Avaliação microbiológica do tratamento periodontal em pacientes com bronquiectasia: ensaio clínico controlado aleatorizado com 3 meses de acompanhamento

Abstract

The association between periodontitis and chronic obstructive pulmonary disease (COPD) has been extensively studied and the aspiration of bacteria residing in the oral cavity is one of the most accepted mechanisms for pulmonary exacerbation. Bronchiectasis has many clinical and pathophysiological similarities to COPD, but to date it has not been correlated with PD. Therefore, this study aimed to evaluate whether periodontal (TP) extraction may result in alteration of sputum microbiota, nasal secretion and saliva in bronchiectasis patients. Through a randomized, prospective, controlled trial, 49 bronchiectasis patients were randomized to the experimental group (n = 26) for scaling and planning root and oral hygiene (OHB) or control (n = 23) oral hygiene. After 3 months, the periogram, quantification of bacteria and evaluation of oral health related to quality of life were performed. Patients in the control group were also treated for ethical reasons. Pseudomonas aeruginosa, Staphylococcus aureus (S. aureus) and Porphyromonas gingivalis (P. gingivalis) present in saliva, nasal secretion and sputum by qPCR baseline assessment and 3 months after PT. The complete periogram of all patients at baseline and 3 months after treatment was performed. The impact of oral changes on quality of life was also measured using the Oral health impact profile questionnaire (Ohip-14). Non-parametric data were submitted to Wilcoxon test. There was a decrease in the number of P.aeruginosa (p = 0.026) and P. gingivalis (p = 0.001) in nasal and P. aeruginosa in saliva (p = 0.037) in the treatment group. There was a decrease in the clinical depth of probing (p = 0.046), gingival index (p = 0.008) and plaque index (p = 0.003) after PT. There was no difference for the total sum of Ohip-14 values, however, there was improvement (p = 0.048) for disability in routine obligations (question 14- OHIP) and improvement in social discomfort (p = 0.077) after PD. It is concluded that, TP promotes a decrease in the amount of P.aeruginosa in nasal secretion and saliva, reflecting the improvement in the quality of life of bronchiectasis patients with periodontitis. ClinicalTrials.gov- NCT02514226.