P52 COPD and periodontitis: co-morbidity yes or no?

Abstract

IntroductionChronic obstructive pulmonary disease (COPD) is an inflammatory disease associated with comorbidities including periodontitis.1–2 Periodontitis is characterised by plaque build-up, anaerobic bacterial overgrowth and gingival inflammation which promotes recruitment and activation of neutrophils leading to alveolar bone destruction and tooth loss. However, the characterisation of periodontitis varies between studies causing some uncertainty of any association.AimTo determine whether clinical indices of periodontitis affects its prevalence in COPD patients with and without Alpha-1-antitrypsin deficiency (AATD) and any association with lung function.Methods108 COPD and 63 PiZ AATD patients underwent dental examinations and lung function testing as part of an EU FP7 cross sectional study.Varying definitions of periodontitis used in previous publications were applied; including criteria from the Centres for Disease Control and Prevention in collaboration with the American Academy of Periodontology CDC-AAP (CDC-AAP) and 5th European Workshop in Periodontology.Periodontal indices of probing depth (PD – depth from gingival margin to the base of periodontal pocket) and clinical attachment level (CAL – distance from the cemento-enamel junction to the gingival margin plus probing depth) were then compared to lung function parameters.ResultsThe prevalence of periodontitis varied depending on the definition used.Prevalence ranged from 0.7–98.6% for the whole cohort, with the lowest prevalence for average probing depth >4 mm, but CDC-AAP criteria gave a prevalence of 84.2% and 98.6% with the 5th European workshop criteria.Lung function was significantly correlated with indices of periodontitis for AATD patients; see Table.ConclusionsThe prevalence of periodontitis depends on the definition used. PD is a marker of current status, whilst CAL represents cumulative disease activity, rather like current lung function parameters.Periodontal indices are correlated with lung function parameters in AATD patients which could reflect the inflammatory and predominantly neutrophilic pathophysiology leading to excessive tissue destruction in both diseases.ReferencesShen TC, et al. Risk of Periodontal Diseases in Patients With Chronic Obstructive Pulmonary Disease: A Nationwide Population-based Cohort Study. Medicine (Baltimore) 2015;94(46):e2047.Chung JH, et al. J Periodontol2016:1–11.Abstract P52 Table 1Relationships between clinical indices of periodontitis and lung function in COPD and AATDSpearman’s Rho and p-valueAverage Probing Depth (PD)Average Clinical Attachment Level (CAL)COPDAATDCOPDAATD% predicted FEV10.085p = NS−0.42p < 0.01−0.03p = NS−0.52p < 0.001% predicted TLCO−0.06p = NS−0.34p < 0.010.01p = NS−0.51p < 0.001% predicted KCO−0.10p = NS−0.30p < 0.05−0.04p = NS−0.42p < 0.01