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Effect of overweight/obesity on response to periodontal treatment: systematic review and a meta‐analysis
Author(s) -
Papageorgiou Spyridon N.,
Reichert Christoph,
Jäger Andreas,
Deschner James
Publication year - 2015
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/jcpe.12365
Subject(s) - overweight , medicine , meta analysis , obesity , adiponectin , randomized controlled trial , cochrane library , diabetes mellitus , endocrinology , insulin resistance
Aim The objective of this study was to investigate whether the response to periodontal treatment differs among obese, overweight or normal‐weight patients. Materials & Methods Both randomized and non‐randomized studies were identified from searches up to July 2013. Risk of bias was assessed with the Downs‐Black checklist, the Cochrane tool and the GRADE framework. Quantitative synthesis was conducted with random‐effects meta‐analyses in subgroups for systemically healthy and diabetic patients. Results A total of 15 studies including 867 patients were included. No significant difference was found for any clinical periodontal parameter between overweight/obese and normal‐weight patients. Periodontal treatment in systemically healthy overweight/obese patients was associated with higher decrease in TNF α levels (1 study) and higher decrease in HbA1c levels (1 study) compared to systemically healthy normal‐weight patients. Contrary to diabetic normal‐weight patients, periodontal treatment in diabetic overweight/obese patients was associated with an increase in adiponectin levels (2 studies) and a decrease in leptin levels (2 studies). However, the quality of existing evidence is low due to inconsistency, imprecision and lack of studies. Conclusions Whereas no difference was found in clinical periodontal parameters, significant differences in inflammatory or metabolic parameters were found between overweight/obese and normal‐weight patients, but existing evidence is weak.