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Updated: Dec 4, 2025

Adjunctive Diode Laser Therapy and Probiotic Lactobacillus Therapy in the Treatment of Periodontitis and Peri-Implant Disease
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Does Nonsurgical Periodontal Treatment Improve Systemic Health?

H L Taylor1, S Rahurkar2,3, T J Treat4

  • 1Department of Health Policy and Management, NLM Public and Population Health Informatics Fellow, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, IN, USA.

Journal of Dental Research
|October 22, 2020
PubMed
Summary

Nonsurgical periodontal treatment

Keywords:
biomarkersclinical outcomesinflammationoral-systemic diseaseperiodontal diseaseperiodontal medicine

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Area of Science:

  • Oral Health and Systemic Disease Link
  • Inflammation and Periodontal Therapy
  • Evidence Synthesis Methodology

Background:

  • Oral health, particularly periodontal health, is increasingly linked to overall systemic health.
  • Periodontal treatment aims to reduce oral inflammation, with hypotheses suggesting this may benefit systemic conditions.
  • Existing systematic reviews (SRs) and meta-analyses (MAs) on this topic show inconsistent findings and methodological concerns.

Purpose of the Study:

  • To systematically review existing SRs/MAs on the effects of nonsurgical periodontal treatment on systemic disease outcomes.
  • To categorize evaluated outcomes (biomarkers, surrogate, clinical endpoints) and assess the methodological quality of included reviews using AMSTAR 2.
  • To identify gaps in the evidence and guide future research and review methodologies.

Main Methods:

  • Conducted a systematic review of published SRs and MAs examining nonsurgical periodontal treatment and systemic outcomes.
  • Categorized systemic outcomes across conditions like diabetes, adverse birth outcomes, cardiovascular disease, obesity, rheumatoid arthritis, and chronic kidney disease.
  • Assessed the methodological rigor of the included reviews using the A Measurement Tool to Assess systematic Reviews 2 (AMSTAR 2) criteria.

Main Results:

  • Fifty-two SRs/MAs were included, with a majority focusing on diabetes and adverse birth outcomes.
  • Surrogate endpoints and biomarkers were more common outcomes than actual clinical disease endpoints.
  • A significant majority (92%) of the reviewed studies received "low" or "critically low" AMSTAR 2 confidence ratings, indicating poor methodological quality.
  • Common methodological shortcomings included lack of protocol registration, inadequate study exclusion justification, insufficient risk of bias assessment, and inappropriate meta-analysis methods.

Conclusions:

  • There is a lack of robust evidence to support the claim that nonsurgical periodontal treatment improves systemic disease outcomes.
  • Future SRs/MAs must adhere to higher methodological standards, including protocol registration and rigorous risk of bias assessment.
  • Further high-quality clinical research, potentially utilizing large-scale matched medical and dental databases, is needed to clarify the systemic effects of periodontal treatment.