabetes type 2 taking stable doses of anti-diabetic medication. Engebretson et al. 2013 report in JAMA that basic periodontal treatment, i.e., scaling and root planing, did not lead to a reduction of HbA1c levels. Instead, HbA1c levels had slightly increased after 6 months, in test subjects receiving basic periodontal treatment even slightly more (normalized mean 0.17%) than in the control group (normalized mean 0.11%) where basic treatment was postponed. The difference was not significant.
“Results Enrollment 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.”