From: Effect of periodontal therapy on COPD outcomes: a systematic review
Periodontal therapy compared to no periodontal therapy in patients with PD and COPD | |||
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Patient or population: patients with PD and COPD Setting: university clinics and Hospitals (India, Taiwan, China, Turkey and USA) Intervention: periodontal therapy Comparison: no periodontal therapy | |||
Outcome no. of participants (studies) | Impact | Certainty | What happens with periodontal therapy |
Exacerbations of COPD assessed with: exacerbation frequency No. of participants: 11,616 (4 studies) | In one study, acute exacerbation rate was 2.54 versus 2.88 per 100 person-years for emergency room use, [adjusted IRR = 0.86 (95% CI 0.78–0.94, p < 0,001)] and 1.36 versus 1.71 per 100 person-years for hospitalizatios, [adjusted IRR = 0.78 (95% CI 0.72–0.85, p < 0,001)] In another study, proportion of frequent exacerbations was statistical significantly (p < 0.004) lower in periodontal therapy group at 2-years follow up In the third study, frequency of exacerbations was 1.95 per patient-years compared to 3.25 in the control group (p = 0.01) In the last study, although supragingival scaling < 1time/year was associated with higher proportion of patients with frequent exacerbations, in the adjusted model no statistical significance was obtained (OR = 2.23, 95% CI: 0.58–8.59, p = 0.24) | ⨁⨁⨁◯ MODERATEa,b,c | Probably reduces frequency of exacerbations of COPD |
Quality of life assessed with: SGRQ follow up: range 4 weeks to 1 years No. of participants: 65 (2 studies) | In one study SGRQ domain scores were lower in study group at one year follow up(p < 0.05 only for activity domain score) In another study, SGRQ and illness Questionnaire responses showed no significant difference between groups | ⨁◯◯◯ VERY LOWc,d | Too heterogenous response to synthesize across studies |
Lung function assessed with: FEV1, FEV1/FVC follow up: range 3 months to 2 years No. of participants: 116 (2 studies) | In one study, although FEV1/FVC mean value increased, no statistical significance was obtained In another study, FEV1 increased statistical significantly in one year follow up for both periodontal therapy groups(p = 0.03), but only for SRP group in two years follow up. FEV1/FVC increased statistical significantly in two years follow up for both periodontal therapy groups(p = 0.02), but only for SRP group in one year follow up (p = 0.04) | ⨁◯◯◯ VERY LOWc,e | Too heterogenous response to synthesize across studies |