类风湿关节炎患者的牙颌面特征。

Dentofacial characteristics of patients with rheumatoid arthritis.

机构信息

Department of Dentomaxillofacial Radiology, Faculty of Dentistry, University of Suleyman Demirel, Dogu Kampusu, 32260, Isparta, Turkey.

出版信息

Clin Oral Investig. 2013 Sep;17(7):1677-83. doi: 10.1007/s00784-012-0861-7. Epub 2012 Oct 11.

DOI:10.1007/s00784-012-0861-7

PMID:23053710

Abstract

OBJECTIVES

The aims of this study are to evaluate the dentofacial morphology of patients with rheumatoid arthritis (RA) and to compare the morphological data with those of healthy age- and sex-matched control subjects.

METHODS

Twenty-seven RA patients (mean age, 45.77 ± 8.64 years) and 25 healthy subjects (mean age, 44.80 ± 8.24 years) participated in this prospective study. Clinical and functional evaluations of the RA patients were assessed. The erythrocyte sedimentation rate, C-reactive protein level, rheumatoid factor level, and anti-citrullinated peptide antibodies (ACPA) titers of RA patients were determined, and DAS28 scores were calculated. Linear and angular measurements were performed on cephalometric tracings and condylar erosion was evaluated on lateral panoramic radiographs. Statistical comparison of the two groups was performed with an independent samples t test. Pearson correlation analysis was used to assess the relationship between the clinical and laboratory parameters.

RESULTS

Based on DAS28 scores, no patient with RA was in the remission period, 3 patients had low, 23 had medium, and 1 had high disease activity. Sixteen (59.26 %) patients with RA had positive ACPA titers. Lateral cephalometric radiographs revealed statistically significant difference between the two groups for the measurement of U1-NA (millimeter; p = 0.047), U1-NA (degrees; p = 0.031), L1-NB (degrees; p = 0.030), IMPA (L1-MP; p = 0.001), interincisal angle (U1-L1; degrees; p = 0.022) and midface length (Co-A; millimeter; p = 0.033). A significant positive linear correlation was found between disease duration time and DAS28 scores (r = 0.066, p = 0.040).

CONCLUSIONS

Dentoalveolar effects of RA on dentofacial morphology are more significant than the skeletal effects. Future studies with larger sample sizes are required to evaluate the exact effects of RA on dentofacial morphology.

CLINICAL RELEVANCE

Clinicians should consider the fact that RA-associated dentoalveolar changes can be observed and may affect the orthodontic treatment process.

摘要

目的

本研究旨在评估类风湿关节炎（RA）患者的面颌形态，并将形态数据与健康年龄和性别匹配的对照受试者进行比较。

方法

本前瞻性研究纳入 27 例 RA 患者（平均年龄 45.77±8.64 岁）和 25 名健康对照者（平均年龄 44.80±8.24 岁）。对 RA 患者进行临床和功能评估。测定 RA 患者的红细胞沉降率、C 反应蛋白水平、类风湿因子水平和抗瓜氨酸化肽抗体（ACPA）滴度，并计算 DAS28 评分。在头颅侧位片上进行线性和角度测量，并评估髁突侵蚀情况。采用独立样本 t 检验对两组进行统计学比较。采用 Pearson 相关分析评估临床和实验室参数之间的关系。

结果

根据 DAS28 评分，无 RA 患者处于缓解期，3 例为低活动度，23 例为中活动度，1 例为高活动度。16 例（59.26%）RA 患者 ACPA 滴度阳性。头颅侧位片显示，两组 U1-NA（毫米；p=0.047）、U1-NA（度；p=0.031）、L1-NB（度；p=0.030）、IMPA（L1-MP；p=0.001）、切牙间角（U1-L1；度；p=0.022）和中面部长度（Co-A；毫米；p=0.033）的测量值存在统计学差异。疾病持续时间与 DAS28 评分之间存在显著的正线性相关（r=0.066，p=0.040）。