One-Year Period Prevalence of Oral Aphthous Ulcers and Oral Health-Related Quality of Life in Patients with Behçet’s Disease (original) (raw)
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Journal of Oral Pathology & Medicine, 2007
BACKGROUND: The aim of the study was to test multidimensional properties of oral health impact profile-14 (OHIP-14) in Behcet's disease (BD) and recurrent aphthous stomatitis (RAS) patients with active oral ulcers. METHODS: Ninety-six BD patients, 28 patients with RAS and 117 healthy controls (HC) were included in this study. In patients with active oral ulcers, the frequency and healing time of ulcers were recorded. Multidimensional properties of OHIP-14 were examined by factor analysis. RESULTS: Factor analysis revealed three subscales and explained 66.49% of overall variance in these patients with active oral ulcers. The score of Subscale 1 was positively correlated with the recurrence of oral ulcers per month (P ¼ 0.037). Subscale 3 scores of the patients treated with colchicine were worse than those treated with immunosuppressives (P ¼ 0.035). CONCLUSIONS: The factor structure of OHIP-14 was found to be reliable and sensitive to clinical parameters and treatment modalities in active patients.
Journal of Oral Pathology & Medicine, 2009
BACKGROUND: Although number, frequency and healing time of oral ulcers and pain are generally used for clinical practice and studies in Behcet's disease (BD) and recurrent aphthous stomatitis (RAS), no standardized activity index is currently present to monitor clinical manifestations associated with oral ulcers. The aim of this study was to develop a standardized composite index (CI) to assess oral ulcer activity in BD and RAS. METHODS: In this cross-sectional study, 121 patients with BD and 45 patients with RAS were included. Sixtyfive percentage of BD and 68.9% of RAS patients were in active stage during the previous 3 months. The developed CI included the presence of oral ulcers, ulcer-related pain and functional status and was evaluated in patients with both active and inactive disease for content validity. RESULTS: Composite index score was observed to be higher in active patients with RAS (6.94 ± 2.19) compared with active BD patients (6.01 ± 2.04) (P = 0.04). The number of oral ulcers and healing time of oral ulcers were significantly higher in RAS compared with BD (P = 0.018, P = 0.001 respectively). CI score correlated with the number of oral ulcers in both BD and RAS (P = 0.000, P = 0.002 respectively). CI score was '0' for inactive patients without oral ulcer in BD and RAS. CONCLUSIONS: The presented CI as an oral ulcer activity index seems to be a reliable and suitable tool for evaluating the clinical impact and disease-specific problems in BD and RAS.
Changes In Oral Health In Patients With Behcet’s Disease: 10-Year Follow Up
Marmara Medical Journal, 2010
The aim of this retrospective study was to evaluate the changes in oral health parameters in patients with Behçet's disease (BD) in a 10-year follow-up study. Patients and Methods: Eighteen BD patients (F/M: 12/6, mean 36.4 ± 9.9 years) followed regularly by clinical, laboratory and oral health examinations for 10 years, were included in the study. Oral health was evaluated by dental and periodontal indices. Patients were given oral hygiene education regularly in each visit. In addition, the number of oral ulcers per month was noted and a disease activity score was calculated. Results: Although the frequency of tooth brushing was higher for the 10-year follow up (median:1.2) than for the baseline (1.0), no significant difference was observed (p=0.06). Also there were no significant differences for the scores of periodontal indices and dental indices at baseline and follow-up (p>0.05). The number of oral ulcers/month was lower at follow-up (median:1) compared to baseline (median:6) (p=0.000). Conclusion: Although painful ulcers affect oral health negatively, dental and periodontal health remained stable in a 10-year follow-up in BD patients with motivation and education for oral hygiene. However, further studies are required to demonstrate whether better oral hygiene effects the course of oral ulcers.
Clinical and experimental rheumatology, 2019
OBJECTIVES The aim of this multicentre study was to understand patients' needs and to evaluate the oral ulcer activity with the Composite Index (CI), according to different treatment modalities in Behçet's syndrome (BS). METHODS BS patients (n=834) from 12 centres participated in this cross-sectional study. Oral ulcer activity (active vs. inactive) and the CI (0: inactive vs. 1-10 points: active) were evaluated during the previous month. The effects of treatment protocols [non-immunosuppressive: non-IS vs. immunosuppressive: (ISs)], severity (mild vs. severe), disease duration (<5 years vs. ≥5 years) and smoking pattern (non-smoker vs. current smoker) were analysed for oral ulcer activity. RESULTS Oral ulcer activity was observed in 65.1% of the group (n=543). In both genders, the activity was higher in mild disease course with non-IS treatment group compared to severe course with ISs (p<0.05). As a resistant group, patients with mild disease course whose mucocutaneous...
Clinical and experimental rheumatology
The aim of this prospective study was to detect minimal clinically important improvement (MCII) of oral health impact profile-14 (OHIP-14) for assessing the effect of treatments for oral ulcers in Behçet's disease (BD). BD patients with active oral ulcers (F/M:36/22) were selected. Baseline and follow-up data were collected by clinical examinations and questionnaires. Patients rated their global impression of change (PGIC) measured by a transitional question. MCII was defined as the difference in mean change from baseline in OHIP-14 between patients with no response to therapy and patients with next higher level of response. Approximately one third (29.3 %) of the patients expressed an improvement during control examinations. A significant correlation was observed between raw change in OHIP-14 score and change in number of oral ulcers (r=0.69 p=0.017). Inactive patients increased from 44.1% in baseline to 58.8% in follow-up examination. A trend towards decreased number of oral u...
Acta dermatovenerologica Croatica : ADC, 2013
Recently, family history and increased frequency of some isolated manifestations of the disease in relatives of patients have been thought to play an important role in the etiopathogenesis of Behçet's disease (BD). Family history has been proposed to participate in diagnostic criteria. Investigating features of patients with different family histories may give an additional insight in understandings BD. The aim of this study was to explore the effect of familial occurrence and family history of recurrent oral ulcers (ROUs) on the clinical features of BD. We analyzed retrospectively 141 BD patients according to the International Study Group criteria. Family history of BD was present in 31.2%, family history of ROUs without BD in 31.9%, and negative family history for BD and ROUs in 36.9% of study patients. All patients were evaluated with respect to demographic and clinical features. There was no significant difference in most clinical features among patients with different famil...
European Journal of Rheumatology, 2018
The assessment of contributing factors to oral ulcer presence in Behçet's disease: Dietary and non-dietary factors Introduction Behçet's disease (BD), first described by Turkish dermatologist Dr. Hulusi Behçet in 1937, is a multi-systemic, chronic inflammatory disorder characterized by mucocutaneous, ocular, vascular, musculoskeletal, and neurological involvement (1, 2). Several auto-inflammatory features such as recurrent self-limited symptoms, notable host predisposition, and an abnormal inflammatory process have been described for BD course (1, 3, 4). A close relationship between the oral environment and disease course is present, and oral microbial infectious foci have been implicated in the etiopathogenesis of BD (5-9). Nowadays a diverse microbial pattern has also been observed in some microbiome studies (8, 10, 11). Oral ulcer (OU), a keystone for the diagnosis of the disease, is usually the initial symptom in most patients, and is a critical component for the evaluation of the disease activity and treatment response in clinical practice (12). Since oral ulcers negatively affect the daily life of patients, poor oral health related quality of life commonly observed (13-15). Even though several treatment choices are present, the prognosis and the outcomes are still not satisfactory for mucocutaneous involvement in BD (16, 17). Some environmental factors such as mechanical factors, smoking patterns, and fatigue may affect the presence of oral ulcers (18). Some foods with acidic, salty, spicy, and hard nutrients might also easily irritate oral mucosa to form oral ulcers (19-21). However, the studies investigating these factors are still limited, and the aim of this study was to assess the contributing factors for oral ulcer presence in BD.
Unmet need in Behcet’s disease: most patients in routine follow-up continue to have oral ulcers
Clinical Rheumatology, 2014
The clinical course of Behcet's disease (BD) as a multisystemic disorder with a remitting-relapsing nature is insufficiently explored. As complete remission should be aimed in all inflammatory diseases, we investigated the frequency of complete remission in patients with BD followed in long-term, routine practice. In this retrospective study, 258 patients with BD who were regularly followed in outpatient clinics were assessed. The demographic and clinical data for active organ manifestations and treatment protocols were evaluated, and "complete remission" for this study was defined as no sign of any disease manifestation in the current visit and the preceding month. Two hundred fifty-eight patients with BD (F/M 130/128, mean age 41.1±11.5 years) were included to the study. Mucocutaneous disease was present in 48.4 % (n=125). Mean visit number was 6.8±2.7, and mean follow-up duration was 45.8±36.5 months. Patients were clinically active in 67.2 % (n=1,182) of the total visits (n=1,757), which increased to 75.6 % (68.1-90.3) when the month preceding the visit was also included. The most common active manifestation was oral ulcers (39.4-63.2 %) followed by other mucocutaneous manifestations and musculoskeletal involvement. When multivariate analysis was performed, oral ulcers, which are the main cause of the clinical activity, negatively correlated with immunosuppressive treatments (β=−0.356, p<0.000) and age (β=−0.183, p=0.04). It is fairly difficult to achieve complete remission in BD with current therapeutic regimens. The reluctance of the clinician to be aggressive for some BD manifestations with low morbidity, such as mucocutaneous lesions and arthritis, might be influencing the continuous, low-disease activity state, especially due to oral ulcers, in BD patients.