مجله دانشکده دندان‌پزشکی اصفهان

رابطه‌ی میان وضعیت پریودنتال و بیماری انسدادی مزمن ریه: یک مطالعه‌ی مقطعی

نوع مقاله : مقاله‌های پژوهشی

چکیده

مقدمه: از آنجا که حفره‌ی دهان به عنوان منبع اصلی پاتوژن‌های ریوی شناخته شده است و بیماری مزمن انسدادی ریه COPD (Chronic obstructive pulmonary disease)، از شایع‌ترین بیماری‌های موجود و از مهم‌ترین عوامل مرگ و میر می‌باشد، هدف از این مطالعه، تعیین رابطه‌ی بین وضعیت پریودنتال و COPD بوده است.
مواد و روش‌ها: این مطالعه‌ی مقطعی از اردیبهشت تا شهریور ماه 1397، بر روی 30 بیمار COPD به عنوان گروه مورد و 30 فرد سالم به لحاظ تنفسی به عنوان گروه شاهد انجام شد. در هر دو گروه، شاخص‌های پریودنتال شامل تحلیل لثه، عمق پروبینگ، شاخص پلاک، شاخص لثه‌ای، از دست رفتن چسبندگی و خون‌ریزی در حین پروبینگ ارزیابی شد. شمار دندان‌های از دست رفته نیز ثبت گردید. داده‌ها با آزمون‌های آماری تی، مجذور کای و من‌ویتنی توسط نرم‌افزار SPSS نسخه‌ی 20 تجزیه و تحلیل شدند (0/05= α).
یافته‌ها: شاخص‌های پریودنتال و همچنین تعداد دندان از دست رفته در گروه COPD، به طور معنی‌داری بیشتر از گروه شاهد بود (p value < 0/001). میانگین سیگار مصرفی گروه COPD نسبت به گروه شاهد، بالاتر بود اما پس از خنثی‌سازی اثر سیگار، همچنان میانگین شاخص‌های پریودنتال در گروه COPD بیشتر از گروه شاهد بود، میانگین شاخص‌های پریودنتال در افراد غیر سیگاری گروه COPD نسبت به افراد غیر سیگاری گروه شاهد نیز بیشتر بود و وضعیت پریودنتال بیماران با افزایش درجه‌ی بیماری COPD ارتباط معنی‌دار داشت (p value < 0/001).
نتیجه‌گیری: این مطالعه نشان داد که بین بیماری پریودنتال و COPD ارتباط قابل توجهی وجود دارد و افراد COPD نسبت به افراد سالم از لحاظ تنفسی، حتی با کنترل عوامل مداخله‌گر سیگار و بهداشت دهان، از نظر پریودنتال دارای وضعیت بدتری بودند.
کلید واژه‌ها: بیماری مزمن انسدادی ریه، بیماری‌های پریودنتال، شاخص‌های پریودنتال

عنوان مقاله [English]

Relationship between Periodontal Status and Chronic Obstructive Pulmonary Disease: A Cross-Sectional Study

چکیده [English]

Introduction: Since Oral cavity is considered the main source of pulmonary pathogens and Chronic Obstructive Pulmonary Disease (COPD) is one of the most prevalent diseases and one of the most important causes of mortality, aim of this study was to determine the relation between periodontal status and COPD.
Materials and Methods: This Cross-Sectional study was performed in April to September 2018 on 30 patients with COPD as a case group and 30 respiratory healthy person as control group. In both groups, periodontal indices such as Gingival Recession(R), Probing Depth (PD), plaque Index (PI), Gingival Index (GI), Clinical Attachment loss (CAL) and Bleeding on Probing (BOP) were evaluated.
The number of Missing Teeth (MT) was also recorded. Data were analyzed by the use of SPSS 22 with t-test, Chi-square, and Mann-Whitney statistical tests (α = 0.05).
Results: Periodontal indices and MT in the COPD group were significantly more than control (p value < 0.001). The mean of smoking in COPD group was higher than control group T, but after neutralization of the effect of smoking, the mean periodontal indices in the COPD group was still more than control, also in non-smokers of COPD group, mean periodontal indices are more than non-smokers of control and the periodontal status was significantly associated with an increase in the grade of COPD (p value < 0.001).
Conclusion: This study showed periodontal diseases have considerable correlation with COPD and patients with COPD even after the control of cigarette smoking and oral hygiene as confounder factors, show worse periodontal conditions.
Keywords: Chronic obstructive pulmonary disease, Periodontal diseases, Periodontal indices.

1. Fatemi K, Banihashemrad S, Tovhidi M, Hosseini SH. Evaluation of the Relationship between Periodontal Disease and Chronic Obstructive Pulmonary Disease. J Mashhad Dent Sch 2009; 33(3): 241-6. [In Persian].
2. Anderson GP, Bozinovski S. Acquired somatic mutations in the molecular pathogenesis of COPD. Trends Pharmacol Sci 2003; 24(2): 71-6.
3. Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2013; 187(4): 347-65.
4. Thomashow B, Crapo J, Yawn B, Mclvor A, Cerreta S, Walsh J, et al. The COPD foundation pocket consultant guide. Chronic Obstr Pulm Dis 2014; 1(1): 83-87.
5. Mojon P, Budtz-Jorgensen E, Micheal JP, Limeback H. Oral health and history of respiratory tract infection in frail institutionalized elders. Gerodontology 1997; 14(1): 9-16.
6. Peter KP, Mute BR, Doiphode SS, Bardapurkar SJ, Borkar MS, Raje DV. Association between periodontal disease and chronic obstructive pulmonary disease: a reality or just a dogma? J Periodontol 2013; 84(12): 1717-23.
7. Scannapieco FA, Stewart EM, Mellotte JM. Colonization of dental plaque by respiratory pathogens in medical intensive care patients. Crit care Med 1992; 20(6): 740-5.
8. Azarpazhooh A, Leake JL. Systematic review of the association between respiratory diseases and oral health. J Periodontol 2006; 77(9): 1465-82.
9. Ledic K, Marinkovic S, Puhar I, Spalj S, Popovic-Grle S, Ivic-Kardum M, et al. Periodontal diseases increase risk for chronic obstructive pulmonary disease. Coll Antropol 2013, 37(3): 937-42.
10. Si Y, Fan H, Song Y, Zhou X, Zhang J, Wang Z. Association between periodontitis and chronic obstructive pulmonary disease in a Chinese population. J Periodontal 2012; 83(10): 1288-96.
11. Bansal M, Khatri M, Taneja V. Potential role of periodontal infection in respiratory diseases -a review. J Med Life 2013; 6(3): 244-8.
12. Najah A, Seham S, Fadhil R. The usefulness of Ramfjord teeth to represent the full-mouth pocket depth in epidemiological study. MDJ. 2010; 7(2): 272-5.
13. Silness J, Löe H. Periodontal disease in pregnancy. II .Correlation between oral hygiene and periodontal condtion. Acta Odontol Scand 1964; 22: 112-35.
14. Löe H. The gingival index, the plaque index and the retention index systems. J Periodontol 1967; 38(6): 610-6
15. Mühlemann HR, Son S. Gingival sulcus bleeding--a leading symptom in initial gingivitis. Helv Odontol Acta 1971; 15(2): 107-13.
16. Mdala I, Olsen I, Haffajee AD, Socransky SS, Thoresen M, Blasio F. Comparing clinical attachment level and pocket depth for predicting periodontal disease progression in healthy sites of patients with chronic periodontitis using multi-state Markov models. J Clin Periodontol 2014; 41(9): 837-45.
17. Newman MG, Takei HH, Klokkevold PR, Carranza FA. Carranz’s clinical periodontology. 12th ed. St. Louis: Saunders Elsevier; 2015.
18. Shen TC, Chang PY, Lin CL, Chen CH, Tu CY, Hsia TC, et al. periodontal treatment reduces risk of adverse respiratory events in patients with chronic obstructive pulmonary disease: a propensity-matched cohort study. Medicine (Baltimore) 2016; 95(20): e3735.
19. Moghadam SA, Shirzaiy M, Risbaf S. The associations between periodontitis and respiratory disease. J Nepal Health Res Counc 2017; 15(35): 1-6.
20. Scarrapieco FA. Role of oral bacteria in respiratory infection. J Periodontol 1999; 70(7): 793-802.
21. Scannapieco FA, Papandonatos GD, Dunford RG. Association between oral conditions and respiratory disease in a national sample survey population. Ann Periodontol 1998; 3(1): 251-6.
22. Gunen H, Hacievliyagil SS, Yetkin O, Gulbas G, Mutlu LC, Pehlivan E. Prevalence of COPD: First epidemiological study of a large region in Turkey. Eur J Intern Med 2008; 19(7): 499-504.
23. Stavem K, Sandvik L, Erikssen J. Can global initiative for Chronic Obstructive Lung Disease stage 0 provide prognostic information on long-term mortality in men? Chest 2006; 130(2): 318-25.
24. Scannapieco FA, Mylotte JM. Relationships between periodontal disease and bacterial pneumonia. J Periodontol 1996; 67(10 Suppl): 1114-22.
25. Deo V, Bhongade ML, Ansari S, Chavan RS. Periodontitis as a potential risk factor for chronic obstructive pulmonary disease: A retrospective study. Indian J Dent Res 2009; 20(4): 466-70.
26. Fourrier F, Cau-Pottier E, Boutigny H, Roussel-Delvallez M, Jourdain M, Chopin C. Effects of dental plaque antiseptic decontamination on bacterial colonization and nosocomial infections in critically ill patients. Intensive Care Med 2000; 26(9): 1239-47.
27. Vadiraj S, Nayak R, choudhary GK, Kudyar N, Spoorthi BR. Periodontal pathogens and respiratory diseases-evaluating their potential association: a clinical and microbiological study. J Contemp Dent Pract 2013; 14(4): 610-5.
28. Oztekin G, Baser U, Kucukcoskun M, Tanrikulu-Kucuk S, Ademoglu E, Isik G, et al. The association between periodontal disease and chronic obstructive pulmonary disease: a case control study. COPD 2014; 11(4): 424-30.
29. Raj R, Manu MK, Prakash PY, Singhal DK, Acharya S. The effect of 6 months or longer duration of chronic obstructive respiratory disease medication on the oral health parameters of adults. Spec Care Dentist 2018; 38(3): 133-8.
30. Kowalski M, Kowalska E, Split M, Split W, Wierzbicka-Ferszt A, Pawlicki L, et al. Assessment of periodontal state in patients with chronic obstructive pulmonary disease--part II. Pol Merkur Lekarski 2005; 19(112): 537-41.
31. Hyman JJ, Reid BC. Cigarette smoking, periodontal disease, and chronic obstructive pulmonary disease. J Periodontol 2004; 75(1): 9-15.
32. Cunningham TJ, Eke PI, Ford ES, Agaku IT, Wheaton AG, Croft JB. Cigarette smoking, tooth loss, and chronic obstructive pulmonary disease: findings from the behavioral risk factor surveillance system. J Periodontol 2016; 87(4): 385-94.
33. Hamalaine P, Suominen H, Keskinen M, Meurman JH. Oral health and reduction in respiratory capacity in a cohort of community-dwelling elderly people: A population-based 5-year follow up study. Gerodontology 2004; 21(4): 209-15.
34. Barros SP, Suruki R, Loewy ZG, Beck JD, Offenbacher S. A cohort study of the impact of tooth loss and periodontal disease on respiratory events among COPD subjects: modulatory role of systemic biomarkers of inflammation. PLoS One 2013; 8(8): e68592.
35. Mojon P. Oral health and respiratory infection. J Can Dent Assoc 2002; 68(6): 340-5.
36. Broaddus VC, Mason RJ. Murray and Nadel's textbook of respiratory medicine. 6th ed. Philadelphia, PA: Elsevier Saunders; 2016.
37. Bergstrom J, Bostrom L. Tobacco smoking and periodontal hemorrhagic responsiveness. J Clin Periodontol 2001; 28(7): 680-5.
38. Chen X, Wolff L, Aeppli D, Guo Z, Luan W, Baelum V. Cigarette smoking, salivary/gingival crevicular fluid cotinine and periodontal status. A 10-year longitudinal study. J Clin Periodontol 2001; 28(4): 331-9.
مجله دانشکده دندان‌پزشکی اصفهان
دوره 16، شماره 1 - شماره پیاپی 1
اسفند 1398
صفحه 1-10