Department of Periodontology, Faculty of Dentistry, Zonguldak Karaelmas University, Zonguldak, Turkey.
J Periodontol. 2011 Apr;82(4):566-74. doi: 10.1902/jop.2010.100439. Epub 2010 Nov 2.
It has become increasingly clear in recent years that periodontal disease can cause a dramatic increase in the levels of markers of systemic inflammation, and that periodontal treatment can result in reduction in the levels of these markers. We have previously shown that the prevalence of moderate to severe periodontitis was significantly higher in patients with familial Mediterranean fever (FMF) with amyloidosis than in patients with FMF without amyloidosis. Thus, the aim of this study is to investigate if chronic periodontitis is associated with secondary amyloidosis in the Black Sea region of Turkey.
A total of 112 patients with biopsy-proven secondary amyloidosis (59 patients with FMF, 40 patients who were either chronically infected or had malignant disease, 13 patients with periodontitis) and 22 healthy subjects, were included in this study. Periodontal health and disease were evaluated using gingival index (GI), papillary bleeding index (PBI), plaque index (PI), and periodontal disease index (PDI). The concentrations of serum acute phase reactants (APRs) were measured at baseline and at 4 to 6 weeks after completion of the non-surgical periodontal therapy.
The prevalence of moderate to severe periodontitis was 47.5% in patients with FMF, 72.5% in patients who were either chronically infected or had malignant disease, and 84.6% in patients with periodontitis. Serum levels of APRs in patients with amyloidosis were reduced significantly after non-surgical periodontal therapy (P <0.01).
Periodontitis can increase the levels of APRs and potentiate the development of amyloidosis either by themselves or association with traditional factors, such as FMF and other chronic inflammatory diseases. Thus, preventing or treating periodontitis might prevent or at least alleviate the progression of amyloidosis. Periodontal evaluation should be performed as part of a medical assessment and considered as an etiologic factor for secondary amyloidosis.
近年来，牙周病会导致全身性炎症标志物水平显著升高，牙周治疗可以降低这些标志物水平，这一点已变得越来越清楚。我们之前已经表明，与无淀粉样变性的家族性地中海热（FMF）患者相比，有淀粉样变性的 FMF 患者中中重度牙周炎的患病率明显更高。因此，本研究旨在探讨慢性牙周炎是否与土耳其黑海地区的继发性淀粉样变性有关。
本研究共纳入 112 名经活检证实患有继发性淀粉样变性的患者（59 名 FMF 患者、40 名慢性感染或患有恶性疾病的患者、13 名牙周炎患者）和 22 名健康对照者。使用牙龈指数（GI）、牙龈乳头出血指数（PBI）、菌斑指数（PI）和牙周病指数（PDI）评估牙周健康和疾病。在基线时和非手术牙周治疗完成后 4 至 6 周测量血清急性期反应物（APR）的浓度。
FMF 患者中中重度牙周炎的患病率为 47.5%，慢性感染或患有恶性疾病的患者为 72.5%，牙周炎患者为 84.6%。淀粉样变性患者经非手术牙周治疗后 APR 血清水平显著降低（P<0.01）。
牙周炎本身或与 FMF 等慢性炎症性疾病等传统因素相关，可能会增加 APR 水平并促进淀粉样变性的发生。因此，预防或治疗牙周炎可能会预防或至少减缓淀粉样变性的进展。应将牙周评估作为医学评估的一部分进行，并将其视为继发性淀粉样变性的病因之一。
