青少年特发性关节炎与牙周病的关系

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Twenty Iraqi patients diagnosed with JIA by rheumatologist (after fulfilling International League of Associations for Rheumatology (ILAR) criteria), compared with 20 healthy control individuals matched age. All patients were sent to specialized pediatric dental clinic in Baghdad where dental examination was applied. The examinations were conducted by two certified specialist pedo-dentist to indices Dental findings (dmf-s/DMF-S), Gingival inflammation (GI), Plaque index (PI). The surfaces of Ramfjord teeth were examined with diagnostic instruments (mirror and periodontal probe) and scored for all indices.\n\nResults: According to joint numbers involved, the polyarticular manner was the most common in 40% of patients, followed by oligoarticular in 35% of patients, and systematic manner in 20% of patients. In addition, one case presented with enthesitis related arthritis. The mean of gingival index (GI) in patients’ group (0.88±0.623) was higher than that of control group (0.61±0.53), without any significant difference (p=0.0545). However, the plaque index (PI) results showed high statistically significant difference (p=0.0162), similarly, the dmfs demonstrated a high significant difference (p=0.026) between patient and control groups. The DMFs was statistically significant (p=0.015), CRP level in relation to the indices, all indices have a significant high level association level (≥5mg/L) over normal level of CRP (<5 mg/L), effect of Prednisolone was statistically significant for GI (p=0.0245), and dmfs (p=0.0015). However, it was not significantly different in the value of PI (p=0.098), and DMFs (p=0.0627). In our study DMARDs (MTX) had a direct effect on GI and PI with a statistically significant difference (p=0.0164), and (p=0.017), respectively. 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引用次数: 0

摘要

背景:青少年特发性关节炎(JIA)是一种病因不明的关节炎,在16岁生日之前开始,持续至少6周,排除其他已知情况。JIA在关节骨与结缔组织交界处有一个破坏性的炎症过程,类似于牙周炎中牙齿周围支撑组织的炎症过程。目的:强调儿科牙医在JIA多学科治疗中的作用(在这种有害疾病变得不可逆转之前进行治疗)。患者和方法:2020年9月至2021年5月,在巴格达教学医院风湿病科和私立风湿病诊所对JIA患者进行病例对照研究。20名由风湿病学家诊断为JIA的伊拉克患者(在满足国际风湿病协会联盟(ILAR)标准后)与20名年龄匹配的健康对照进行比较。所有病人都被送到巴格达的儿童牙科专科诊所,在那里进行牙科检查。由两名注册儿科牙医进行检查,以评估口腔检查结果(dmf-s/ dmf-s)、牙龈炎症(GI)、菌斑指数(PI)。用诊断仪器(镜和牙周探针)检查拉姆峡湾牙表面,并对各项指标进行评分。结果:按受累关节数分,以多关节方式最常见,占40%,其次为少关节方式,占35%,系统方式占20%。另外,1例表现为感染性关节炎。患者组牙龈指数(GI)平均值(0.88±0.623)高于对照组(0.61±0.53),差异无统计学意义(p=0.0545)。而斑块指数(PI)结果与对照组比较,差异有统计学意义(p=0.0162), dmfs结果与对照组比较,差异有统计学意义(p=0.026)。DMFs与各指标相关,各指标的相关水平(≥5mg/L)均高于CRP正常水平(< 5mg/L),强的松龙对GI (p=0.0245)、DMFs的影响均有统计学意义(p=0.0015)。而PI值(p=0.098)和DMFs值(p=0.0627)差异无统计学意义。在我们的研究中,DMARDs (MTX)对GI和PI有直接影响,差异有统计学意义(p=0.0164), (p=0.017)。最后,MTX对dmfs和dmfs的作用不显著。结论:本研究用于评价JIA患儿口腔健康的各项指标:GI与健康儿童比较无显著差异;PI明显高于健康儿童;dmfs/ dmfs均明显高于健康儿童。高CRP水平与GI、PI、dmfs有显著相关性,与dmfs无显著相关性。在JIA治疗中,泼尼松龙对所有指标(尤其是GI和DMFs)均有显著改变,非甾体抗炎药仅对PI有显著改变,DMARDs (MTX)对GI和PI有直接影响,但对DMFs无作用,对DMFs无显著影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Relationship between juvenile idiopathic arthritis and periodontal diseases
Background: Juvenile idiopathic arthritis (JIA) is an arthritis of unknown etiology that begins before the 16th birthday and persists for at least six weeks with other known conditions excluded. In JIA, there is a destructive inflammatory process in the border between bone and connective tissue of the joint similar to the inflammatory process of the supporting tissue around the tooth in periodontitis. Objective: To emphasize the role of a pedo-dentist in the multidisciplinary management of JIA (to treat this detrimental disease before it becomes irreversible). Patients and Methods: A case-control study was conducted among JIA patients at Baghdad Teaching Hospital, Rheumatology Unit and private rheumatology clinic during the period September 2020 to May 2021. Twenty Iraqi patients diagnosed with JIA by rheumatologist (after fulfilling International League of Associations for Rheumatology (ILAR) criteria), compared with 20 healthy control individuals matched age. All patients were sent to specialized pediatric dental clinic in Baghdad where dental examination was applied. The examinations were conducted by two certified specialist pedo-dentist to indices Dental findings (dmf-s/DMF-S), Gingival inflammation (GI), Plaque index (PI). The surfaces of Ramfjord teeth were examined with diagnostic instruments (mirror and periodontal probe) and scored for all indices. Results: According to joint numbers involved, the polyarticular manner was the most common in 40% of patients, followed by oligoarticular in 35% of patients, and systematic manner in 20% of patients. In addition, one case presented with enthesitis related arthritis. The mean of gingival index (GI) in patients’ group (0.88±0.623) was higher than that of control group (0.61±0.53), without any significant difference (p=0.0545). However, the plaque index (PI) results showed high statistically significant difference (p=0.0162), similarly, the dmfs demonstrated a high significant difference (p=0.026) between patient and control groups. The DMFs was statistically significant (p=0.015), CRP level in relation to the indices, all indices have a significant high level association level (≥5mg/L) over normal level of CRP (<5 mg/L), effect of Prednisolone was statistically significant for GI (p=0.0245), and dmfs (p=0.0015). However, it was not significantly different in the value of PI (p=0.098), and DMFs (p=0.0627). In our study DMARDs (MTX) had a direct effect on GI and PI with a statistically significant difference (p=0.0164), and (p=0.017), respectively. Finally, the role of MTX on dmfs and DMFs was not significant. Conclusions: The indices used in this study to evaluate oral health in JIA children were GI has no significant difference compared to healthy children; PI was significantly higher compared to healthy children; the dmfs/DMFS both showed significantly higher compared to healthy children. The high CRP level has a significant association with GI, PI and dmfs, but no significant association with DMFs. Regarding the JIA treatment, Prednisolone has significantly modified all indices (in particular GI and DMFs), NSAIDs has significantly modified PI only, DMARDs (MTX) had direct effect on GI and PI, but no role on dmfs and no significant effect on DMFs.
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