Effects of periodontal treatment on lung function and exacerbation frequency in patients with chronic obstructive pulmonary disease and chronic periodontitis: A 2‐year pilot randomized controlled trial

Abstract

Effects of periodontal treatment on lung function and exacerbation frequency in patients with chronic obstructive pulmonary disease and chronic periodontitis: A 2-year pilot randomized controlled trial. J Clin Periodontol 2014; 41: 564-572. doi: 10.1111/jcpe.12247. AbstractAim: To evaluate the direct effects of periodontal therapy in Chronic Obstructive Pulmonary Disease (COPD) patients with chronic periodontitis (CP). Materials and Methods: In a pilot randomized controlled trial, 60 COPD patients with CP were randomly assigned to receive scaling and root planing (SRP) treatment, supragingival scaling treatment, or oral hygiene instructions only with no periodontal treatment. We evaluated their periodontal indexes, respiratory function, and COPD exacerbations at baseline, 6 months, 1, and 2 years. Results: Compared with the control group, measurements of periodontal indexes were significantly improved in patients in two treatment groups at 6-month, 1-year, and 2-year follow-up (all p < 0.05). Overall, the means of forced expiratory volume in the first second/forced vital capacity (FEV1/FVC) and FEV1 were significantly higher in the two therapy groups compared with the control group during the follow-up (p < 0.05). In addition, the frequencies of COPD exacerbation were significantly lower in the two therapy groups than in the control group at 2-year follow-up (p < 0.05). Conclusions: Our preliminary results from this pilot trial suggest that periodontal therapy in COPD patients with CP may improve lung function and decrease the frequency of COPD exacerbation.

Systematic review and meta-analysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts

“…Eleven studies met the inclusion criteria for reporting the effect of SRP compared with no treatment, supragingival scaling, or debridement on chronic periodontitis. [18][19][20][21][22][23][24][25][26][27][28] Six were splitmouth studies, 18-23 and 5 were parallel-group studies. [24][25][26][27][28] All studies were small (from 7 to 43 per group).…”

“…9 SRP treatment resulted in a 0.49-millimeter gain in CAL (95% confidence interval [CI], 0.36-0.62 mm) ( Figure 3). [18][19][20][21][22][23][24][25][26][27][28] Two of the observations were outliers, with 1 study 20 having a large benefit and 1 study 25 having a small standard error; however, when we removed these 2 studies, the result remained statistically significant (0.43; 95% CI, 0.19-0.67). We judged the overall level of certainty in the evidence to be moderate on the basis of the evidence profile in Table 2.…”

Effects of periodontal treatment on exacerbation frequency and lung function in patients with chronic periodontitis: study protocol of a 1-year randomized controlled trial

“…The pathophysiological process linking both conditions is the destruction of connective tissue and exacerbated inflammatory reaction with large recruitment of neutrophils [3]. In 1 year, periodontal treatment (PT) was able to reduce annual number of COPD exacerbations from 9 to 4 [4]. …”

Does Treatment of Periodontal Disease Influence Systemic Disease?

“…130 Chronic obstructive pulmonary disease Chronic obstructive pulmonary disease (COPD) is strongly associated with poor periodontal status, 131 frequency of professional dental care, and knowledge about oral health. 132 In COPD, periodontal treatment is reported to improve lung capacity function 133 and lessen the frequency of exacerbations. 133,134 However, a small study with 30 participants did not find any effect of periodontal therapy on quality of life 4 weeks after treatment, nor was there any effect on the COPD.…”

“…132 In COPD, periodontal treatment is reported to improve lung capacity function 133 and lessen the frequency of exacerbations. 133,134 However, a small study with 30 participants did not find any effect of periodontal therapy on quality of life 4 weeks after treatment, nor was there any effect on the COPD. The study did demonstrate that power brushes could be used without any adverse events.…”