Main Oral Manifestations in Immune-Mediated and Inflammatory Rheumatic Diseases (original) (raw)
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2012
context: Systemic autoimmune and inflammatory diseases often manifest oral lesions in their earliest stages, and early diagnosis, which may be spurred by a dental examination, is key for improved outcomes. After systemic diagnosis, oral lesions benefit from specialized care by dentists in collaboration with the medical team. this review aims to educate dental clinicians about the most relevant systemic autoimmune and inflammatory conditions with accompanying oral lesions, their implications for health, and management strategies supported by the biomedical literature and clinical experience. ulcerative conditions including Behcet and Crohn diseases are discussed, along with rheumatic conditions including Sjögren syndrome, lupus erythematosus, and rheumatoid arthritis.
Brazilian Journal of Health Review, 2021
Rheumatoid Arthritis (RA) is a chronic multifactorial disease characterized by inflammation of the synovial membranes that line the joints and affect 1% of the world population. This narrative review aims to discuss a highlight mechanisms about the main oral manifestations in patients with rheumatoid arthritis researching epidemiological data. This narrative review was performed by searching the literature on the MEDLINE / PubMed databases for articles in English focused on oral diseases in patients with RA. Scientific studies show that RA patients are at high risk of developing oral changes, for example, periodontal disease (PD), Sjögren's syndrome (SS), xerostomia and temporomandibular joint disorder (TMD). There is a complex interrelation between oral diseases and RA, with sufficient scientific evidence to assure that there is an association that is bidirectional and impacts the pathogenesis and evolution of these conditions. This bidirectional connection with effects on the inflammatory profile of individuals reinforces the need for future clinical studies that confirm the effectiveness of prevention and early diagnosis protocols for rheumatological disease and the main associated oral diseases.
Oral manifestations of patients with lupus erythematosus
Dental Clinics of North …, 2005
1. Dent Clin North Am. 2005 Jan;49(1):127-41, ix. Oral manifestations of patients with lupus erythematosus. Brennan MT, Valerin MA, Napeñas JJ, Lockhart PB. Department of Oral Medicine, Carolinas Medical Center, 1000 Blythe Boulevard, Charlotte, NC 28232, USA. ...
Caspian Journal of Internal Medicine, 2021
Background: Rheumatoid arthritis (RA) is the most common chronic inflammatory joint disease. Complications of RA can cause low quality of life and disabilities. Nowadays, despite all the medical developments, etiology of RA is unclear. Both soft and hard tissue damages occur in RA and periodontitis due to chronic inflammation and also since tissue damage presentation and pathogenesis of RA and periodontitis are the same, this study was done for evaluating the relationship between clinical and laboratory findings in RA patients with their oral status and disease activity. Methods: This case-control study was performed on 236 patients; 118 RA patients and 118 cases of normal people. Gingivitis, dental caries and plaques, oral hygiene and severity of periodontitis were measured based on gingival index, plaque index, clinical attachment level, Decayed Missing Filled index and oral hygiene index-simplified. Disease activity was assessed according to Diseases Activity Score-28. Blood samp...
Oral Manifestation on Systemic Lupus Erythematosus Patients
International Journal of Public Health and Clinical Sciences, 2019
Background: Periodontitis worldwide reported increasing 57.3% between 20 years also reported 6 th most prevalence disease around the world. Imune response abnormalities, hyperactivity of production of autoantibodies deposited in human tissue and organ could affect oral cavity condition. Objectives: To find oral manifestation on SLE patients and correlate with SLE severity. Methods: Subjects were 61 patients with SLE (age 17-51 years; diagnosed using SLICC) collected from Dr. Saiful Anwar General Hospital, Malang Indonesia. Oral Manidestation is measured by clinical examination and SLE severity measured using SLEDAI. Result: A total 61 SLE subjects were included in this study. We found that 54 patients (88,53%) subjects with SLE had periodontitis. 7 subject had no periodontitis, 11 mild periodontitis, 43 severe periodontitis. There is correlation between oral condition and SLE severity. Periodontitis and SLEDAI score showed significant (p<0.0001) and strong positive correlation (r=0.948) Discussion : Our study found high rates of gingivitis, periodontitis, bop, low plaque index, and low calculus index. SLE is chronic autoimmune disease develop autoantibodies and immune complexes, because of immune respon abnormalities.It could be forming autoantibodies cause DNA damage, lipid peroxidation, protein. This condition induce collagen breakdown, RANKL, osteoclast stimulation until alveolar bone resorption resulting poor oral condition and periodontitis. Conclusion: Our study showed that oral condition were associated with SLE disease activity
Oral Manifestation of Systemic Lupus Erythematosus
Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2017
Background: Periodontitis worldwide reported increasing 57.3% between 20 years also reported 6 th most prevalence disease around the world. Imune response abnormalities, hyperactivity of production of autoantibodies deposited in human tissue and organ could affect oral cavity condition. Objectives: To find oral manifestation on SLE patients and correlate with SLE severity. Methods: Subjects were 61 patients with SLE (age 17-51 years; diagnosed using SLICC) collected from Dr. Saiful Anwar General Hospital, Malang Indonesia. Oral Manidestation is measured by clinical examination and SLE severity measured using SLEDAI. Result: A total 61 SLE subjects were included in this study. We found that 54 patients (88,53%) subjects with SLE had periodontitis. 7 subject had no periodontitis, 11 mild periodontitis, 43 severe periodontitis. There is correlation between oral condition and SLE severity. Periodontitis and SLEDAI score showed significant (p<0.0001) and strong positive correlation (r=0.948) Discussion : Our study found high rates of gingivitis, periodontitis, bop, low plaque index, and low calculus index. SLE is chronic autoimmune disease develop autoantibodies and immune complexes, because of immune respon abnormalities.It could be forming autoantibodies cause DNA damage, lipid peroxidation, protein. This condition induce collagen breakdown, RANKL, osteoclast stimulation until alveolar bone resorption resulting poor oral condition and periodontitis. Conclusion: Our study showed that oral condition were associated with SLE disease activity
Clinical Oral Investigations, 2020
Objective To evaluate the impact of oral alterations on the quality of life (QoL) of individuals with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Methods A case-control study in 32 individuals with RA, 28 with SLE, and 29 in the control group (CG). The questionnaire SF-36 (Medical Outcomes Study Short-Form 36) was used to evaluate the health-related quality of life (HRQoL), and OHIP-14 (Oral Health Impact Profile-14) was used to evaluate the oral health-related quality of life (OHRQoL). The severity of xerostomia was evaluated by the Xerostomia Inventory (XI). In the clinical examination, decayed (D-T), missing(M-T), and filled teeth (F-T) (DMF-T), periodontal status, plaque index (PI), gingival index (GI), unstimulated whole salivary flow rate (UWSFR), and stimulated whole salivary flow rate (SWSFR) were also assessed. Data were analyzed by Student's t tests, chi-square test, Kruskal-Wallis test, ANOVA, Pearson's correlation, and Spearman's correlation. Results Individuals with RA had a higher caries index (D-T/p = 0.004) and more frequent periodontal disease (PI/p = 0.017). In the SLE group, there was a significant lower salivary flow (SFR/p = 0.016, SFMS/p = 0.004) and severe xerostomia (p = 0.002). The impact of ORHQoL in individuals with RA occurred due to oral candidiasis, halitosis, and xerostomia, compromising the HRQoL. Overall, OHRQoL and HRQoL were more compromised in individuals with SLE, with xerostomia being the main oral problem. Conclusion Individuals with RA and SLE present oral diseases with negative impact on their QoL. Clinical relevance This study shows the main oral manifestations in rheumatic autoimmune diseases, with mainly xerostomia compromising the quality of life. Keywords Quality of life. Oral health-related quality of life. Oral health. Xerostomia. Systemic lupus erythematosus. Rheumatoid arthritis
Oral manifestations of systemic lupus erythematosus
British Journal of Oral and Maxillofacial Surgery, 1997
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.
Zanjan University of Medical Sciences, 2023
Background and Objective: Due to the overall wide range of oral manifestations and the lack of comprehensively categorized information in Iran, this study was performed to investigate the prevalence of different oral manifestations and report their possible associated factors in patients with SLE. Materials and Methods: This cross-sectional study was performed on 96 SLE patients referred to two rheumatology clinics in Yazd, Iran, from September 2020 to February 2021. SLE patients were diagnosed based on the last revision of American College of Rheumatology (ACR) criteria in 1997. A questionnaire was created to collect demographic information and oral health status. Data were analyzed using SPSS v20.0 and p-values of P < 0.05 were considered statistically significant. Results: This study included 13 men (13.5%) and 83 women (86.5%), with an average age of 31.9 ±11.35 years. Oral lesions were diagnosed in 64.4% of patients, with white and red lesions being the most frequent (58%), and the most common region involved was buccal mucosa (25.8%). 97.1% of participants had caries and 86.5% had periodontal diseases. There was a significant association between the presence of oral lesions and female gender, longer duration and higher activity level of the disease and simultaneous presence of periodontal disease and missing or filled teeth. (P < 0.05). Conclusion: Given the frequency of oral lesions in more than 60% of patients, as well as the high incidence of caries and periodontal disorders, regular oral examinations in these patients appear to be particularly important. Keywords: Oral health, Oral lesions, Lupus Erythematosus
Oral health and orofacial function in patients with rheumatoid arthritis
Rheumatology International, 2019
The aim of the study was to describe the oral health and orofacial function of Mexican patients with rheumatoid arthritis (RA) and their association with clinical and radiological aspects of the disease. Patients with RA received a complete odontological exam, which also included a clinical and radiographic assessment of the temporomandibular joint (TMJ). The rheumatologic assessment included detailed profiling of the disease and serological and radiographic parameters. The study included 62 RA patients; the median (min-max) age was 51 (18-72) years old and 8.5 (1-39) years of disease duration. The 63.6% of the patients had DAS28 ≥ 3.2, and a median (min-max) of Sharp/van der Heijde score (SvdHS) of 41 (0-214). 98.3% of the patients presented caries, which were severe in 53.3% of the cases. The 73.8% of the patients were missing teeth due to caries, with a median (min-max) of 4 (0-32) teeth missing per patient. Oral hygiene was classified as bad in 49.1% of patients and only 15.3% of them had a healthy periodontium. The TMJ function was abnormal in 98.4% of the patients and 62.9% of them presented moderate or severe TMJ disorder (TMD). The radiographic damage of the TMJ correlated positively with the SvdHS. No correlations were found between disease activity or structural progression and orofacial variables, including periodontitis. There are severe oral and orofacial health problems in RA patients despite having medical attention for their disease. Multidisciplinary management remains an area of opportunity for both the medical specialists and the health system in our country.