ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Periodontal Therapy on HIV Patients Undergoing HAART May Provide Slight Benefit in Periodontal Health
Clinical Question In adult HIV patients undergoing HAART, are clinical outcomes (BOP, clinical attachments, and reduction in pocket depth) from periodontal therapy significantly improved compared to HIV patients without HAART therapy?
Clinical Bottom Line Clinical outcomes in periodontal health are slightly improved in adult HIV patients undergoing HAART (highly active antiretroviral therapy) when periodontal therapy is delivered to them.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 22472296Fricke/201280 HIV infected adults, divided into 2 group: one that received HAART therapy, and one that was therapy naiveCase Control Study
Key resultsOf the periodontal parameters that were tested (probing pocket depth, gingival recession, clinical attachment level, papilla bleeding score, periodontal screening index and index for decayed, missed, and filled teeth), only the clinical marker for inflammation (the papilla bleeding score) achieved a significant difference, being twice as high (P ˂ 0.001) in the therapy naïve group (0.58 ± 0.40 versus 1.02 ± 0.59). Periodontal monitoring and early therapy is suggested regardless if the patient is on HAART therapy.
#2) 24295071John/2013120 randomly selected male and female HIV-positive patients aged between 17-55 years of ageCase Control Study
Key resultsNo significant differences were found between patients on HAART and their plaque index or their gingival index. However, it was shown that HAART patients' probing depths and clinical attachments were significantly affected (p= 0.0065 and p= 0.0029).
Evidence Search (periodontal[All Fields] AND ("therapy"[Subheading] OR "therapy"[All Fields] OR "therapeutics"[MeSH Terms] OR "therapeutics"[All Fields]) AND ("hiv"[MeSH Terms] OR "hiv"[All Fields]) AND ("patients"[MeSH Terms] OR "patients"[All Fields])) AND "loattrfree full text"[sb]
Comments on
The Evidence
Validity: The evidence for this question is based on case-controlled studies. There was no systematic review to support the evidence. Stronger evidence is still needed to answer this question. For the time being, the evidence provides support that periodontal treatment should be given to HAART patients. Perspective: There is slight benefit in periodontal parameters in patients who use HAART therapy. Though it is slight, the clinician may want to use periodontal therapy on their patients with HIV in order to control their periodontal disease.
Applicability It is important for clinicians to understand how to treat patients with HIV, especially in regards to their periodontal status. HIV patients are immunologically compromised to begin with, thus it is important to treat other diseases that will further impair their health.
Specialty/Discipline (General Dentistry) (Periodontics)
Keywords HIV, periodontal parameters, HAART therapy
ID# 2849
Date of submission: 03/31/2015spacer
E-mail ahmadm3@livemail.uthscsa.edu
Author Mariam Ahmad
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Archie A. Jones, DDS
Faculty mentor/Co-author e-mail jonesA@uthscsa.edu
Basic Science Rationale
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