AB0895-HPR A Moderated Mediation Analysis for Poor Oral Health-Related Quality of Life in Patients with Behçet’s Disease (original) (raw)
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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...
Genetics Research International, 2014
The aim of this study was to investigate the 1-year period prevalence of oral aphthous ulcers (OAUs) and their association with oral health-related quality of life (OHQOL) in patients with Behçet’s disease (BD) and in the general population. In this cross-sectional study, 675 patients with Behçet’s disease (BD group) and 1,097 males and females in the Japanese general population (control group) completed both questionnaires on their OAU status during the prior year and the General Oral Health Assessment Index (GOHAI). In the BD group, 84% of patients reported experiencing an OAU during the previous year, and the mean number of OAUs/year was 13. In the control group, 31% of individuals experienced an OAU during the previous year, and the mean number of OAUs/year was one. Multivariate analysis indicated that both BD patients (OR, 6.2; 95% CI, 4.8–8.0) and controls (OR, 2.6; 95% CI, 2.0–3.5) who had OAUs at least twice per year were more likely to have GOHAI scores below the norm than ...
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...
Journal of Oral Rehabilitation, 2018
Objectives: The aim of the study was to examine whether oral health as an infection focus could mediate disease course in patients with Behçet's disease (BD). Methods: In the study, oral health of 194 BD patients was examined at baseline and followup periods. The reasons for last dental visits were recorded as tooth extraction or regular control visits/planned treatments at the end of follow-up period. The Behçet's disease severity score was calculated with higher scores indicating a more severe course. Mediation analysis was carried out to assess the effects of oral health on disease severity score at followup period in the study. Results: Dental and periodontal indices were found to be higher at follow-up visit compared to those of baseline (p<0.05). Disease severity score was found to be higher in males (5.3±2.4) compared to females (4.4±2.5) in the whole group (p=0.005). Moreover, patients having tooth extraction at their last dental visit and patients with dental caries had a more Accepted Article This article is protected by copyright. All rights reserved. severe disease course (5.4±2.4; 5.5±2.5) compared to others (4.2±2.3; 4.4±2.4)(p<0.0001). In multiple mediation analysis, disease severity score was a dependent variable and was directly mediated by male gender (B=-0.8822, p=0.0145) and indirectly mediated through the presence of dental caries (B=0.9509 p=0.0110) and need of tooth extraction (B=0.8758 p=0.0128). Conclusion: Both presence of dental caries and need of tooth extraction were observed to be effective mediators for a more severe disease course in BD. Therefore, better oral health should be aimed to eliminate microbial factors, which are a part of pathogenic processes.
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.
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.
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.
Journal of Oral Pathology & Medicine, 2009
Objective: The aim of the study was to evaluate the influence of dental and periodontal treatments to the course of oral ulcers in patients with Behcet’s disease (BD).Methods: Fifty-eight consecutive BD patients with oral ulcers were studied. Twenty-nine patients were in the intervention group (F/M: 15/14, mean age: 39.6 ± 6.9 years) and 29 (F/M: 15/14, 39.4 ± 10.6 years) were followed with a conventional treatment approach. In addition to oral hygiene education, dental and periodontal treatments were carried out in the intervention group, whereas the control group was only given oral hygiene education. Patients were evaluated in the pre-treatment observation period (1 month), treatment period (1 month) and 6 months after treatment.Results: An increase in the number of new oral ulcers (4.1 ± 3.5) was observed within 2 days during the treatment compared with 3–30 days during treatment month (2.3 ± 1.2) (P = 0.002). However, 6 months after the treatment, the number of oral ulcers (1.9 ± 1.5) was significantly lower compared with the pre-treatment observation (4.8 ± 3.2) (P = 0.000) and treatment periods (6.4 ± 2.3) in the intervention group (P = 0.05), whereas a similar oral ulcer presence was observed in the control group (2.8 ± 2.4, 3.7 ± 2.3 and 4.8 ± 4.3, respectively) (P > 0.05). Dental and periodontal indices were also better in the intervention group during the 6-month follow-up.Conclusion: Our results suggest that, in BD patients, dental and periodontal therapies could be associated with a flare-up of oral ulcers in the short term, but may decrease their number in longer follow-up. They also lead to a better oral health.
Oral ulcer activity in Behcet’s disease: Poor medication adherence is an underestimated risk factor
European Journal of Rheumatology, 2017
The aim of this study was to evaluate the relationship between oral ulcer activity and medication adherence according to gender in Behçet's disease (BD) patients. Material and Methods: The study group included 330 BD patients (F/M: 167/163, mean age: 38.5±10.5 years). Oral ulcer activity and medication adherence were evaluated in the previous month. Medication adherence was evaluated using the 8-item Morisky Medication Adherence Scale (MMAS-8) having a score range of "0" to "8" with high scores indicating better adherence. Low adherence was defined as <6 points on MMAS-8. Results: Over half of the group had active oral ulcers (n=219, 66.4%) within the month preceding the visit. The number of oral ulcers was significantly higher in female patients with low medication adherence (2.39±3.24) than in the rest of the female group (1.28±2.05; p=0.023). Although a similar trend was also observed in male patients (2.14±3.3 vs. 1.81±2.31), a significant relationship was not observed (p=0.89). The frequency of medication intake per day was lower in patients with high medication adherence than in the rest of the study group (p=0.04). Conclusion: Low medication adherence is a hidden risk factor in the management of BD. Poor adherence was associated with oral ulcer activity in female BD patients.