Table 2.

Comparison of periodontal treatment effects on glycemic control in patients with type 1 diabetes

	Reference	Study design	Follow-up	Periodontal therapy	Metabolic control outcome measure	Periodontal parameters assesseda	Effects on metabolic control
1a	Aldridge et al. (study 1) 199511	RCT	2 months	41 T1DM subjects with gingivitis and early periodontitis Treatment group: oral hygiene instructions, scaling, correction of restoration margins, reinforcement at one month Control group: no treatment	Glycated hemoglobin, fructosamine	PI, BOP, PD	Periodontal treatment showed no effect on glycated hemoglobin levels
1b	Aldridge et al. (study 2) 199511	RCT	2 months	23 subjects were recruited and divided into 2 groups Treatment group: oral hygiene instructions, scaling/root planing, extractions, root canal therapy Control group: no treatment	Glycated hemoglobin	PI, BOP, PD	Periodontal treatment showed no effect on glycated hemoglobin levels
2	Smith et al. 199612	Treatment study Non-RCT	2 months	Scaling and root planing using an ultrasonic scaler, curettes, oral hygiene instructions	Glycated hemoglobin	PD, CAL, GI Gingival fluid AST levels	No significant change in glycated hemoglobin
3	Westfelt et al. 199613	Treatment study Non-RCT	5 years	20 patients with diabetes, T1DM or T2DM, were recruited Patients received oral hygiene instruction, scaling and root planing, subgingival scaling and surgery at sites with BOP and PD >5 mm	Glycated hemoglobin	PI, GI	The mean value of HbA1c between baseline and 24 months was not significantly different from 24 to 60 months
4	Christgau et al. 199814	Treatment study, Non-RCT	2 months	20 T1DM (n = 7) or T2DM (n = 13) with periodontal disease Scaling and root planing, irrigation with chlorhexidine, oral hygiene instructions, extractions	Glycated hemoglobin	PI, Papilla bleeding index, BOP, PD, Probing attachment level (PAL)	No changes in glycated hemoglobin
5	Skaleric et al. 200415	RCT	6 months	20 patients with poorly controlled diabetes (HbA1c 7.5%) and periodontitis Presence of 4 teeth with 5 mm periodontal pockets and BOP The test group received scaling and root planing with minocycline microspheres (Arestin®) The control group received only scaling and root planing	Glycated hemoglobin	PI, GI, PD, CAL	Demonstrated reduction in HbA1c levels in both groups, but the intergroup difference was not statistically significant
6	Llambés et al. 200816	RCT	3 months	60 T1DM subjects with moderate to severe periodontitis Test group received scaling and root planing, chlorhexidine mouthwash, and doxycycline 100 mg for 15 days Control group: same treatment as test group but doxycycline was not given	Glycated hemoglobin	PI, BOP, PD, CAL	No changes in glycosylated hemoglobin
7	Tervonen et al. 200917	Non-RCT	2 months	Oral hygiene education, scaling, root planing, with or without periodontal surgery	Glycated hemoglobin		No improvement in glycemic control was reported by many subjects
8	Buzinin et al. 201418	Non-RCT		41 Malaysian subjects: 20 subjects were T1DM with chronic periodontal disease (test group) and 21 only chronic periodontal diseases Both groups received oral hygiene instructions and one session of full-mouth debridement	Glycated hemoglobin	PI, GI, PD, PAL	No changes in HbA1c level in the test group
9	Lopes et al. 201719	Non-RCT	6 months	70 patients with periodontitis; 3 groups Control group (n = 11): systemically healthy subjects Test-group 1 (n = 14): subjects with T1DM Test-group 2 (n = 27): subjects with T2DM Basic periodontal treatment, oral hygiene instructions, scaling and root planing, supportive therapy; additional 2 g amoxicillin as antibiotic prophylaxis 1 h before—for subjects with diabetes	Glycated hemoglobin	PI, BOP, PD, CAL	Periodontal treatment was more effective for glycemic control in T1DM patients than in T2DM

^aPI: Plaque Index; GI: Gingival Index; BOP: bleeding on probing; PD: pocket depth; CAL: clinical attachment level