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Updated: May 11, 2026

Adjunctive Diode Laser Therapy and Probiotic Lactobacillus Therapy in the Treatment of Periodontitis and Peri-Implant Disease
Published on: May 9, 2022
Evidence that periodontal treatment improves diabetes outcomes: a systematic review and meta-analysis
Steven Engebretson1, Thomas Kocher
1Department of Periodontology and Implant Dentistry, New York University College of Dentistry, 345 East 24th Street, New York, NY 10010, USA. spe2002@nyu.edu
Context:
The effect of periodontal therapy on diabetes outcomes has not been established.
Objective:
This update examines the effect of periodontal treatment on diabetes outcomes.
Data Sources:
Literature since October 2009 using MEDLINE.
Study Eligibility Criteria:
Published RCTs including periodontal therapy for diabetic subjects, a metabolic outcome, an untreated control group, and follow-up of 3 months.
Data Extraction:
Pre-defined data fields, including study quality indicators were used.
Data Synthesis:
A search revealed 56 publications of which 9 met inclusion criteria. Mean change of HbA1c from baseline was compared across treatment groups. Pooled analysis was based on random effects models.
Results:
A meta-analysis indicated a mean treatment effect of _0.36% HbA1c (CI _0.54, _0.19) compared to no treatment after periodontal therapy (p < 0.0001). Heterogeneity tests revealed only minimal evidence of publication bias (I2 = 9%).
Limitations:
Small sample size and high risk of bias remain problematic for studies of this type. Periodontal therapy varied considerably.
Conclusion:
The modest reduction in HbA1c observed as a result of periodontal therapy in subjects with type 2 diabetes is consistent with previous systematic reviews. Despite this finding, there is limited confidence in the conclusion due to a lack of multi-centre trials of sufficient sample size are lacking.
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