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Table 1 Summary of adjusted results of cross-sectional studies

From: Epidemiologic relationship between periodontitis and type 2 diabetes mellitus

Study

Evaluated PD related conditions

Definition of T2DM

Main conclusion and outcome

PD/non-PD

Awuti

2012 [20]

Moderate PD: PPD ≤6 mm, or CAL of 3–4 mm; or possible presence of slight loose teeth (N = 98)

Severe PD: PPD > 6 mm, or CAL ≥5 mm; or more than one loose tooth (N = 77)

Control: non-PD (N = 509)

The 1999 WHO criteria and ADA standards

T2DM was more prevalent in moderate PD compared with no PD.

Adjusted OR = 4.033, 95%CI 2.069–7.861

T2DM was more prevalent in severe PD compared with no PD.

Adjusted OR = 2.313, 95%CI 1.042–5.137

Choi

2011 [22]

Top quintile category versus the bottom quintile

CAL: Quintile 1 mean CAL = 0.2 mm (N = 2412)

Quintile 5 mean CAL = 3.0 mm (N = 2453)

ADA criteria

T2DM was more prevalent in mean CAL 3.0 mm compared with mean CAL 0.2 mm. Adjusted OR = 4.77, 95%CI 2.69–8.46

 

Top quintile category versus the bottom quintile

PPD: Quintile 1 mean PPD = 0.7 mm (N = 2451)

Quintile 5 mean PPD = 2.2 mm (N = 2449)

T2DM was more prevalent in mean PPD 2.2 mm compared with mean PPD 0.7 mm. Adjusted OR = 1.63, 95%CI 1.10–2.42

Mohamed

2013 [37]

Chronic PD: at least one site with PPD of > 4 mm (N = 290)

Control: non-PD (N = 157)

The 1999 WHO criteria

T2DM was more prevalent in chronic PD compared with non-PD. Adjusted OR = 4.07, 95%CI 1.74–9.49

 

Tooth mobility (N = 153)

Control: without tooth mobility (N = 294)

T2DM was more prevalent in participants with tooth mobility compared with those without. Adjusted OR = 5.90, 95%CI 2.26–15.39

 

NOT > 21 teeth (N = 381)

Control: NOT≤21 teeth (N = 66)

T2DM was less prevalent in participants with > 21teeth, with an OR of 0.23. Adjusted OR = 0.23, 95%CI 0.08–0.63

Nesse

2010 [40]

PD: CPITN score was ≥3, indicating PPD ≥4 mm (N = 217)

Control:non-PD (N = 320)

Clinical examination;

or medical record

T2DM was more prevalent in PD compared with non-PD. Adjusted OR = 4, 95%CI 1.03–15.3

Saito

2004 [46]

high portion category compared in the low portion

CAL: Low mean CAL < 1.5 mm (N = 18)

High mean CAL > 2.5 mm (N = 38)

The WHO criteria

T2DM was more prevalent in mean CAL > 2.5 mm compared with mean CAL 0.2 mm. Adjusted OR = 2.0, 95%CI 1.0–3.9

 

PPD: Low mean PPD < 1.3 mm (N = 18)

High mean PPD > 2.0 mm (N = 32)

T2DM was more prevalent in mean PPD > 2.0 mm compared with < 1.3 mm. Adjusted OR = 2.6, 95%CI 1.3–5.0

Saito

2006 [45]

Mean alveolar bone loss (N = 131)

Control: Low alveolar bone loss (N = 49)

The WHO criteria

Mean alveolar bone loss as a continuous variable showed a 1% increase in mean alveolar bone loss corresponded to a 6% increased prevalence of T2DM. Adjusted OR = 1.06 95%CI 1.00–1.12

T2DM/non-T2DM

Kaur

2009 [25]

Top quartile compared with three lower quartiles

LOT (Quartile 4 vs 1–3)

T2DM: After the age of 29; or insulin started > 1 year after disease onset (N = 310)

Non-T2DM (N = 1858)

The OR for increase tooth loss was 1.65 times higher for the T2DM patients compared with non-T2DM participants. Adjusted OR = 1.65, 95%CI 1.13–2.39

Kowall

2015 [27]

PD: at least 2 non-adjacent teeth CAL ≥ 3 mm

Poorly controlled T2DM:HbA1c ≥7% (N = 64)

Better controlled T2DM:HbA1c < 7% (N = 137)

Non-T2DM (N = 2145)

PD was more prevalent in poorly controlled T2DM patients compared with non-T2DM participants, which was not statistically significant. Adjusted OR = 1.60 95%CI 0.55–4.63

The prevalence of PD showed no difference between better controlled T2DM patients and non-T2DM participants. Adjusted OR = 0.94 95%CI 0.52–1.67

 

Top quartile compared with three lower quartiles

Mean CAL ≥ 4 mm (Quartile 4 vs 1–3)

The OR for CAL ≥ 4 mm was 1.36 times higher in poorly controlled T2DM patients compared with non-T2DM participants, which was not statistically significant. Adjusted OR = 1.36 95%CI 0.75–2.49

The prevalence of CAL ≥ 4 mm showed no difference between better controlled T2DM patients and non-T2DM participants. Adjusted OR = 0.94 95%CI 0.61–1.45

 

Top quartile compared with three lower quartiles

Mean PPD (Quartile 4 vs 1–3)

The OR for top PPD was 1.31 times higher for the poorly controlled T2DM patients compared with non-T2DM participants, which was not statistically significant. Adjusted OR = 1.31 95%CI 0.75–2.30

The prevalence of mean PPD showed no difference between better controlled T2DM patients and non-T2DM participants. Adjusted OR = 1.13 95%CI 0.75–1.71

 

Lowest quartile compared with three higher quartiles

NOT (Quartile1 vs 2–4)

The OR for NOT was 1.49 times higher in poorly controlled T2DM patients compared with non-T2DM participants, which was no statistically significant Adjusted OR = 1.49 95%CI 0.92–2.40

NOT showed no difference between better controlled T2DM patients and non-T2DM participants. Adjusted OR = 1.05 95%CI 0.74–1.50

Leung

2008 [30]

Chronic PD: CPI score of 4 in any one sextant (WHO, 1997).

T2DM: Clinical examination; or medical record (N = 364)

Non-T2DM (N = 161)

PD was more prevalent in T2DM patients compared with non-T2DM participants. Adjusted OR = 1.84 95%CI 1.22–2.77

 

CAL ≥ 6 mm

The OR for CAL ≥ 6 mm was 1.71 times higher for T2DM patients compared with non-T2DM participants. Adjusted OR = 1.71, 95%CI 1.13–2.59

Nelson

1990 [39]

PD: < 24 teeth present;>  6 teeth with ≥25% bone loss and any tooth with ≥50% bone loss.

T2DM: OGTT ≥11.1 mmol/l (N = 720)

Non-T2DM (N = 1553)

PD was more prevalent in T2DM patients compared with non-T2DM patients. Adjusted OR = 1.64, 95%CI 1.50–1.79

Saito

2005 [47]

Mean PPD ≥1.9 mm

T2DM: The WHO criteria (N = 27)

Non-T2DM (N = 360)

The OR for PPD ≥ 1.9 mm was 1.4 times higher for the T2DM patients compared with non-T2DM participants, which was not statistically significant. Adjusted OR = 1.4 95%CI 0.6–3.2

 

Mean CAL ≥2.42 mm

The OR for CAL ≥ 2.42 mm was 1.5 times higher for the T2DM patients compared with non-T2DM participants, which was not statistically significant. Adjusted OR = 1.5 95%CI 0.7–3.2

Tanwir

2009 [51]

Missing fewer teeth

T2DM: Clinical examination; or medical record (N = 88)

Non-T2DM (N = 80)

The OR for missing or fewer teeth was 2.3 times higher for the diabetic patients compared with non-T2DM patients. Adjusted OR = 2.3 95%CI 1.32–4.14

Tsai

2002 [52]

Severe PD: at least two sites CAL ≥6 mm at least one site PPD ≥5 mm

Poorly control T2DM:HbA1c ≥9% (N = 170)

Better control T2DM:HbA1c < 9% (N = 260)

Non-T2DM (N = 3841)

Severe PD was more prevalent in poorly controlled T2DM patients compared with non-T2DM participants. Adjusted OR = 2.90 95%CI 1.40–6.03

Severe PD was more prevalent in better controlled T2DM patients compared with non-T2DM participants, but was not statistically significant. Adjusted OR = 1.56 95%CI 0.90–2.68

Wang

2009 [53]

PD: The WHO 1997 criteria

T2DM: The 1999 WHO criteria (N = 193)

Non-T2DM (N = 8468)

PD was more prevalent in T2DM patients compared with non-T2DM participants. Adjusted OR = 1.34 95%CI 1.07–1.74

  1. PD: periodontitis; T2DM: type 2 diabetes mellitus; CAL: clinical attachment loss; PPD: periodontal pocket depth; NOT: number of teeth; LOT: loss of teeth; HbA1c: glycated hemoglobin; OR: odds ratio; CPI: community periodontal index; RPI: Russell periodontal index