Yavuz PAHLİVAN, Ahmet Mesut ONAT, Kamile ERCİYAS, Kemal ÜSTÜN

Romatoid artrit ve periodontal sağlık

Periodontal hastalıklarla bazı sistemik hastalıklar karşılıklı etkileşim içerisindedirler. Periodontal hastalıklar patojenlere karşı lokal ve sistemik konak cevabını değiştirir. Bu değişim genel sağlığı ve bazı sistemik hastalıkların seyrini etkiler. Bazı sistemik hastalıklarda periodontal sağlık üzerine olumsuz katkı sağlar. Bu çalışmanın amacı Romatoid Artritli bireylerin mevcut ağız sağlığını ve periodontal durumunu değerlendirmektir. Çalışmaya Romatoid Artrit tanısı konulmuş 65 birey (55 kadın, 10 erkek) dahil edildi. Tüm bireylerden gingival indeks, plak indeksi, sondalabilen cep derinliği, klinik ataşman düzeyi ölçüldü ve eksik diş sayısı kaydedildi. İlave olarak dental radyografiler alındı. Çalışmaya katılan bireylerin periodontal parametre değerleri yüksek bulundu. Bireylerin %63'ünde gingivitis, %22'inde kronik periodontitis ve %4.6'sında agresif periodontitis tanısı konulurken, %10.8'inde periodontal hastalık tespit edilememiştir. Romatoid artrit hastalığı bulunan bireylerin periodontal sağlığının iyi olmadığı gösterilmiştir. Periodontitisin oluşturduğu sistemik etkilerin romatoid artrin sistemik bulgularını etkileme riskinden korunabilmeleri için periodontal sağlıklarına önem vermeleri büyük önem taşımaktadır.

Rheumatic arthritis and priodontal health

Periodontal diseases are characterized with inflammation in periodontal supportive tissues and alveolar bone resorption. They might interfere with systemic health or systemic disease pattern via localand systemic host response occurred against bacteria. The aim 'offthis study is to compare the öraf and periodontal health status of ' rheumatoid.arthritis.'65 subjects with rheumatoid arthritis (55 female, , 10 male) were included in this study.,Patie,ntsswere evaluated both clinically and radio graphically: The measurement of gingival index, plaque inaex,probing,depth, clinical attachment levels and the number of missing teeth we're recorded. All of the clinical periodontal parameters were found significantly higher in RA group. Our results showed that percentage of patients with gingivitis was 63%, patients with chronic periodontitis was 22%, periodontitis patients with aggressive periodontitis 'was 4.6%/ The results of this study showed weak oral health and Çeribdöhta] - status in1 patients with rheumatoid arthritis.

PDF

___

l.Pishon N, Pishon T, Kroger J, Gülmez E, Kleber BM, Bernimounlin JP, et al. Association among rheumatoid arthritis, oral hygiene, and periodontitis. J Periodontol. 2008;79:979-986.
2.Tüter G, Aykan T, Kurtiş B, Toyman U, Pınar S, Okyay K. Evaluation of the oral health status in patients with coronnary artery disease. Türkiye Klinikleri J Dental Sci. 2008; 14:85-90.
3.Taylor GW. Bidirectional interrelationships between diabetes and periodontal diseases: an epidemiologic perspective. Ann Periodontol. 2001;6:99-112.
4.Brown DL, Desai KK, Vakili BA, Nouneh C, Lee HM, Golub LM. Clinical and biochemical results of the metalloproteinase inhibition with subantimicrobial doses of doxycycline to prevent acute coronory syndromes (MIDAS) pilot trial. Arterioscler Thromb Vase Biol. 2004;24:733-738.
5.Payne JB, Reinhardt RA, Nummikoski PV, Golub LM. Doxycycline effects on oral bone loss in postmenopausal women. J Dent Res. 2001;80:55.
6.Bartold PM, Marshall RI, Haynes DR. Periodontitis and rheumatoid arthritis: a review. J Periodontol. 2005;76:2066-2074.
7.Symmons DP. Epidemiology of rheumatoid arthritis:Determinants of onset, persistence and outcome. Best Pract Res Clin Rheumatol. 2002;16:707-722.
8.Pers JO, Saraux A, Pierre R, and Youinou P. Anti-TNF-a immunotherapy is associated with increased gingival inflammation without clinical attachment loss in subjects with rheumatoid arthritis. J Periodontol. 2008;79:1645-1651.
9. Yetkin Ay Z, Bozkurt FY, Akkus S. Romatoid artrit hastalarının periodontal sağlık durumunun değerlendirilmesi. Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi. 2007;14(3):26-29.
lO.Löe H, Silness J. Periodontal disease in pregnancy. I Prevalance and severity. Acta Odont Scand. 1963;21:533-551.
ll.Silness J, Löe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odont Scand. 1964;22:121-135.
12.Helenius LM, Tervahartiala P, Helenius I, Al-Sukhun j, Kivisaari L, Suuronen R, et al. Clinical, radiographic and MRI findings of the temporomandibular joint in patients with different rheumatic diseases. Int J Oral Maxillofac Surg. 2006;35:983-989.
13.Mercado F, Marshall RI, Klestov AC, Bartold PM. Is there a relationship between rheumatoid arthritis and periodontal disease? J Clin Periodontol. 2000;27:267-272.
14.Bıyıkoğlu B, Buduneli N, Kardeşler L, Aksu K, Öder G, Kütükçüler N. Evaluation of t-PA, PA-2, IL-la, and PGE2 in gingival crevicular fluid of rheumatoid arthritis patients with periodontal disease. 3 Clin Periodontol. 2006;33:605-611.
15.Bozkurt FY, Yetkin Ay Z, Berker E, Tepe E, Akkus S. Anti-inflammatory Cytokines in Gingival Crevicular Fluid in Patients with Periodontitis and Rheumatoid Arthritis: a preliminary report. Cytokine. 2006;35:180-185.
16.Bozkurt FY, Berker E, Akkuş S, Bulut Ş. Relationship between IL-6 levels in gingival crevicular fluid and periodontal status in patients with rheumatoid arthritis and adult periodontitis. J Periodontol. 2000;71:1756-1760.
17.Sjöström L, Laurell L, Hugoson A, Hakansson JP. Periodontal conditions in adults with rheumatoid arthritis. Community Dent Oral Epidemiol. 1989;17:234-236.
18-Tolo K, Jorkend L. Serum antibodies and loss of periodontal bone in patients with rheumatoid arthritis, j Clin Periodontol. 1990;17:288-291.
19.Mercado F, Marshall RI, Klestov AC, Bartold PM. Relationship between rheumatoid arthritis and periodontitis. J Periodontol. 2001;72:779-787.
2O.AI-Katma MK, Bissada NF, Bordeaux JM, Sue J, Askari AD. Control of periodontal infection reduces the severity of active rheumatoid arthritis. J Clin Rheumatol. 2007;13:134-137.
21.Tuominen R, Reunanen A, Paunio M, Paunio I, Aromaa A Oral health indicators poorly predict coronary heart disease death. J Dent Res. 2003;82:713-718.
22.Risheim H, Kjoerheim V, Arneberg P. Improvement of oral hygiene in patients with rheumatoid arthritis. Scand J Dent Res. 1992;100:172-175.
23.Treister N, Glick M. Rheumatoid arthritis: areview and suggested dental care considerations. JADA. 1999; 130: 689-697.