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Sobieszczański J, Mertowski S, Sarna-Boś K, Stachurski P, Grywalska E, Chałas R. Root Canal Infection and Its Impact on the Oral Cavity Microenvironment in the Context of Immune System Disorders in Selected Diseases: A Narrative Review. J Clin Med 2023; 12:4102. [PMID: 37373794 DOI: 10.3390/jcm12124102] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/09/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
The oral cavity has a specific microenvironment, and structures such as teeth are constantly exposed to chemical and biological factors. Although the structure of the teeth is permanent, due to exposure of the pulp and root canal system, trauma can have severe consequences and cause the development of local inflammation caused by external and opportunistic pathogens. Long-term inflammation can affect not only the local pulp and periodontal tissues but also the functioning of the immune system, which can trigger a systemic reaction. This literature review presents the current knowledge on root canal infections and their impact on the oral microenvironment in the context of immune system disorders in selected diseases. The result of the analysis of the literature is the statement that periodontal-disease-caused inflammation in the oral cavity may affect the development and progression of autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, or Sjogren's syndrome, as well as affecting the faster progression of conditions in which inflammation occurs such as, among others, chronic kidney disease or inflammatory bowel disease.
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Affiliation(s)
- Jarosław Sobieszczański
- Preclinical Dentistry Lab, Medical University of Lublin, Chodźki 6 Street, 20-093 Lublin, Poland
| | - Sebastian Mertowski
- Department of Experimental Immunology, Medical University of Lublin, 4a Chodźki Street, 20-093 Lublin, Poland
| | - Katarzyna Sarna-Boś
- Department of Dental Prosthetics, Medical University of Lublin, Chodźki 6 Street, 20-093 Lublin, Poland
| | - Piotr Stachurski
- Department of Pediatric Dentistry, Medical University of Lublin, 20-093 Lublin, Poland
| | - Ewelina Grywalska
- Department of Experimental Immunology, Medical University of Lublin, 4a Chodźki Street, 20-093 Lublin, Poland
| | - Renata Chałas
- Department of Oral Medicine, Medical University of Lublin, Chodźki 6 Street, 20-093 Lublin, Poland
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Sojod B, Pidorodeski Nagano C, Garcia Lopez GM, Zalcberg A, Dridi SM, Anagnostou F. Systemic Lupus Erythematosus and Periodontal Disease: A Complex Clinical and Biological Interplay. J Clin Med 2021; 10:jcm10091957. [PMID: 34063235 PMCID: PMC8125164 DOI: 10.3390/jcm10091957] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 12/12/2022] Open
Abstract
Reports on the association of periodontal disease (PD) with systemic lupus erythematosus (SLE) have regularly been published. PD is a set of chronic inflammatory conditions linked to a dysbiotic microbial biofilm, which affects the periodontal tissues, resulting eventually in their destruction and contributing to systemic inflammation. SLE is a multi-system chronic inflammatory autoimmune disease that has a wide range of clinical presentations, touching multiple organ systems. Many epidemiological studies have investigated the two-way relationship between PD and SLE, though their results are heterogeneous. SLE and PD are multifactorial conditions and many biological-based hypotheses suggest common physiopathological pathways between the two diseases, including genetics, microbiology, immunity, and environmental common risk factors. By focusing on recent clinical and translational research, this review aimed to discuss and give an overview of the relationship of SLE with PD, as well as looking at the similarities in the immune-pathological aspects and the possible mechanisms connecting the development and progression of both diseases.
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Affiliation(s)
- Bouchra Sojod
- Service d’Odontologie, Hôpital Universitaire Pitié Salpêtrière (AP-HP), 75013 Paris, France; (B.S.); (G.M.G.L.); (A.Z.)
- Faculté de Chirurgie Dentaire-Garancière, Université de Paris, 75006 Paris, France
| | | | - Glenda Melissa Garcia Lopez
- Service d’Odontologie, Hôpital Universitaire Pitié Salpêtrière (AP-HP), 75013 Paris, France; (B.S.); (G.M.G.L.); (A.Z.)
- Faculté de Chirurgie Dentaire-Garancière, Université de Paris, 75006 Paris, France
| | - Antoine Zalcberg
- Service d’Odontologie, Hôpital Universitaire Pitié Salpêtrière (AP-HP), 75013 Paris, France; (B.S.); (G.M.G.L.); (A.Z.)
- Faculté de Chirurgie Dentaire-Garancière, Université de Paris, 75006 Paris, France
| | | | - Fani Anagnostou
- Service d’Odontologie, Hôpital Universitaire Pitié Salpêtrière (AP-HP), 75013 Paris, France; (B.S.); (G.M.G.L.); (A.Z.)
- Faculté de Chirurgie Dentaire-Garancière, Université de Paris, 75006 Paris, France
- B3OA, CNRS UMR 7052-INSERM U1271, Université de Paris, 75010 Paris, France;
- Correspondence:
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Benli M, Batool F, Stutz C, Petit C, Jung S, Huck O. Orofacial manifestations and dental management of systemic lupus erythematosus: A review. Oral Dis 2020; 27:151-167. [PMID: 31886584 DOI: 10.1111/odi.13271] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 12/14/2019] [Accepted: 12/24/2019] [Indexed: 12/14/2022]
Abstract
Systemic lupus erythematosus (SLE) is an autoimmune multisystem disease with numerous clinical manifestations. There is no consensus about the ideal oral management for this group of patients to date. This review aimed to describe the broad spectrum of orofacial and clinical manifestations and their therapeutic approaches. Studies concerning orofacial manifestations of SLE and dental treatment modalities were selected by a literature search (1978-2019) using Google Scholar, PubMed/MEDLINE electronic databases. The initial search strategy provided a total of 129 articles, and of these, 30 were included for qualitative synthesis. The reviewed studies revealed that SLE patients are more at risk of compromised oral and dental health exhibiting increased risk of periodontal diseases and temporomandibular joint disorders. The use of systemic drugs especially immunosuppressive and anticoagulants in SLE patients may also influence their oral management. Results emphasize the need to carry out, at an early stage of the disease, an appropriate oral management of these patients to improve oral health-related quality of life and to prevent the need of more invasive therapeutics. A multidisciplinary approach is needed for dental and medical management of such patients.
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Affiliation(s)
- Merve Benli
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey
| | - Fareeha Batool
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France.,Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France
| | - Céline Stutz
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France
| | - Catherine Petit
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France.,Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France.,Pôle de Médecine et de Chirurgie Bucco-Dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Sophie Jung
- Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France.,Pôle de Médecine et de Chirurgie Bucco-Dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,CNRS UPR 3572 "Immunologie, Immunopathologie et Chimie Thérapeutique (I2CT)", Institut de Biologie Moléculaire et Cellulaire (IBMC), Strasbourg, France
| | - Olivier Huck
- INSERM, UMR 1260 'Osteoarticular and Dental Regenerative Nanomedicine', Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Strasbourg, France.,Faculté de Chirurgie Dentaire, Université de Strasbourg, Strasbourg, France.,Pôle de Médecine et de Chirurgie Bucco-Dentaires, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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Oral Manifestations of Systemic Lupus Erythematosus Patients in Qatar: A Pilot Study. Int J Rheumatol 2018; 2018:6052326. [PMID: 29849650 PMCID: PMC5914093 DOI: 10.1155/2018/6052326] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/11/2018] [Accepted: 03/11/2018] [Indexed: 12/16/2022] Open
Abstract
Objective The purpose of this pilot study was to assess the prevalence of oral manifestations among systemic lupus erythematosus (SLE) patients in Qatar, in order to warrant future studies that would investigate each one of these manifestations with detail and further scrutiny. Methods Study procedures took place between November 2014 and April 2016. All patients visiting the outpatient rheumatology clinics at Hamad General Hospital, Doha, Qatar, were asked to join. The American College of Rheumatology (ACR) 1997 criteria of SLE were used. The patients were examined initially by a rheumatologist and were later scheduled for an appointment with a dentist at the same institution. A total of 77 patients were recruited for the study. Results Prevalence rates for the different oral manifestations ranged from 2.4% for soft palate ulcers, cheilitis, and oral candida to 88.1% for the presence of cavitation. Gingivitis, periodontal disease, cavities, and missing teeth were observed in more than 50% of the sample. The prevalence of periodontal disease and missing teeth was higher among those with an SLE duration > 8 years. On the contrary, the prevalence of gingivitis and cavities was higher among those with an SLE duration ≤ 8 years. Conclusion This study found high rates of gingivitis, periodontal disease, cavities, and missing teeth among SLE patients in Qatar. It is recommended that healthcare providers of such patients monitor the presence of any oral manifestations in order to arrange for early treatment and prevention efforts. Future prospective longitudinal studies with adequate sample size and power are needed in order to ascertain any causation factors or common etiology pathways.
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Al-Mutairi KD, Al-Zahrani MS, Bahlas SM, Kayal RA, Zawawi KH. Periodontal findings in systemic lupus erythematosus patients and healthy controls. Saudi Med J 2016; 36:463-8. [PMID: 25828284 PMCID: PMC4404481 DOI: 10.15537/smj.2015.4.10746] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To compare periodontal findings in systemic lupus erythematosus (SLE) patients and healthy controls, and to determine, whether there is a correlation between periodontal parameters and SLE biomarkers. METHODS This cross-sectional study was conducted in the Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia between November 2012 and February 2014. Twenty-five participants diagnosed with SLE and 50 healthy controls were selected. Periodontal assessment consisted of clinical attachment level (CAL), probing depth (PD), bleeding on probing, and plaque scores. For the SLE group, several laboratory tests were obtained, such as, white blood cell count, hemoglobin level, platelet count, anti-nuclear antibody, anti-double-stranded DNA antibody, calcium level, and vitamin D. RESULTS Periodontal findings in SLE patients and controls were not significantly different. The SLE patients who had no flare-ups for more than a year showed significant bleeding on probing and deeper PD compared with those who had flare-ups less than a year before starting the study. The SLE patients with arthritis symptoms showed more CAL than those without arthritis. In the SLE patients, no significant correlation was found between their periodontal findings and SLE biomarkers. CONCLUSION Periodontal health was not different between SLE patients and healthy controls. In SLE patients however, flare-ups and presence of arthritis had a significant relation with periodontal health.
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Affiliation(s)
- Khalid D Al-Mutairi
- Dental Department, Prince Sultan Armed Forces Hospital, Al-Madinah Al-Munawwarah, Kingdom of Saudi Arabia. E-mail.
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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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Sete MRC, Figueredo CMDS, Sztajnbok F. Periodontitis and systemic lupus erythematosus. REVISTA BRASILEIRA DE REUMATOLOGIA 2015; 56:165-70. [PMID: 27267530 DOI: 10.1016/j.rbre.2015.09.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 07/03/2015] [Indexed: 11/28/2022] Open
Abstract
A large number of studies have shown a potential association between periodontal and autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus (SLE). Similar mechanisms of tissue destruction concerning periodontitis and other autoimmune diseases have stimulated the study of a possible relationship between these conditions. This study aims to review the literature about this potential association and their different pathogenic mechanisms. Considering that periodontal disease is a disease characterized by inflammation influenced by infectious factors, such as SLE, it is plausible to suggest that SLE would influence periodontal disease and vice versa. However, this issue is not yet fully elucidated and several mechanisms have been proposed to explain this association, as deregulation mainly in innate immune system, with action of phagocytic cells and proinflammatory cytokines such as IL-1β and IL-18 in both conditions' pathogenesis, leading to tissue destruction. However, studies assessing the relationship between these diseases are scarce, and more studies focused on common immunological mechanisms should be conducted to further understanding.
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Affiliation(s)
| | | | - Flavio Sztajnbok
- Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil; Division of Pediatric Rheumatology, Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG), Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil; Sector of Rheumatology, Núcleo de Estudos da Saúde do Adolescente (NESA), Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
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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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Wang CY, Chyuan IT, Wang YL, Kuo MYP, Chang CW, Wu KJ, Hsu PN, Nagasawa T, Wara-aswapati N, Chen YW. β2-Glycoprotein I-Dependent Anti-Cardiolipin Antibodies Associated With Periodontitis in Patients With Systemic Lupus Erythematosus. J Periodontol 2015; 86:995-1004. [PMID: 25817824 DOI: 10.1902/jop.2015.140664] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND It was reported that patients with systemic lupus erythematosus (SLE) exhibited increased levels of anticardiolipin (anti-CL) antibodies, a class of antiphospholipid antibodies associated with thrombosis. β2-glycoprotein I (β2GPI) has been considered as the actual target antigen for anti-CL antibodies. This study investigates the association of periodontal infection with anti-CL antibodies in patients with SLE. METHODS Fifty-three SLE female patients and 56 healthy female volunteers were recruited in this case-control study. All participants received periodontal examinations. The presence of Porphyromonas gingivalis and Treponema denticola in saliva and plaque samples was detected by polymerase chain reaction. Levels of serum anti-CL and anti-β2GPI antibodies were examined using enzyme-linked immunosorbent assay. RESULTS Patients with SLE exhibited more periodontal attachment loss and increased titers of serum anti-CL and anti-β2GPI antibodies compared with healthy controls. Patients with active SLE who harbored P. gingivalis or P. gingivalis together with T. denticola intraorally exhibited significantly higher anti-CL and anti-β2GPI antibodies than those without these bacteria. Anti-CL and anti-β2GPI antibody levels correlated positively with clinical attachment level. Furthermore, increased anti-β2GPI antibody levels were significantly associated with C-reactive protein and erythrocyte sedimentation rate. CONCLUSIONS Elevated anti-CL and anti-β2GPI antibody levels were associated with periodontopathic bacteria and periodontal breakdown in patients with SLE. Periodontitis might be a modifiable risk factor for SLE.
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Affiliation(s)
- Chen-Ying Wang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Periodontology, National Taiwan University Hospital, Taipei, Taiwan
| | - I-Tsu Chyuan
- Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan
| | - Ya-Li Wang
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Periodontology, National Taiwan University Hospital, Taipei, Taiwan
| | - Mark Yen-Ping Kuo
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Periodontology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Wen Chang
- Department of Periodontology, National Taiwan University Hospital, Taipei, Taiwan
| | - King-Jean Wu
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Periodontology, National Taiwan University Hospital, Taipei, Taiwan
| | - Ping-Ning Hsu
- Graduate Institute of Immunology, College of Medicine, National Taiwan University.,Department of Internal Medicine, National Taiwan University Hospital
| | - Toshiyuki Nagasawa
- Department of Integrated Dental Education, Division of Advanced Clinical Education, School of Dentistry, Health Sciences University of Hokkaido, Hokkaido, Japan
| | - Nawarat Wara-aswapati
- Department of Periodontology, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
| | - Yi-Wen Chen
- Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.,Department of Periodontology, National Taiwan University Hospital, Taipei, Taiwan
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Yasudo H, Ando T, Takeuchi M, Nakano H, Itonaga T, Takehara H, Isojima T, Miura K, Harita Y, Takita J, Oka A. Systemic lupus erythematosus complicated with liver cirrhosis in a patient with Papillon-Lefèvre syndrome. Lupus 2014; 23:1523-7. [DOI: 10.1177/0961203314547794] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
We report the first case of a girl who presented with Papillon-Lefèvre syndrome (PLS) and subsequently developed systemic lupus erythematosus and liver cirrhosis. This indicates that autoimmune diseases can be a complication in patients with PLS. Cathepsin C gene mutations were not found in our patient or her mother. Thus, other genetic factors may have been involved in this patient.
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Affiliation(s)
- H Yasudo
- Department of Pediatrics, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - T Ando
- Department of Pediatrics, Tokyo University Graduate School of Medicine, Tokyo, Japan
- Laboratory for Allergic Disease, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | | | - H Nakano
- Department of Dermatology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - T Itonaga
- Department of Pediatrics, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - H Takehara
- Department of Pediatrics, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - T Isojima
- Department of Pediatrics, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - K Miura
- Department of Pediatrics, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - Y Harita
- Department of Pediatrics, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - J Takita
- Department of Pediatrics, Tokyo University Graduate School of Medicine, Tokyo, Japan
| | - A Oka
- Department of Pediatrics, Tokyo University Graduate School of Medicine, Tokyo, Japan
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Fernandes EGC, Savioli C, Siqueira JTT, Silva CAA. Oral health and the masticatory system in juvenile systemic lupus erythematosus. Lupus 2007; 16:713-9. [PMID: 17728364 DOI: 10.1177/0961203307081124] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Our objectives were to evaluate the oral health and the masticatory system of 48 juvenile systemic lupus erythematosus (JSLE) patients and to compare them with 48 healthy children and adolescents. Demographic data, clinical manifestations and therapies of JSLE were reviewed. The DMFT index (DMFTI), the plaque (PI) and the gingival bleeding (GI) indices, dental relationship, facial profile, clinical dysfunction and mandibular mobility indices were evaluated. The two groups were homogeneous regarding age, gender, Brazilian social-economic class and dental decay index (P > 0.05). Of note, the medians of the PI and the GI were higher in JSLE patients than in controls (61.5 versus 38.10, P = 0.003 and 26.0 versus 15.95, P = 0.014; respectively). Likewise, a linear statistical correlation was evidenced between the JSLE duration and the GI (P = 0.017, r = 0.11), cumulative dose of prednisone and the PI (P = 0.01, r = 0.385) and cumulative dose of prednisone and the GI ( P = 0.001, r = 0.471). The clinical dysfunction and mandibular mobility indices were higher in JSLE patients versus controls (P = 0.002, P = 0.025). Moreover, the median of the mandibular mobility index was higher in JSLE patients who used at least one immunosuppressive than on those who did not use this medication (P = 0.0001). These results suggest that JSLE patients had an inadequate oral hygiene, higher incidence of gingivitis and temporomandibular joint dysfunction.
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Affiliation(s)
- E G C Fernandes
- Pediatric Rheumatology Unit, Department of Pediatrics, Hospital das Clinicas, School of Medicine, University of São Paulo, Rua Senador César Lacerda Vergueiro 494/82, Vila Madalena, CEP 05435-010 São Paulo, SP, Brazil
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Stanford TW, Rees TD. Acquired immune suppression and other risk factors/indicators for periodontal disease progression. Periodontol 2000 2003; 32:118-35. [PMID: 12756038 DOI: 10.1046/j.0906-6713.2003.03210.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Thomas W Stanford
- Department of Peiodontics Baylor College of Dentistry Texas A&M University System Health Science Center, Dallas, Texas, USA
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