Effects of Periodontal Therapy on Biomarker Levels of TNF-α, hsCRP & IL-1β and Clinical Outcome in Patients with COPD & Severe Chronic Periodontitis

All the eligible subjects based on inclusion and exclusion criteria consenting for study will be included and will be allocated randomly to one of the groups on the basis of CAL.

Information related to demographic variables including age, gender, education, income, history of smoke- and smokeless tobacco use, time since cessation of smoking, brushing habit, alcohol consumption and history of past dental treatment will be considered.

A thorough medical history of any chronic or systemic disease will be taken.

Periodontal examination

All the selected subjects will be examined in a standardized way for assessment of periodontal status by recording following clinical parameters at baseline and after one year at Department of Periodontics, Maulana Azad Institute of Dental Sciences, New Delhi:

•Full Mouth Bleeding score (Ainamo & Bay 1975)19

•Probing pocket depth: will be assessed by using UNC-15 periodontal probe (University of North Carolina-15) from the gingival margin to the bottom of periodontal sulcus or pocket.

•Clinical attachment level by detecting the CEJ using periodontal probe.

Periodontal Therapy

It comprises of oral hygiene instructions and appropriate periodontal therapy for test group patients and follow ups will be done at 3,6,9,12 months.

Biomarker levels of TNF-α, hsCRP & IL-1β

Peripheral venous blood will be collected from the patients in test and control group at baseline and at the end of one year for the evaluation of biomarker levels of TNF-α, hsCRP & IL-1β.

Assessment of quality of life by using SGRQ questionnaire

Quality of life will be assessed by using standardized St. George’s Respiratory Questionnaire in both the groups at baseline and after one year at Department of pulmonary medicine, Lok Nayak Hospital, New Delhi.

Lung functions

Spirometry will be done at Department of Pulmonary Medicine, Lok Nayak Hospital, New Delhi for each patient in both the group at baseline and at the end of one year by a trained professional. FEV1, FCV & FEV1/FCV will be calculated for the categorization of COPD patients according to GOLD criteria.

Acute exacerbation in COPD & Number of hospitalization

A moderate exacerbation is defined as sustained worsening of baseline respiratory symptoms for >2 days that required oral corticosteroids and antibiotics prescribed by physician. Severe exacerbation is defined by the requirement for hospitalization. Data for the exacerbation and number of hospitalization will be collected for 12 months during the quarterly visits, and any additional visit referral.