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Published in: BMC Pulmonary Medicine 1/2021

Open Access 01-12-2021 | COPD Exacerbation | Research Article

Effect of periodontal therapy on COPD outcomes: a systematic review

Authors: Ioulianos Apessos, Athanasios Voulgaris, Michalis Agrafiotis, Dimitrios Andreadis, Paschalis Steiropoulos

Published in: BMC Pulmonary Medicine | Issue 1/2021

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Abstract

Background

Latest evidence suggests that periodontitis is prevalent among patients with chronic obstructive pulmonary disease (COPD), while recent studies have also reported a potential benefit of periodontal treatment on several COPD outcomes. This systematic review aims to determine the impact of periodontal treatment on exacerbation rate, lung function and quality of life of COPD patients.

Methods

A systematic search of electronic databases of PubMed, Scopus, Virtual Health Library, ScienceDirect, Wiley Online Library, Web of Science, ProQuest Dissertation and Theses Global and Google Scholar was conducted. Search restricted to studies involving human subjects which were published from January 2000 to March 2020 in English language. Distiller Systematic Review software was used for data management. Risk of bias was assessed using Risk of Bias 2 (RoB2) and Risk of Bias for non-randomized studies of intervention (ROBINS-I) tools. Overall quality of evidence was judged based on Grading of Recommendations Assessment, Development and Evaluation working group methodology.

Results

Out of 1442 articles retrieved, 7 full text articles were included in the review. Limited evidence suggests that periodontal treatment in patients with COPD and periodontitis is associated with reduced exacerbation frequency and a slower lung function decline rate, while its effects on quality of life remain unclear. In addition, periodontal treatment in COPD is associated with lower hospitalization rates and reduced all-cause mortality. Significant methodological differences were noted amongst included studies, while very low-to-moderate overall quality of evidence was demonstrated.

Conclusions

Although it is reasonable to advise COPD patients not to neglect their dental health, further studies are warranted to determine the role of periodontal therapy on COPD clinical outcomes.
Appendix
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Literature
1.
go back to reference Vogelmeier CF, Criner GJ, Martinez FJ, Anzueto A, Barnes PJ, Bourbeau J, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary. Am J Respir Crit Care Med. 2017;195(5):557–82.PubMedCrossRef Vogelmeier CF, Criner GJ, Martinez FJ, Anzueto A, Barnes PJ, Bourbeau J, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary. Am J Respir Crit Care Med. 2017;195(5):557–82.PubMedCrossRef
3.
go back to reference Wedzicha JA, Seemungal TAR. COPD exacerbations: defining their cause and prevention. Lancet Lond Engl. 2007;370(9589):786–96.CrossRef Wedzicha JA, Seemungal TAR. COPD exacerbations: defining their cause and prevention. Lancet Lond Engl. 2007;370(9589):786–96.CrossRef
4.
go back to reference Rubinsztajn R, Przybyłowski T, Maskey-Warzechowska M, Karwat K, Chazan R. Exacerbations of chronic obstructive pulmonary disease and quality of life of patients. Adv Exp Med Biol. 2016;884:69–74.PubMedCrossRef Rubinsztajn R, Przybyłowski T, Maskey-Warzechowska M, Karwat K, Chazan R. Exacerbations of chronic obstructive pulmonary disease and quality of life of patients. Adv Exp Med Biol. 2016;884:69–74.PubMedCrossRef
5.
6.
go back to reference Voulgaris A, Archontogeorgis K, Steiropoulos P, Papanas N. Cardiovascular disease in patients with chronic obstructive pulmonary disease, obstructive sleep apnoea syndrome and overlap syndrome. Curr Vasc Pharmacol. 2020. Voulgaris A, Archontogeorgis K, Steiropoulos P, Papanas N. Cardiovascular disease in patients with chronic obstructive pulmonary disease, obstructive sleep apnoea syndrome and overlap syndrome. Curr Vasc Pharmacol. 2020.
7.
go back to reference Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, et al. Periodontitis: consensus report of workgroup 2 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions. J Clin Periodontol. 2018;45(Suppl 20):S162–70.PubMedCrossRef Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH, et al. Periodontitis: consensus report of workgroup 2 of the 2017 world workshop on the classification of periodontal and peri-implant diseases and conditions. J Clin Periodontol. 2018;45(Suppl 20):S162–70.PubMedCrossRef
8.
go back to reference Tonetti MS, Jepsen S, Jin L, Otomo-Corgel J. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: A call for global action. J Clin Periodontol. 2017;44(5):456–62.PubMedCrossRef Tonetti MS, Jepsen S, Jin L, Otomo-Corgel J. Impact of the global burden of periodontal diseases on health, nutrition and wellbeing of mankind: A call for global action. J Clin Periodontol. 2017;44(5):456–62.PubMedCrossRef
9.
go back to reference Hobbins S, Chapple IL, Sapey E, Stockley RA. Is periodontitis a comorbidity of COPD or can associations be explained by shared risk factors/behaviors? Int J Chron Obstruct Pulmon Dis. 2017;4(12):1339–49.CrossRef Hobbins S, Chapple IL, Sapey E, Stockley RA. Is periodontitis a comorbidity of COPD or can associations be explained by shared risk factors/behaviors? Int J Chron Obstruct Pulmon Dis. 2017;4(12):1339–49.CrossRef
10.
go back to reference Takeuchi K, Matsumoto K, Furuta M, Fukuyama S, Takeshita T, Ogata H, et al. Periodontitis is associated with chronic obstructive pulmonary disease. J Dent Res. 2019;98(5):534–40.PubMedCrossRef Takeuchi K, Matsumoto K, Furuta M, Fukuyama S, Takeshita T, Ogata H, et al. Periodontitis is associated with chronic obstructive pulmonary disease. J Dent Res. 2019;98(5):534–40.PubMedCrossRef
11.
go back to reference Zeng X-T, Tu M-L, Liu D-Y, Zheng D, Zhang J, Leng W. Periodontal disease and risk of chronic obstructive pulmonary disease: a meta-analysis of observational studies. PLoS ONE. 2012;7(10):e46508.PubMedPubMedCentralCrossRef Zeng X-T, Tu M-L, Liu D-Y, Zheng D, Zhang J, Leng W. Periodontal disease and risk of chronic obstructive pulmonary disease: a meta-analysis of observational studies. PLoS ONE. 2012;7(10):e46508.PubMedPubMedCentralCrossRef
12.
go back to reference Shen T-C, Chang P-Y, Lin C-L, Chen C-H, Tu C-Y, Hsia T-C, 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.CrossRef Shen T-C, Chang P-Y, Lin C-L, Chen C-H, Tu C-Y, Hsia T-C, 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.CrossRef
13.
go back to reference Holtfreter B, Richter S, Kocher T, Dörr M, Völzke H, Ittermann T, et al. Periodontitis is related to lung volumes and airflow limitation: a cross-sectional study. Eur Respir J. 2013;42(6):1524–35.PubMedCrossRef Holtfreter B, Richter S, Kocher T, Dörr M, Völzke H, Ittermann T, et al. Periodontitis is related to lung volumes and airflow limitation: a cross-sectional study. Eur Respir J. 2013;42(6):1524–35.PubMedCrossRef
14.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
15.
go back to reference Tan L, Wang H, Pan C, Zhao J. Periodontal health and chronic obstructive pulmonary disease stratified by smoking: a meta-analysis. Int J Clin Exp Med. 2016;9(12):23190–7. Tan L, Wang H, Pan C, Zhao J. Periodontal health and chronic obstructive pulmonary disease stratified by smoking: a meta-analysis. Int J Clin Exp Med. 2016;9(12):23190–7.
16.
go back to reference Shi Q, Zhang B, Xing H, Yang S, Xu J, Liu H. Patients with chronic obstructive pulmonary disease suffer from worse periodontal health-evidence from a meta-analysis. Front Physiol. 2018;9:33.PubMedPubMedCentralCrossRef Shi Q, Zhang B, Xing H, Yang S, Xu J, Liu H. Patients with chronic obstructive pulmonary disease suffer from worse periodontal health-evidence from a meta-analysis. Front Physiol. 2018;9:33.PubMedPubMedCentralCrossRef
17.
go back to reference Gomes-Filho IS, Cruz SS da, Trindade SC, Passos-Soares J de S, Carvalho-Filho PC, Figueiredo ACMG, et al. Periodontitis and respiratory diseases: a systematic review with meta-analysis. Oral Dis. 2019. Gomes-Filho IS, Cruz SS da, Trindade SC, Passos-Soares J de S, Carvalho-Filho PC, Figueiredo ACMG, et al. Periodontitis and respiratory diseases: a systematic review with meta-analysis. Oral Dis. 2019.
18.
go back to reference Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;1(4):1.CrossRef Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;1(4):1.CrossRef
19.
go back to reference Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;28(366):l4898.CrossRef Sterne JAC, Savović J, Page MJ, Elbers RG, Blencowe NS, Boutron I, et al. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;28(366):l4898.CrossRef
21.
go back to reference Peters JL, Sutton AJ, Jones DR, Abrams KR, Rushton L. Contour-enhanced meta-analysis funnel plots help distinguish publication bias from other causes of asymmetry. J Clin Epidemiol. 2008;61(10):991–6.PubMedCrossRef Peters JL, Sutton AJ, Jones DR, Abrams KR, Rushton L. Contour-enhanced meta-analysis funnel plots help distinguish publication bias from other causes of asymmetry. J Clin Epidemiol. 2008;61(10):991–6.PubMedCrossRef
22.
go back to reference Guyatt GH, Oxman AD, Schünemann HJ, Tugwell P, Knottnerus A. GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology. J Clin Epidemiol. 2011;64(4):380–2.CrossRefPubMed Guyatt GH, Oxman AD, Schünemann HJ, Tugwell P, Knottnerus A. GRADE guidelines: a new series of articles in the Journal of Clinical Epidemiology. J Clin Epidemiol. 2011;64(4):380–2.CrossRefPubMed
23.
go back to reference Schünemann HJ, Cuello C, Akl EA, Mustafa RA, Meerpohl JJ, Thayer K, et al. GRADE guidelines: 18. How ROBINS-I and other tools to assess risk of bias in nonrandomized studies should be used to rate the certainty of a body of evidence. J Clin Epidemiol. 2019;111:105–14.PubMedCrossRef Schünemann HJ, Cuello C, Akl EA, Mustafa RA, Meerpohl JJ, Thayer K, et al. GRADE guidelines: 18. How ROBINS-I and other tools to assess risk of bias in nonrandomized studies should be used to rate the certainty of a body of evidence. J Clin Epidemiol. 2019;111:105–14.PubMedCrossRef
24.
go back to reference Carrasco-Labra A, Brignardello-Petersen R, Santesso N, Neumann I, Mustafa RA, Mbuagbaw L, et al. Improving GRADE evidence tables part 1: a randomized trial shows improved understanding of content in summary of findings tables with a new format. J Clin Epidemiol. 2016;74:7–18.PubMedCrossRef Carrasco-Labra A, Brignardello-Petersen R, Santesso N, Neumann I, Mustafa RA, Mbuagbaw L, et al. Improving GRADE evidence tables part 1: a randomized trial shows improved understanding of content in summary of findings tables with a new format. J Clin Epidemiol. 2016;74:7–18.PubMedCrossRef
25.
go back to reference Schünemann HJ, Brożek J, Guyatt G, Oxman A, editors. GRADE handbook for grading quality of evidence and strength of recommendations. Updated October 2013. The GRADE Working Group, 2013. 2013. guidelinedevelopment.org/handbook. Schünemann HJ, Brożek J, Guyatt G, Oxman A, editors. GRADE handbook for grading quality of evidence and strength of recommendations. Updated October 2013. The GRADE Working Group, 2013. 2013. guidelinedevelopment.org/handbook.
26.
27.
go back to reference Das K, Das SJ, Sarma J. Effects of phase I periodontal therapy on the quality of life in COPD patients. Das K, Das SJ, Sarma J. Effects of phase I periodontal therapy on the quality of life in COPD patients.
28.
go back to reference Agado BE, Crawford B, DeLaRosa J, Bowen DM, Peterson T, Neill K, et al. Effects of periodontal instrumentation on quality of life and illness in patients with chronic obstructive pulmonary disease: a pilot study. J Dent Hyg JDH. 2012;86(3):204–14.PubMed Agado BE, Crawford B, DeLaRosa J, Bowen DM, Peterson T, Neill K, et al. Effects of periodontal instrumentation on quality of life and illness in patients with chronic obstructive pulmonary disease: a pilot study. J Dent Hyg JDH. 2012;86(3):204–14.PubMed
29.
go back to reference Zhou X, Han J, Liu Z, Song Y, Wang Z, Sun Z. Effects of periodontal treatment on lung function and exacerbation frequency in patients with chronic obstructive pulmonary disease and chronic periodontitis: a. J Clin Periodontol. 2014;41(6):564–72.PubMedCrossRef Zhou X, Han J, Liu Z, Song Y, Wang Z, Sun Z. Effects of periodontal treatment on lung function and exacerbation frequency in patients with chronic obstructive pulmonary disease and chronic periodontitis: a. J Clin Periodontol. 2014;41(6):564–72.PubMedCrossRef
30.
go back to reference Shen T-C, Chang P-Y, Lin C-L, Chen C-H, Tu C-Y, Hsia T-C, et al. Periodontal treatment reduces risk of adverse respiratory events in patients with chronic obstructive pulmonary disease. Med US. 2016;95(20):e3735.CrossRef Shen T-C, Chang P-Y, Lin C-L, Chen C-H, Tu C-Y, Hsia T-C, et al. Periodontal treatment reduces risk of adverse respiratory events in patients with chronic obstructive pulmonary disease. Med US. 2016;95(20):e3735.CrossRef
31.
go back to reference Kucukcoskun M, Baser U, Oztekin G, Kiyan E, Yalcin F. Initial periodontal treatment for prevention of chronic obstructive pulmonary disease exacerbations. J Periodontol. 2013;84(7):863–70.PubMedCrossRef Kucukcoskun M, Baser U, Oztekin G, Kiyan E, Yalcin F. Initial periodontal treatment for prevention of chronic obstructive pulmonary disease exacerbations. J Periodontol. 2013;84(7):863–70.PubMedCrossRef
32.
go back to reference Liu Z, Zhang W, Zhang J, Zhou X, Zhang L, Song Y, et al. Oral hygiene, periodontal health and chronic obstructive pulmonary disease exacerbations. J Clin Periodontol. 2012;39(1):45–52.PubMedCrossRef Liu Z, Zhang W, Zhang J, Zhou X, Zhang L, Song Y, et al. Oral hygiene, periodontal health and chronic obstructive pulmonary disease exacerbations. J Clin Periodontol. 2012;39(1):45–52.PubMedCrossRef
33.
go back to reference Madalli R, Kheur S, Reddy M, Kheur M, Mahalle A. Assessment of role of Porphyromonas gingivalis as an aggravating factor for chronic obstructive pulmonary disease patients with periodontitis. Dent Hypotheses. 2016;7(3):100–6.CrossRef Madalli R, Kheur S, Reddy M, Kheur M, Mahalle A. Assessment of role of Porphyromonas gingivalis as an aggravating factor for chronic obstructive pulmonary disease patients with periodontitis. Dent Hypotheses. 2016;7(3):100–6.CrossRef
34.
go back to reference Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol. 1999;4(1):1–6.PubMedCrossRef Armitage GC. Development of a classification system for periodontal diseases and conditions. Ann Periodontol. 1999;4(1):1–6.PubMedCrossRef
35.
go back to reference Garcia-Rio F, Miravitlles M, Soriano JB, Muñoz L, Duran-Tauleria E, Sánchez G, et al. Systemic inflammation in chronic obstructive pulmonary disease: a population-based study. Respir Res. 2010;11(1):63.PubMedPubMedCentralCrossRef Garcia-Rio F, Miravitlles M, Soriano JB, Muñoz L, Duran-Tauleria E, Sánchez G, et al. Systemic inflammation in chronic obstructive pulmonary disease: a population-based study. Respir Res. 2010;11(1):63.PubMedPubMedCentralCrossRef
36.
go back to reference Van Eeden SF, Sin DD. Oxidative stress in chronic obstructive pulmonary disease: a lung and systemic process. Can Respir J J Can Thorac Soc. 2013;20(1):27–9. Van Eeden SF, Sin DD. Oxidative stress in chronic obstructive pulmonary disease: a lung and systemic process. Can Respir J J Can Thorac Soc. 2013;20(1):27–9.
37.
go back to reference Sinden NJ, Stockley RA. Systemic inflammation and comorbidity in COPD: a result of “overspill” of inflammatory mediators from the lungs? Rev Evid Thorax. 2010;65(10):930–6.CrossRef Sinden NJ, Stockley RA. Systemic inflammation and comorbidity in COPD: a result of “overspill” of inflammatory mediators from the lungs? Rev Evid Thorax. 2010;65(10):930–6.CrossRef
40.
go back to reference Matthews JB, Wright HJ, Roberts A, Ling-Mountford N, Cooper PR, Chapple ILC. Neutrophil hyper-responsiveness in periodontitis. J Dent Res. 2007;86(8):718–22.PubMedCrossRef Matthews JB, Wright HJ, Roberts A, Ling-Mountford N, Cooper PR, Chapple ILC. Neutrophil hyper-responsiveness in periodontitis. J Dent Res. 2007;86(8):718–22.PubMedCrossRef
41.
go back to reference Irwin RS, Richardson ND. Side effects with inhaled corticosteroids: the physician’s perception. Chest. 2006;130(1 Suppl):41S-53S.PubMedCrossRef Irwin RS, Richardson ND. Side effects with inhaled corticosteroids: the physician’s perception. Chest. 2006;130(1 Suppl):41S-53S.PubMedCrossRef
42.
go back to reference Beeraka SS, Natarajan K, Patil R, Manne RK, Prathi VS, Kolaparthi VSK. Clinical and radiological assessment of effects of long-term corticosteroid therapy on oral health. Dent Res J. 2013;10(5):666–73. Beeraka SS, Natarajan K, Patil R, Manne RK, Prathi VS, Kolaparthi VSK. Clinical and radiological assessment of effects of long-term corticosteroid therapy on oral health. Dent Res J. 2013;10(5):666–73.
43.
go back to reference Cardoso EM, Reis C, Manzanares-Céspedes MC. Chronic periodontitis, inflammatory cytokines, and interrelationship with other chronic diseases. Postgrad Med. 2018;130(1):98–104.PubMedCrossRef Cardoso EM, Reis C, Manzanares-Céspedes MC. Chronic periodontitis, inflammatory cytokines, and interrelationship with other chronic diseases. Postgrad Med. 2018;130(1):98–104.PubMedCrossRef
44.
go back to reference Usher AKH, Stockley RA. The link between chronic periodontitis and COPD: a common role for the neutrophil? BMC Med. 2013;13(11):241.CrossRef Usher AKH, Stockley RA. The link between chronic periodontitis and COPD: a common role for the neutrophil? BMC Med. 2013;13(11):241.CrossRef
45.
go back to reference Zhou X, Wang J, Liu W, Huang X, Song Y, Wang Z, et al. Periodontal status and microbiologic pathogens in patients with chronic obstructive pulmonary disease and periodontitis: a case-control study. Int J Chron Obstruct Pulmon Dis. 2020;15:2071–9.PubMedPubMedCentralCrossRef Zhou X, Wang J, Liu W, Huang X, Song Y, Wang Z, et al. Periodontal status and microbiologic pathogens in patients with chronic obstructive pulmonary disease and periodontitis: a case-control study. Int J Chron Obstruct Pulmon Dis. 2020;15:2071–9.PubMedPubMedCentralCrossRef
46.
go back to reference Tan L, Wang H, Li C, Pan Y. 16S rDNA-based metagenomic analysis of dental plaque and lung bacteria in patients with severe acute exacerbations of chronic obstructive pulmonary disease. J Periodontal Res. 2014;49(6):760–9.PubMedCrossRef Tan L, Wang H, Li C, Pan Y. 16S rDNA-based metagenomic analysis of dental plaque and lung bacteria in patients with severe acute exacerbations of chronic obstructive pulmonary disease. J Periodontal Res. 2014;49(6):760–9.PubMedCrossRef
47.
go back to reference Agado B, Bowen DM. Does the link between COPD and periodontitis affect dental hygiene treatment. Access. 2009;23(4):19–21. Agado B, Bowen DM. Does the link between COPD and periodontitis affect dental hygiene treatment. Access. 2009;23(4):19–21.
49.
go back to reference Sapey E, Yonel Z, Edgar R, Parmar S, Hobbins S, Newby P, et al. The clinical and inflammatory relationships between periodontitis and chronic obstructive pulmonary disease. J Clin Periodontol. 2020. Sapey E, Yonel Z, Edgar R, Parmar S, Hobbins S, Newby P, et al. The clinical and inflammatory relationships between periodontitis and chronic obstructive pulmonary disease. J Clin Periodontol. 2020.
50.
go back to reference Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS. GOLD Scientific Committee. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med. 2001;163(5):1256–76.PubMedCrossRef Pauwels RA, Buist AS, Calverley PM, Jenkins CR, Hurd SS. GOLD Scientific Committee. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary. Am J Respir Crit Care Med. 2001;163(5):1256–76.PubMedCrossRef
51.
go back to reference Halpin DM, Miravitlles M, Metzdorf N, Celli B. Impact and prevention of severe exacerbations of COPD: a review of the evidence. Int J Chron Obstruct Pulmon Dis. 2017;5(12):2891–908.CrossRef Halpin DM, Miravitlles M, Metzdorf N, Celli B. Impact and prevention of severe exacerbations of COPD: a review of the evidence. Int J Chron Obstruct Pulmon Dis. 2017;5(12):2891–908.CrossRef
52.
go back to reference Dransfield MT, Kunisaki KM, Strand MJ, Anzueto A, Bhatt SP, Bowler RP, et al. Acute exacerbations and lung function loss in smokers with and without chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2017;195(3):324–30.PubMedPubMedCentralCrossRef Dransfield MT, Kunisaki KM, Strand MJ, Anzueto A, Bhatt SP, Bowler RP, et al. Acute exacerbations and lung function loss in smokers with and without chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2017;195(3):324–30.PubMedPubMedCentralCrossRef
53.
go back to reference Amerio E, Mainas G, Petrova D, Giner Tarrida L, Nart J, Monje A. Compliance with supportive periodontal/peri-implant therapy: a systematic review. J Clin Periodontol. 2020;47(1):81–100.PubMedCrossRef Amerio E, Mainas G, Petrova D, Giner Tarrida L, Nart J, Monje A. Compliance with supportive periodontal/peri-implant therapy: a systematic review. J Clin Periodontol. 2020;47(1):81–100.PubMedCrossRef
Metadata
Title
Effect of periodontal therapy on COPD outcomes: a systematic review
Authors
Ioulianos Apessos
Athanasios Voulgaris
Michalis Agrafiotis
Dimitrios Andreadis
Paschalis Steiropoulos
Publication date
01-12-2021
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2021
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-021-01429-2

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