Table 2 Characteristics of the studies included in the systematic review. For periodontal outcomes see main text
From: Effect of periodontal therapy on COPD outcomes: a systematic review
First author/year/Country [Ref.] | Study design | Study population | Study groups | Periodontal interventions | Outcomes/associations | Follow up period | Results |
|---|---|---|---|---|---|---|---|
Das/2017/India [27] | Randomized controlled trial | 35 COPD patients with CP | Periodontal treatment, n = 17 No treatment, n = 18 | Mouth scaling and root planning with hand instruments versus no treatment | SGRQ | 1 year | Treatment group: improvement in the SGRQ “activity” subscore (53.68 ± 16.37 vs. 38.20 ± 13.18; p = 0.005) Control group: no change in SGRQ |
Madalli/2016/India [33] | Before-after treatment prospective cohort | 30 COPD patients with CP | N/A | Supragingival scaling | FEV1/FVC | 3–5 months | No significant improvement in FEV1/FVC |
Shen/2016/Taiwan [30] | Retrospective propensity-matched case–control | 11,124 COPD patients with CP | Periodontal treatment, n = 5562 No treatment, n = 5562 | Subgingival curettage and root planning and/or invasive periodontal flap surgery versus no treatment | ER visits for COPD exacerbation Hospitalizations for adverse respiratory events ICU admissions All-cause mortality | 5 years from inclusion Occurrence of an adverse respiratory event Death Withdrawal from the insurance system | ER visits per 100 person-years for COPD exacerbation: 2.54 ( treatment group) versus 2.88 (control group); adjusted IRR of 0.86 (95% CI 0.78–0.94; p < 0.001) Hospitalizations for adverse respiratory events per 100 person-years: 2.75 (treatment group) versus 3.65 (control group); adjusted IRR 0.74 (95% CI 0.69–0.80; p < 0.001) ICU admissions per 100 person-years: 0.66 (treatment group) versus 0.75 (control group); adjusted IRR 0.84 (95% CI 0.75–0.94; p < 0.01) All-cause mortality per 100 person-years: 1.81 (treatment group) versus 2.87 (control group); adjusted rate ratio 0.57 (95% CI 0.52–0.62; p < 0.001) |
Zhou/2014/China [29] | Randomized controlled trial | 30 moderate-to-severe COPD patients | Supragingival scaling, root planning and maintenance care (SRP group), n = 20 Supragingival scaling and maintenance care (scaling group), n = 20 No treatment (control group), n = 20 | SRP versus scaling versus no treatment | FEV1 (% predicted), FEV1/FVC Proportion of frequent exacerbations (≥ 2/year) | 2 years | Control group lung function compared to baseline Lower FEV1 at 2 years (56.3 ± 16.4 vs. 51.6 ± 18.4, p < 0.05) Lower FEV1/FVC at 1 and 2 years (0.55 ± 0.11 vs. 0.54 ± 0.11 vs. 0.53 ± 0.11; p < 0.05) SRP versus control group Higher FEV1 at 1 year (55.9 ± 16 vs. 53.6 ± 18.7; p < 0.05) and at 2 years (57.1 ± 19 vs. 51.6 ± 18.4; p < 0.05) Higher FEV1/FVC at 1 year (0.59 ± 0.09 vs. 0.54 ± 0.11; p < 0.05) and at 2 years (0.57 ± 0.10 vs. 0.53 ± 0.11; p < 0.05) Scaling versus control group: Higher FEV1 at 1 year (59.6 ± 17.1 vs. 53.6 ± 18.7, p < 0.005) Higher FEV1/FVC at 2 years (0.56 ± 0.11 vs. 0.53 ± 0.11, p < 0.05) Proportion of frequent exacerbations in SRP versus scaling versus control group 30% versus 15.8% versus 66.7%; p < 0.004 Adjusted OR for frequent exacerbations SRP group: 0.29, (95% CI 0.10–0.84; p = 0.02) Scaling group: 0.004 (95% CI 0.003–0.64; p = 0.02) No differences in lung function and exacerbations between the 2 treatment groups |
Kucukcoskun/2013/ Turkey [31] | Prospective case–control | 40 COPD patients with CP and ≥ 1 exacerbation in the previous year | Periodontal treatment, n = 20 No treatment, n = 20 | Full-mouth scaling and root planning with hand instruments and ultrasonic devices | Exacerbation frequency in 12 months Number of hospitalizations | 12 months | Exacerbation frequency per patient-year: 1.95 (treatment group) versus 3.25 (control group) Exacerbation frequency decreased in treatment group (3 ± 1.83 vs. 1.95 ± 1.46; p = 0.01) but remained unchanged in the control group (3.5 ± 4.62 vs. 3.25 ± 3.35; p = NS) Hospitalizations increased from 4/year to 7/year in the treatment group and from 10/year to 12/year in the control group |
Agado/2012/USA [28] | Randomized controlled trial | 30 COPD patients with CP | Periodontal debridement with ultrasonic device, n = 10 Periodontal debridement with hand instruments, n = 10 No treatment, n = 10 | Periodontal debridement | SGRQ-A 5-point Likert scale of health status self-perception 7-item illness questionnaire | 4–6 weeks | No improvement in SGRQ-A, health status self-perception and illness questionnaire post treatment |
Liu/2012/China [32] | Cross-sectional | 392 COPD patients | Frequent exacerbators (≥ 2 events/year), n = 183 Infrequent exacerbators (< 2 events/year), n = 209 | Supragingival scaling ≥ 1/year, n = 15 < 1/year, n = 377 | Correlation between periodontal/oral health and its treatment and frequency of COPD exacerbations | N/A | Risk factors for frequent exacerbations ≤ 25 remaining teeth (adjusted OR 1.69, 95% CI 1.03–2.77; p = 0.04) < 1 daily brushing frequency (adjusted OR 4.19, 95% CI 1.44–12.1; p = 0.008) |