Objectives: To explore the age differences in the effect of multi-component periodontal treatment on oral and metabolic indicators in people with periodontitis and diabetes.
Methods: Six databases (PubMed/Medline, Embase, CINHAL, Web of Science, Cochrane Library, and ProQuest) were searched from database inception to August 2022. Trials reporting the effects of multi-component periodontal treatment on oral and metabolic indicators in people over 18 years old with periodontitis and diabetes were included. We used bivariate and multivariate meta-regression models to examine the association between age and treatment effect size. The primary outcomes were changes in pocket depth (PD), clinical attachment level (CAL), and hemoglobin A1c (HbA1c).
Results: A total 115 trials (119 articles) met the inclusion criteria. Pooled evidence demonstrated that multi-component periodontal treatment significantly reduced PD (g=0.929, 95% CI [0.689-1.169], I2=94.1%), CAL (g=0.879, 95% CI [0.669-1.089], I2=92.1%), and HbA1c (g=0.603, 95% CI [0.443-0.763], I2=87.5%). There was a significant decreasing trend in the effect size for PD (P for trend = 0.020) and CAL (P for trend = 0.028) as age increases. Results from multivariate meta-regression showed that age was associated with smaller effects of PD (β [standard error] = -0.123 [0.041], P=0.004) and CAL (-0.159 [0.055], P=0.006). The effect size for HbA1c was smaller in participants older than 55 years compared to their younger counterparts (-0.792 [0.322], P=0.017).
Conclusions: The effect size of multi-component periodontal treatments on PD and CAL may decrease as people with periodontitis and diabetes age increases. The treatment effect on HbA1c is significantly lower in people older than 55 compared to their younger counterparts. The components of periodontal treatment should be adjusted to the individual’s periodontal and glycemic control levels.
Z.Zhu: None. X.Qi: None. Y.Zheng: None. Y.Pei: None. B.Wu: None.
National Institutes of Health (P30AG059304, P50MD017356)
