Efficacy of Antioxidant Supplementation to Non-Surgical Periodontal Therapy on Metabolic Control in Type 2 Diabetes Patients: A Network Meta-Analysis.

This network meta-analysis (NMA) investigated the effectiveness of antioxidants as adjuncts to non-surgical periodontal therapy (NSPT) in the glycated hemoglobin (HbA1c) control of type 2 diabetes (T2D) patients with periodontitis. PubMed, Cochrane, LILACS, Web of Science, Scopus, Embase, LIVIVO, and grey literature were searched. Risk of bias was assessed with the RoB v2.0 tool. A frequentist NMA assessed HbA1c improvement, through standardized mean difference under a random-effects model. Certainty of evidence was addressed through the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) partially contextualized framework. Ten randomized controlled clinical trials were included, with 234 patients receiving alpha lipoic acid (ALA), cranberry juice, cranberry juice enriched with omega-3, fenugreek, ginger, grape seed, lycopene, melatonin, omega-3, propolis or vitamin C supplementation to NSPT, and 220 patients receiving NSPT alone or with placebo. Nine studies were meta-analyzed. HbA1c improved when NSPT was combined with propolis, ALA and melatonin supplementation (moderate-to-low certainty), compared to NSPT alone or with placebo. Risk of bias issues were found in eight studies. In conclusion, the use of propolis supplementation to NSPT probably results in HbA1c improvement in T2D patients with periodontitis (large effect with moderate certainty), while ALA and melatonin supplementation may contribute to reduce the HbA1c in T2D patients with periodontitis (large effects with low certainty).

Relação entre tabagismo e risco genético às doenças periodontais – revisão de literatura / Relationship between smoking and genetic risk for periodontal disease – Literature review / Relationship between smoking and genetic risk for periodontal disease – Literature review

Introdução: As doenças periodontais (DP) consistem em um grupo de doenças que afetam a gengiva e as estruturas de suporte dos dentes (cemento radicular, ligamento periodontal e osso alveolar). Caracterizam-se como doença multifatorial resultante da interação de bactérias periodontopatogênicas com o sistema imune do hospedeiro. Estudos têm investigado como a genética e o tabagismo influenciam certos indivíduos, aumentando o risco de desenvolvimento da DP. Objetivo: O objetivo desta revisão de literatura foi analisar a relação entre genética, tabagismo e manifestações clínicas da doença periodontal, descrevendo o papel dos genes e da resposta imunológica na evolução da doença. Revisão de literatura: Estudos têm demonstrado que: (1) A predisposição genética para periodontite deve-se a vários polimorfismos de genes; (2) O tabaco é um fator de risco conhecido para DP, por isso, fumantes têm mais chances de apresentar periodontite e têm doença periodontal mais grave quando comparados a não fumantes; (3) Existe uma relação entre genética e tabagismo e sua influência na DP, porém esta ainda não está completamente esclarecida. Conclusão: Fatores genéticos e tabagismo exercem papel importante no início e progressão da DP. Entretanto, a relação tabagismo-genética e como esta influencia na evolução da DP ainda requer esclarecimento.

Introduction: Periodontal diseases (PD) consist of a group of diseases that affect the gingiva and the tooth’s supporting structures (cementum, periodontal ligament and alveolar bone). They are characterized as multifactorial disease resulting from the interaction of periodontal bacteria and the host immune system. Studies have investigated how genetic and smoking affect certain individuals, increasing the chances of developing PD. Objective: The objective of this study was to analyze the relationship between genetics, smoking and clinical manifestations of periodontal disease, describing the role of genes and the immune response in the disease progression. Literature review: Studies have shown that: (1) genetic predisposition to periodontal disease is often due to several polymorphisms of genes; (2) Tobacco is a known risk factor for PD, so smokers are more likely to have periodontitis and they have more severe periodontal disease compared to non-smokers; (3) There is a relationship between genetics and smoking and its influence on DP, but this is still unclear. Conclusion: Genetic factors and smoking have an important role in the beginning and progression of PD. However, smoking-genetic relationship and how this influences the progression of PD is still not fully elucidated.