Full Proceeding Paper
PERIODONTAL DISEASE ASSOCIATED WITH CORTICOSTEROID IN ASTHMA PATIENTS-A
SYSTEMATIC REVIEW
SURIJANA MAPPANGARA
1*
, IRMAH BASIR
1
, SRI OKTAWATI
1
, MARDIANA ADAM
1
, HARUN ACHMAD
2
1
Department of Periodontology, Faculty of Dentistry, University of Hasanuddin, Makassar, Indonesia,
2
Department of Pedodontic, Faculty
of Dentistry, University of Hasanuddin, Makassar, Indonesia
Email: surijana_m@yahoo.com
Received: 22 Jan 2019, Revised and Accepted: 25 May 2019
ABSTRACT
To observe the changed in periodontal disease in asthma patients using corticosteroid drugs. Electronic searches on Wiley, Pubmed, and Cochrane
were conducted to identify articles published in dental journals from January 2004 to December 2017 focusing on the effects of corticosteroid use in
asthma patients. Manual searches of published full-text articles and related articles were performed afterwards. Of the 73 studies that explain this,
only 3 studies were compatible with the inclusion criteria. The initial database search produced 195 articles. All articles were selected for full-text
review. There were 3 studies selected for inclusion, with 97.837 patients as subjects. Most studies were using inhaled corticosteroids in addition to
the use of systemic corticosteroid drugs, and antihistamines. One studies mention that there no evidence of association been asthma and
periodontal disease from the adolescent population. Corticosteroids are used in the treatment of asthma diseases, but the use of corticosteroid
drugs, especially with inhaled methods, increases the risk of periodontal disease compared to patients who do not use corticosteroid drugs.
Keywords: Asthma, Corticosteroid, Drugs, Periodontal disease
© 2019 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open-access article under the CC BY license (http://creativecommons. org/licenses/by/4.0/)
DOI: http://dx.doi.org/10.22159/ijap.2019.v11s4.35295
INTRODUCTION
Asthma is a respiratory disease with characteristics of inflammation
and bronchoconstriction, which can occur in any age group, such as
children, adolescents, adults, and elderly [1]. Infection in the
respiratory tract, allergies, exposure to allergens, and weather
changes are the trigger factors in asthma with different symptoms
and limited respiratory tract. This condition can limit the activity
and the acute condition can cause the main problem in health care
and in some cases, the condition can become fatal and cause death
[2]. The prevalence of asthma is about 300 million people in the
world and this number is assured to increase by 100 million people
in 2025 [3]. Therefore, the pharmacological choices to treat asthma
disease are by reducing the disease symptom, controlling the
disease, and providing additional therapy [2].
In adults, the prevalence of asthma disease is higher in women than
men. Recently, the more effective and available treatment for asthma
is by using inflammatory medication (e. g. inhaled glucocorticosteroid)
and also can by adding bronchodilator agent (e. g. agonist β2) if
necessary [4]. Patients who are using an inhaler must be given a clear
instruction of use: 4 times daily. A long-term of the drug’s usage can
cause a health problem in the oral cavity [3]. McDerra et al. [5]. Found
that 4–10 y old children with asthma disease usually have more plaque
and calculus than healthy children without asthma. They also have a
higher prevalence of gingivitis. In 1992, Von Wowern et al. [6]. Also
reported that the reduced composition bone mineral of the mandible
may be caused by the used of systemic corticosteroid.
MATERIALS AND METHODS
This systematic review was written based on the PRISMA guidelines
(Preferred Reporting Items for Systematic Reviews and Meta-
Analyses) for reporting the events evaluated by interventions and
health care behaviors [7]. PICO questions (population, intervention,
control, and outcome) [8] used in this systematic review were:
P (population): children, adults, and elderly patients who are
suffering from asthma
I (intervention): the use of anti-asthmatic drugs corticosteroid and
antihistamines
C (comparison/control): healthy patients without asthma
O (outcome): the relation between periodontal disease and asthma
patients who were using anti-asthmatic drugs such as corticosteroid
Search strategy
The electronic searches were conducted on Wiley Online Library,
PubMed, and Cochrane Online Library databases focusing on English
literature, which supports this study. The searches were done to
identify published articles in the dental journal from January 2004 to
December 2017, focusing on the use of the anti-asthmatic drug’s
effects on periodontal disease in asthma patients. The MesH
keywords used in this search were “asthma” and “corticosteroid”.
The searches were limited to English articles, publication date, and
type of articles. The manual searches of the full-text articles were
done afterward. There were 73 studies compatible with this, but
only 3 studies were compatible with the inclusion criteria. The drugs
used in this study were anti-asthmatic drugs (e. g. corticosteroid)
and antihistamines.
The specific keywords were used in this search and the results were
evaluated based on PICO questions characteristics.
Eligibility criteria
The inclusion criteria in this systematic review are based on
parameters which are the articles that published in English from
January 2004 to December 2017 about periodontal disease associated
with corticosteroid in asthma patients and at least 24-30 mo after
using follow up evaluation. The age of patients was about 7-86 y old.
While the exclusion criteria used in this systematic review are the
article that published in not in English, articles in any systematic
review and meta-analyses, the articles only explaining other
respiratory diseases.
Selection of study
The specific keywords were used by participating authors to find the
articles by reviewing and selecting the abstract and full-text articles.
The authors then selected the articles that were compatible with the
inclusion criteria independently. After that, all the abstract and full-
text articles were downloaded and evaluated individually. The
eligibility criteria was used to identify the articles which will be used
in this systematic review.
Data extraction
The data were extracted by the authors with the following
parameter: publication year, studies on the animal, and other
accompanying diseases. All the full-text articles that were
International Journal of Applied Pharmaceutics
ISSN- 0975-7058 Vol 11, Special Issue 4, 2019