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Pires JR, Nogueira MRS, Nunes AJF, Degand DRF, Pessoa LC, Damante CA, Zangrando MSR, Greghi SLA, de Rezende MLR, Sant'Ana ACP. Deposition of Immune Complexes in Gingival Tissues in the Presence of Periodontitis and Systemic Lupus Erythematosus. Front Immunol 2021; 12:591236. [PMID: 33841392 PMCID: PMC8027066 DOI: 10.3389/fimmu.2021.591236] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 02/19/2021] [Indexed: 11/21/2022] Open
Abstract
Systemic lupus erythematosus (SLE) is a complex chronic autoimmune disease characterized by tissue damage and widespread inflammation in response to environmental challenges. Deposition of immune complexes in kidneys glomeruli are associated with lupus nephritis, determining SLE diagnosis. Periodontitis is a chronic inflammatory disease characterized by clinical attachment and bone loss, caused by a microbial challenge - host response interaction. Deposition of immune complex at gingival tissues is a common finding in the course of the disease. Considering that, the primary aim of this study is to investigate the deposition of immune complexes at gingival tissues of SLE patients compared to systemically healthy ones, correlating it to periodontal and systemic parameters. Twenty-five women diagnosed with SLE (SLE+) and 25 age-matched systemically healthy (SLE-) women were included in the study. Detailed information on overall patient's health were obtained from file records. Participants were screened for probing depth (PD), clinical attachment loss (CAL), gingival recession (REC), full-mouth bleeding score (FMBS) and plaque scores (FMPS). Bone loss was determined at panoramic X-ray images as the distance from cementenamel junction to alveolar crest (CEJ-AC). Gingival biopsies were obtained from the first 15 patients submitted to surgical periodontal therapy of each group, and were analyzed by optical microscopy and direct immunofluorescence to investigate the deposition of antigen-antibody complexes. Eleven (44%) patients were diagnosed with active SLE (SLE-A) and 14 (56%) with inactive SLE (LES-I). Mean PD, CAL and FMBS were significantly lower in SLE+ than SLE-(p < 0.05; Mann Whitney). The chronic use of low doses of immunosuppressants was associated with lower prevalence of CAL >3 mm. Immunofluorescence staining of markers of lupus nephritis and/or proteinuria was significantly increased in SLE+ compared to SLE-, even in the presence of periodontitis. These findings suggest that immunomodulatory drugs in SLE improves periodontal parameters. The greater deposition of antigen-antibody complexes in the gingival tissues of patients diagnosed with SLE may be a marker of disease activity, possibly complementing their diagnosis.
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Affiliation(s)
- Julien Rodrigues Pires
- Discipline of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry at Bauru, University of São Paulo, Bauru, Brazil
| | | | | | | | | | - Carla Andreotti Damante
- Discipline of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry at Bauru, University of São Paulo, Bauru, Brazil
| | | | - Sebastião Luiz Aguiar Greghi
- Discipline of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry at Bauru, University of São Paulo, Bauru, Brazil
| | - Maria Lúcia Rubo de Rezende
- Discipline of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry at Bauru, University of São Paulo, Bauru, Brazil
| | - Adriana Campos Passanezi Sant'Ana
- Discipline of Periodontics, Department of Prosthodontics and Periodontics, School of Dentistry at Bauru, University of São Paulo, Bauru, Brazil
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Sete MRC, Carlos JC, Lira-Junior R, Boström EA, Sztajnbok FR, Figueredo CM. Clinical, immunological and microbial gingival profile of juvenile systemic lupus erythematosus patients. Lupus 2018; 28:189-198. [PMID: 30563424 DOI: 10.1177/0961203318819134] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Periodontal disease has been associated with rheumatic diseases; however, few studies have evaluated the association with systemic lupus erythematosus (SLE), and its impact on the local inflammatory and microbial profiles. Therefore, this study evaluated the levels of several cytokines in gingival crevicular fluid (GCF) and serum from juvenile SLE (jSLE) patients with gingival inflammation, compared with controls. In addition, we assessed their subgingival microbial profile. Thirty jSLE patients and 29 systemically healthy individuals were recruited. Participants were rheumatologically and periodontally examined, and GCF, serum and intrasulcular biofilm were collected. Cytokines were analysed by bead-based multiplex assays and the bacterial profile by checkerboard DNA-DNA hybridization. jSLE patients presented higher percentages of dental plaque and bleeding than controls, as well as increased mean probing depth and attachment loss. After adjustment for multiple comparisons, GCF levels of interleukin (IL)-1β, IL-8, granulocyte colony-stimulating factor (G-CSF), interferon-γ and monocyte chemoattractant protein-1 were significantly higher, whereas the levels of granulocyte-macrophage colony-stimulating factor were significantly lower in jSLE patients. In serum, G-CSF levels tended to be higher in jSLE patients (adjusted p-value = 0.06). Intrasulcular counts of Aggregatibacter actinomycetemcomitans were significantly higher in jSLE patients as compared with controls. We conclude that patients with jSLE present a worse periodontal condition associated with altered levels of pro-inflammatory cytokines in GCF and increased counts of A. actinomycetemcomitans in the intrasulcular biofilm.
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Affiliation(s)
- M R C Sete
- 1 Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - J C Carlos
- 1 Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - R Lira-Junior
- 2 Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - E A Boström
- 2 Division of Oral Diseases, Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - F R Sztajnbok
- 3 Unit of Rheumatology, Adolescent Health Studies Center, Rio de Janeiro State University, Rio de Janeiro, Brazil
| | - C M Figueredo
- 1 Department of Periodontology, Faculty of Odontology, Rio de Janeiro State University, Rio de Janeiro, Brazil.,4 Division of Periodontology, School of Dentistry and Oral Health, Griffith University, Queensland, Australia
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Zhang Q, Zhang X, Feng G, Fu T, Yin R, Zhang L, Feng X, Li L, Gu Z. Periodontal disease in Chinese patients with systemic lupus erythematosus. Rheumatol Int 2017. [PMID: 28631047 DOI: 10.1007/s00296-017-3759-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Disease of systemic lupus erythematosus (SLE) and periodontal disease (PD) shares the common multiple characteristics. The aims of the present study were to evaluate the prevalence and severity of periodontal disease in Chinese SLE patients and to determine the association between SLE features and periodontal parameters. A cross-sectional study of 108 SLE patients together with 108 age- and sex-matched healthy controls was made. Periodontal status was conducted by two dentists independently. Sociodemographic characteristics, lifestyle factors, medication use, and clinical parameters were also assessed. The periodontal status was significantly worse in SLE patients compared to controls. In univariate logistic regression, SLE had a significant 2.78-fold [95% confidence interval (CI) 1.60-4.82] increase in odds of periodontitis compared to healthy controls. Adjusted for potential risk factors, patients with SLE had 13.98-fold (95% CI 5.10-38.33) increased odds against controls. In multiple linear regression model, the independent variable negatively and significantly associated with gingival index was education (P = 0.005); conversely, disease activity (P < 0.001) and plaque index (P = 0.002) were positively associated; Age was the only variable independently associated with periodontitis of SLE in multivariate logistic regression (OR 1.348; 95% CI: 1.183-1.536, P < 0.001). Chinese SLE patients were likely to suffer from higher odds of PD. These findings confirmed the importance of early interventions in combination with medical therapy. It is necessary for a close collaboration between dentists and clinicians when treating those patients.
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Affiliation(s)
- Qiuxiang Zhang
- School of Nursing, Nantong University, Nantong, China.,Department of Rheumatology, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, People's Republic of China
| | - Xiaoli Zhang
- Department of Rheumatology, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, People's Republic of China
| | - Guijaun Feng
- Department of Stomatology, Affiliated Hospital of Nantong University, Nantong, China
| | - Ting Fu
- School of Nursing, Nantong University, Nantong, China.,Department of Rheumatology, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, People's Republic of China
| | - Rulan Yin
- School of Nursing, Nantong University, Nantong, China.,Department of Rheumatology, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, People's Republic of China
| | - Lijuan Zhang
- School of Nursing, Nantong University, Nantong, China.,Department of Rheumatology, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, People's Republic of China
| | - Xingmei Feng
- Department of Stomatology, Affiliated Hospital of Nantong University, Nantong, China
| | - Liren Li
- School of Nursing, Nantong University, Nantong, China
| | - Zhifeng Gu
- Department of Rheumatology, Affiliated Hospital of Nantong University, 20th Xisi Road, 226001, Nantong, People's Republic of China.
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Calderaro DC, Ferreira GA, Corrêa JD, Mendonça SMS, Silva TA, Costa FO, Lúcio Teixeira A. Is chronic periodontitis premature in systemic lupus erythematosus patients? Clin Rheumatol 2016; 36:713-718. [PMID: 27557901 DOI: 10.1007/s10067-016-3385-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Revised: 08/12/2016] [Accepted: 08/14/2016] [Indexed: 12/15/2022]
Abstract
The aim of this study was to compare the frequency and severity of chronic periodontitis (CP) in systemic lupus erythematosus (SLE) patients with individuals without rheumatic diseases. Seventy-five patients with SLE were compared to 75 individuals without rheumatic diseases (control group) matched for age, educational level, and income. The activity of SLE was assessed with the Systemic Lupus Erythematosus Disease Activity Index 2000. Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index for Systemic Lupus Erythematosus evaluated SLE-related damage. Dental evaluation included measuring plaque index and parameters of periodontal disease (probing depth, clinical attachment level, and bleeding on probing). Fifty-one (68 %) SLE patients and 42 (56 %) control individuals had CP (p = 0.13). Periodontal status was similar in both groups. Considering only individuals with CP, SLE patients were younger than controls (40.7 ± 9.8 versus 46.14 ± 12.5 years of age, p = 0.02). CP was not associated with activity or therapeutics in SLE patients. Severity of periodontal parameters was similar in SLE patients and control subjects; however, CP occurred earlier in SLE patients.
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Affiliation(s)
- Débora Cerqueira Calderaro
- Rheumatology Service, Hospital das Clínicas, Universidade Federal de Minas Gerais, Rua Dona Nancy de Vasconcelos Gomes, 125/401, Sagrada Família, Belo Horizonte, Minas Gerais, CEP: 31030-071, Brazil.
| | - Gilda Aparecida Ferreira
- Department of Locomotor System, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Jôice Dias Corrêa
- Cellular Biology Post-graduation Program, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | | | - Antônio Lúcio Teixeira
- Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Há associação entre o lúpus eritematoso sistêmico e a doença periodontal? REVISTA BRASILEIRA DE REUMATOLOGIA 2016. [DOI: 10.1016/j.rbr.2015.03.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Calderaro DC, Ferreira GA, de Mendonça SMS, Corrêa JD, Santos FX, Sanção JGC, da Silva TA, Teixeira AL. Is there an association between systemic lupus erythematosus and periodontal disease? REVISTA BRASILEIRA DE REUMATOLOGIA 2015; 56:280-4. [PMID: 27267648 DOI: 10.1016/j.rbre.2015.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Accepted: 03/01/2015] [Indexed: 02/08/2023] Open
Abstract
Periodontal disease results from the interaction between pathogenic bacteria that colonize supragingival and subgingival biofilms and the host, triggering an inflammatory response, with systemic effects leading to immune-mediated destruction of the attachment apparatus and loss of supporting alveolar bone. Immunological pathways and predisposing genetic factors common to periodontal disease and rheumatic diseases, including systemic lupus erythematosus, have been described. Case reports have suggested greater severity of periodontal disease in patients with systemic lupus erythematosus. However, studies evaluating the influence of the treatment of one disease on the clinical and laboratory manifestations of the other have yielded conflicting results.
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Affiliation(s)
- Débora Cerqueira Calderaro
- Post-Graduate Program in Infectious and Parasitic Diseases, Medicine School, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
| | - Gilda Aparecida Ferreira
- Department of Locomotor System, School of Medicine, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | - Jôice Dias Corrêa
- Post-Graduate Program in Cell Biology, Biological Sciences Institute, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | | | - Tarcília Aparecida da Silva
- Department of Clinics, Pathology and Surgery, Dental School, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Antônio Lúcio Teixeira
- Medicine School, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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Baratta CA, Brown TJ, Al-Dhalaan F, Ringuette MJ. Evolution and Function of SPARC and Tenascins: Matricellular Counter-Adhesive Glycoproteins with Pleiotropic Effects on Angiogenesis and Tissue Fibrosis. EVOLUTION OF EXTRACELLULAR MATRIX 2013. [DOI: 10.1007/978-3-642-36002-2_7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Leung WK, Chu CH, Mok MY, Yeung KWS, Ng SKS. Periodontal status of adults with systemic sclerosis: case-control study. J Periodontol 2011; 82:1140-5. [PMID: 21815717 DOI: 10.1902/jop.2010.100593] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Systemic sclerosis (SSc) is a systemic autoimmune disease that affects connective tissue in the skin, blood vessels, and major organs of the body. This project aims to compare the periodontal status of dentate Hong Kong Chinese with and without SSc. METHODS Thirty-six non-smoking adults with SSc (one male and 35 females: aged 50.6 ± 11.7 years; free from Sjögren syndrome) attending a teaching hospital were age- and sex-matched to systemically healthy controls attending a dental hospital. Both groups had similar demographic characteristics but a lower proportion of patients with SSc were working or studying (P <0.05). Twenty-three (32%) of all participants were regular dental attendees. Orthopantomogram radiographs were taken. Participants were surveyed and periodontally examined. RESULTS Both groups had a similar number of erupted teeth, proportion of sites with detectable plaque, and mean full-mouth clinical attachment level, whereas controls had less bleeding on probing (49.3% ± 22.6% versus 78.4% ± 19.6%; P <0.001) and a shallower mean full-mouth probing depth (1.92 ± 0.44 mm versus 2.52 ± 0.58 mm; P <0.001). Radiographically, patients with SSc had wider periodontal ligament spaces (0.36 ± 0.06 mm versus 0.33 ± 0.03 mm; P <0.01). CONCLUSIONS Hong Kong Chinese adults with SSc seem to exhibit higher levels of periodontal inflammation and wider radiographic periodontal ligament spaces than age- and sex-matched controls. Future studies are warranted to further investigate any associations between these periodontal features and SSc.
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Affiliation(s)
- W Keung Leung
- Prince Philip Dental Hospital, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
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9
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Chu CH, Yeung CMK, Lai IA, Leung WK, Mok MY. Oral health of Chinese people with systemic sclerosis. Clin Oral Investig 2011; 15:931-9. [PMID: 20938795 PMCID: PMC3212684 DOI: 10.1007/s00784-010-0472-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2010] [Accepted: 09/28/2010] [Indexed: 11/21/2022]
Abstract
The aim was to study oral health status, salivary function, and oral features of Chinese people with Systemic Sclerosis (SSc). Chinese people with SSc attending a university specialist clinic were invited for a questionnaire survey and a clinical examination. Ethics approval was sought (UW 08-305). Gender- and age-matched individuals without SSc who attended a university dental hospital were recruited for comparison. Forty-two SSc patients with a mean age of 54.0 ± 12.2 were examined. This study found no Chinese people with systemic sclerosis were periodontally healthy and many (76%) had periodontal pockets despite most of them (93%) practiced daily tooth-brushing. They all had caries experience (DMFT = 10.5) and many (65%) had untreated decay. Mucosal telangiectasia was a common oral feature (80%). They had lower resting salivary flow rates (0.18 ± 0.17 ml/min vs. 0.31 ± 0.21 ml/min; p = 0.003) and pH values (6.90 ± 0.40 vs. 7.28 ± 0.31; p < 0.001) and reduced maximal mouth opening (40.1 ± 6.5 mm vs. 43.6 ± 7.0 mm) than people without SSc.
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Affiliation(s)
- C H Chu
- Faculty of Dentistry, The University of Hong Kong, 3B61, Prince Philip Dental Hospital, 34 Hospital Road, Hong Kong SAR, China.
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10
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Iwabuchi H, Fujibayashi T, Yamane GY, Imai H, Nakao H. Relationship between hyposalivation and acute respiratory infection in dental outpatients. Gerontology 2011; 58:205-11. [PMID: 22104982 DOI: 10.1159/000333147] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Accepted: 09/09/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Hyposalivation may affect respiratory disease because the mouth serves as the entrance to the respiratory apparatus, as well as to the digestive tract. Patients with acute respiratory infection generally have a favorable prognosis and a short natural course. However, in cases in which the host has lowered resistance, such as in elderly patients, the infection may develop into pneumonia. OBJECTIVES A prospective study was performed to examine the relationship between hyposalivation, which is common in elderly patients, and acute respiratory infection, which tends to become severe in elderly patients. METHODS The subjects were 323 male and female patients ≥40 years old who lived in Utsunomiya City and surrounding areas and regularly visited the Department of Dentistry and Oral Surgery, Tochigi National Hospital. A 6-month follow-up survey was performed to examine development of acute respiratory infection. Age, sex, and known risk factors were also investigated. Hyposalivation was defined as a saliva production (saliva secretion rate) of ≤0.6 ml/min. Multivariate analysis adjusted for age and sex was performed to examine potential risk factors associated with the development of acute respiratory infection. RESULTS Data were analyzed for 278 subjects who completed the follow-up survey. The incidence of acute respiratory infection was 60.4%, while hyposalivation was present in 96 subjects (35.5%). Multivariate analysis showed that the incidence of acute respiratory infection was higher in subjects with hyposalivation than in those without hyposalivation (adjusted odds ratio 1.761, p = 0.048). CONCLUSION The results of this study suggest that hyposalivation may be a risk factor for acute respiratory infection. This also suggests that improvement of hyposalivation might prevent acute respiratory infection.
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Affiliation(s)
- Hiroshi Iwabuchi
- Department of Dentistry and Oral Surgery, Tochigi National Hospital, Utsunomiya, Japan.
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11
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Leung WK, Chu CH, Mok MY, Yeung KWS, Ng SKS. Periodontal Status of Adults With Systemic Sclerosis: Case-Control Study. J Periodontol 2011:1-9. [PMID: 21284551 DOI: 10.1902/jop.2011.100593] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: Systemic sclerosis (SSc) is a systemic autoimmune disease that affects connective tissue in the skin, blood vessels and major organs of the body. This project aimed to compare the periodontal status of dentate Hong Kong Chinese with and without SSc. Methods: Thirty-six non-smoking adults with SSc (35 women; 50.6 ? 11.7 years, free from Sjogren's syndrome) attending a teaching hospital were age- and sex-matched to systemically healthy controls attending a dental hospital. Both groups had similar demographic characteristics but a lower proportion of SSc patients were working or studying (p < 0.05). Twenty-three (32.0%) of all participants were regular dental attendees. Orthopantomogram rediograph were taken. Participants were surveyed and periodontally examined. Results: Both groups had a similar number of erupted teeth, proportion of sites with detectable plaque, and mean full-mouth probing attachment level, whereas controls had less bleeding on probing (BOP(%), 49.3 ? 22.6 vs. 78.4 ? 19.6; p < 0.001) and a shallower mean full-mouth probing pocket depth (PPD(mm), 1.92 ? 0.44 vs. 2.52 ? 0.58; p < 0.001). Radiographically, SSc patients had wider periodontal ligament spaces. (PDL (mm), 0.36 ? 0.06 vs. 0.33 ? 0.03, p < 0.01) Conclusion: Hong Kong Chinese SSc adults seem to exhibit higher levels of periodontal inflammation and wider radiographic PDL spaces than age- and sex- matched controls. Future studies are warranted to further investigate any associations between these periodontal features and SSc.
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Affiliation(s)
- W Keung Leung
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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12
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Mehra A. Periodontal space widening in patients with systemic sclerosis: a probable explanation. Dentomaxillofac Radiol 2008; 37:183; author reply 184. [PMID: 18316513 DOI: 10.1259/dmfr/13827970] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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13
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14
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Cone-beam computed tomography in assessment of periodontal ligament space: in vitro study on artificial tooth model. Clin Oral Investig 2008; 12:233-9. [PMID: 18247066 DOI: 10.1007/s00784-008-0186-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Accepted: 01/11/2008] [Indexed: 01/09/2023]
Abstract
The aim of this in vitro study was to compare cone-beam computed tomography (CBCT) to conventional radiography (RG) in the assessment of the periodontal ligament space. A phantom with a variable "artificial" periodontal ligament space (0, 100, 200, 300, and 400 microm) was used as a model. The examinations were performed simultaneously with RG and NewTom 9000 digital volume tomograph. Assorted after increasing widths, 15 RGs and 15 CBCT images were presented for judgment to 20 dentists (DD), 20 dental assistants, and 20 dental students. Several weeks later, the same images were randomly mixed and presented to the same 20 DD again. The trial shows that RG gaps wider than 200 microm could be correctly identified by all participants with an accuracy of nearly 100%. A significant difference was observed between the modalities (p<0.05 and p<0.001) where conventional RGs performed better than CBCT for assessment of periodontal ligament space. Interobserver variation in relation to each technique was evaluated and no significant difference was found (p>0.05). In subjective evaluations of image quality with CBCT, the results were basically inferior for images of artificial periodontal ligament space, regardless of the experience of the observers.
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Kesić L, Mihailović D, Pešić Z, Obradović R. False gingival enlargement as a diagnostic problem: a case report. Int J Dent Hyg 2008; 6:68-71. [DOI: 10.1111/j.1601-5037.2007.00285.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Abstract
Lupus erythematosus is the great imitator of other diseases. There is a broad range of cutaneous symptoms induced by lupus or by its various treatments. This article provides a short overview of uncommon presentations of cutaneous symptoms in the lupus spectrum.
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Affiliation(s)
- Uwe Wollina
- Department of Dermatology, Academic Teaching Hospital Dresden-Friedrichstadt, 01067 Dresden, Germany.
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Reina S, Sterin-Borda L, Orman B, Borda E. Autoantibodies against cerebral muscarinic cholinoceptors in Sjögren syndrome: functional and pathological implications. J Neuroimmunol 2004; 150:107-15. [PMID: 15081254 DOI: 10.1016/j.jneuroim.2004.01.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2003] [Revised: 01/05/2004] [Accepted: 01/05/2004] [Indexed: 11/19/2022]
Abstract
Previous studies have demonstrated that antibodies against muscarinic acetylcholine receptors (mAChRs) from exocrine glands, correlates with Sjögren syndrome (SS) in the majority of patients. The aim of the present investigation was to establish if serum IgG antibodies present in SS interacts with cerebral mAChRs. Results show that anti-cerebral IgG are present in the sera of 40% SS patients studied. Autoantibodies were able to interact with mAChRs of cerebral frontal cortex membranes inhibiting the [(3)H]QNB binding to its specific receptor. Moreover, tested by ELISA and dot blot they recognized the synthetic peptides corresponding to the second extracellular loop of human M(1) and M(3) mAChR. In addition, the corresponding affinity-purified anti-M(1) and anti-M(3) peptide IgGs displayed an agonistic activity, stimulating phosphoinositide hydrolysis. The results support the notion that serum IgG autoantibodies in SS patients target cerebral mAChRs may have some role in the pathogenesis of higher cognitive dysfunction present in SS patients.
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Affiliation(s)
- Silvia Reina
- Pharmacology Unit, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina
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Beikler T, Flemmig TF. Implants in the medically compromised patient. CRITICAL REVIEWS IN ORAL BIOLOGY AND MEDICINE : AN OFFICIAL PUBLICATION OF THE AMERICAN ASSOCIATION OF ORAL BIOLOGISTS 2003; 14:305-16. [PMID: 12907698 DOI: 10.1177/154411130301400407] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Dental clinicians are confronted with an increasing number of medically compromised patients who require implant surgery for their oral rehabilitation. However, there are few guidelines on dental implant therapy in this patient category, so that numerous issues regarding pre- and post-operative management remain unclear to the dental clinician. Therefore, the aim of the present review is to offer a critical evaluation of the literature and to provide the clinician with scientifically based data for implant therapy in the medically compromised patient. This review presents the current knowledge regarding the influence of the most common systemic and local diseases on the outcome of dental implant therapy, e.g., abnormalities in bone metabolism, diabetes mellitus, xerostomia, and ectodermal dysplasias. Specific pathophysiologic aspects of the above-mentioned diseases as well as their potential implications for implant success are critically appraised. In line with these implications, guidelines for pre- and post-operative management that may assist in the successful implant-supported rehabilitation of this patient category are proposed.
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Affiliation(s)
- Thomas Beikler
- Department of Periodontology, University of Münster, Waldeyerstr. 30, 48149 Münster, Germany.
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Abstract
Sjögren syndrome (SS), the second most common autoimmune rheumatic disease, refers to keratoconjunctivitis sicca and xerostomia resulting from immune lymphocytes that infiltrate the lacrimal and salivary glands. However, differential diagnosis remains confusing due to the high prevalence of vague symptoms of dryness, fatigue, and myalgias in the general population. The problems of diagnosis are further compounded by the finding of "positive" antinuclear antibodies in a high percent of the general population. Unless minor salivary gland biopsies are read by experienced observers, nonspecific changes of sialadenitis are frequently confused with the focal lymphocytic infiltrates that are characteristic of SS. The distinction between fibromyalgia patients with low titer antinuclear antibodies and primary SS remains difficult. Even in patients fulfilling strict criteria for SS, the genomic search for critical genes has proven difficult due to the multigenic pattern of inheritance and strong role of currently undefined environmental factors. No single environmental factor has been detected in the majority of SS patients. SS-like syndrome has been detected in certain patients with HTLV-1 and hepatitis C infection, providing clues to pathogenesis. Even in SS patients with marked sicca symptoms, minor salivary gland biopsy shows that almost 50% of glandular cells are still detected on biopsy. These results imply the importance of immune factors such as cytokines and autoantibodies in decreasing neuro-secretory circuits and induction of glandular dysfunction. Of potential importance, an antibody against muscarinic M3 receptor that can decrease secretory function when injected into rodents is frequently found in the sera of SS patients. Newly developed topical and oral therapies can ease the oral and ocular dryness. Orally administered agonists of the muscarinic M3 receptor (pilocarpine and cevimeline) have recently been approved by the US Food and Drug Administration to increase salivary secretion. Topical ocular use of low-dose corticosteroids or cyclosporin may decrease conjunctival surface inflammation. In a Phase II double-blind study, orally administered interferon alpha (150 U) led to improved saliva flow and symptoms. In pregnant patients with evidence of fetal distress, oral dexamethasone is preferred because this agent crosses the placenta effectively. In animal models, antagonists of tumor necrosis factor and inhibitors of de novo pyrimidine synthesis appear promising.
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Affiliation(s)
- R I Fox
- Allergy and Rheumatology Clinic, Scripps Memorial Hospital and Research Foundation, La Jolla, California 92037, USA.
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