IADR Abstract Archives
Effect of Proton Pump Inhibitors on Periodontal Disease Severity
Objectives: Proton pump inhibitors (PPIs) are prescribed for treatment of conditions related to excess gastric acid production. PPIs affect bone metabolism and alter the gastrointestinal microbiome. Periodontitis develops in response to pathogenic changes in the oral microbiome, leading to loss of attachment. Consequently, the objective of this study was to assess whether PPIs influence the pathogenesis of periodontal disease.
Methods: Following IRB approval, review of 1,513 medical records from patients seeking care at a faculty periodontal practice (2016-2019) and meeting specific inclusion criteria were identified. From that population, patients retrospectively diagnosed with generalized periodontitis stage III to IV, grade B to C, were further assessed (N=433). Periodontal disease severity was determined by separately calculating the proportion of teeth with probing depths ≥5mm or ≥6mm. Records were reviewed to obtain demographic information, medications, disease and smoking history. Statistical significance was measured using independent sample t-tests using equal or unequal variances as indicated (IBM SPSS Statistics v26).
Results: A statistically significant inverse relationship was found between the use of PPIs and the proportion of teeth having periodontal probing depths ≥5mm or ≥6mm. The prevalence of probing depths ≥5mm from patients using PPIs was 28.1%, vs. 55.8% in non-PPI users (CI[95%]=14.2%-41.5%, P<0.001). Similarly, the prevalence of probing depths ≥6mm from patients taking PPIs was 14.8%, vs. 31.1% in non-PPI users (CI[95%]=6.0%-26.5%, P=0.001). Exclusion of risk factors potentially affecting periodontitis yielded similarly significant results. There were no significant differences in plaque index among any of the groups (P>0.05).
Conclusions: PPI use is significantly associated with a decreased proportion of elevated probing depths. Prospective and animal studies currently are underway to elucidate the mechanism and assess whether adjunctive use of PPIs might be considered for treatment of periodontitis. Supported in part by the Department of Periodontics and Endodontics, SUNYAB.
Methods: Following IRB approval, review of 1,513 medical records from patients seeking care at a faculty periodontal practice (2016-2019) and meeting specific inclusion criteria were identified. From that population, patients retrospectively diagnosed with generalized periodontitis stage III to IV, grade B to C, were further assessed (N=433). Periodontal disease severity was determined by separately calculating the proportion of teeth with probing depths ≥5mm or ≥6mm. Records were reviewed to obtain demographic information, medications, disease and smoking history. Statistical significance was measured using independent sample t-tests using equal or unequal variances as indicated (IBM SPSS Statistics v26).
Results: A statistically significant inverse relationship was found between the use of PPIs and the proportion of teeth having periodontal probing depths ≥5mm or ≥6mm. The prevalence of probing depths ≥5mm from patients using PPIs was 28.1%, vs. 55.8% in non-PPI users (CI[95%]=14.2%-41.5%, P<0.001). Similarly, the prevalence of probing depths ≥6mm from patients taking PPIs was 14.8%, vs. 31.1% in non-PPI users (CI[95%]=6.0%-26.5%, P=0.001). Exclusion of risk factors potentially affecting periodontitis yielded similarly significant results. There were no significant differences in plaque index among any of the groups (P>0.05).
Conclusions: PPI use is significantly associated with a decreased proportion of elevated probing depths. Prospective and animal studies currently are underway to elucidate the mechanism and assess whether adjunctive use of PPIs might be considered for treatment of periodontitis. Supported in part by the Department of Periodontics and Endodontics, SUNYAB.