Oral health and the masticatory system in juvenile systemic lupus erythematosus

Abstract

Our objectives were to evaluate the oral health and the masticatory system of 48 juvenile systemic lupus erythematosus (JSLE) patients and to compare them with 48 healthy children and adolescents. Demographic data, clinical manifestations and therapies of JSLE were reviewed. The DMFT index (DMFTI), the plaque (PI) and the gingival bleeding (GI) indices, dental relationship, facial profile, clinical dysfunction and mandibular mobility indices were evaluated. The two groups were homogeneous regarding age, gender, Brazilian social-economic class and dental decay index (P > 0.05). Of note, the medians of the PI and the GI were higher in JSLE patients than in controls (61.5 versus 38.10, P = 0.003 and 26.0 versus 15.95, P = 0.014; respectively). Likewise, a linear statistical correlation was evidenced between the JSLE duration and the GI (P = 0.017, r = 0.11), cumulative dose of prednisone and the PI (P = 0.01, r = 0.385) and cumulative dose of prednisone and the GI ( P = 0.001, r = 0.471). The clinical dysfunction and mandibular mobility indices were higher in JSLE patients versus controls (P = 0.002, P = 0.025). Moreover, the median of the mandibular mobility index was higher in JSLE patients who used at least one immunosuppressive than on those who did not use this medication (P = 0.0001). These results suggest that JSLE patients had an inadequate oral hygiene, higher incidence of gingivitis and temporomandibular joint dysfunction.

Periodontal Disease and Autoimmunity: What We Have Learned from Microbiome Studies in Rheumatology

“…In another study, SLE patients had a significant 1.69-fold increased odds (CI 1.37-3.25) of having periodontitis defined by CAL > 3 mm [125]. These findings have been replicated in juvenile SLE patients where periodontal parameters were significantly higher than in controls [122]. Interestingly, SLE disease activity as measured by SLEDAI index correlates with periodontal condition and is a significant predictor of periodontitis [125,126].…”

Periodontal disease in pediatric rheumatic diseases

“…The most important risk factors for gingivitis were longer disease duration and higher cumulative dose of prednisone. 64 In C-SLE patients, active elastase was observed in gingival crevicular fl uid (GCF) from infl amed sites, even in the presence of signifi cantly lower levels of IL-18 and IL-13. In contrast, the plasma levels of IL-18 and the erythrocyte sedimentation rate were signifi cantly higher in this group of patients.…”

Aseptic Arthritis of the Bilateral Temporomandibular Joint Mimicking Rheumatological Diseases

“…3 The differential diagnosis should include avascular necrosis of the condylar head, manifestation of rheumatoid arthritis and juvenile rheumatoid arthritis in the TMJ, trauma and lupus arthritis of the TMJ. 4 Laboratory tests and diagnostic imaging remain important for proper assessment due to the similarity of clinical manifestations of TMJ arthritis. Sickle cell disease may cause TMJ arthritis, and should be considered although rarely seen in the differential diagnosis of TMJ arthritis.…”