Koutsochristou Vassiliki, Zellos Aglaia, Dimakou Konstantina, Panayotou Ioanna, Siahanidou Sultana, Roma-Giannikou Eleftheria, Tsami Alexandra
*First Department of Pediatrics, University of Athens School of Medicine, Athens, Greece; and †Department of Periodontology, University of Athens Dental School, Athens, Greece.
Inflamm Bowel Dis. 2015 Aug;21(8):1839-46. doi: 10.1097/MIB.0000000000000452.
Previous reports have demonstrated a higher prevalence of dental caries and periodontal disease in adults with inflammatory bowel disease (IBD), but similar data in children and adolescents do not exist. The aim of the study was to evaluate the status of dental caries, oral hygiene, gingival status and periodontal treatment needs of children with IBD.
In this case-control study, 55 children on remission from a single outpatient IBD clinic, aged 4 to 18 years (12.27 ± 3.67 yr) and 55 matched systemically healthy controls of a dental practice were assessed prospectively. The evaluation included medical history, dental questionnaire in both groups, and previous and current medical therapy of children with IBD. Additionally, the decayed, missing, and filled tooth (dmf-t or DMF-T), simplified gingival, plaque control record and community periodontal treatment needs indices were evaluated.
Children with IBD compared with controls had a statistically significant (P < 0.001) higher dmf-t (2.95 versus 0.91) or DMF-T (5.81 versus 2.04) index and a higher gingival inflammation (simplified gingival, 40% versus 24%) although the respectively dental plaque index showed no significant difference (plaque control record, 42% versus 41%). Also, the community periodontal treatment needs was significantly higher compared with controls (P < 0.001); most of the patients with IBD needed treatment of gingivitis (47% versus 4%), and none of them had healthy periodontium (0% versus 69%).
The results of this case-control study demonstrate a higher frequency of dental caries, more clinical signs of gingival inflammation, and increased periodontal treatment needs in children and adolescents with IBD despite similar oral hygiene status.
既往报告显示，炎症性肠病（IBD）成人患者中龋齿和牙周病的患病率较高，但儿童和青少年中缺乏类似数据。本研究旨在评估IBD患儿的龋齿状况、口腔卫生、牙龈状况及牙周治疗需求。
在这项病例对照研究中，前瞻性评估了来自单一门诊IBD诊所的55名缓解期患儿，年龄4至18岁（12.27±3.67岁），以及牙科诊所的55名匹配的全身健康对照。评估内容包括两组的病史、牙科问卷，以及IBD患儿既往和当前的药物治疗。此外，还评估了龋失补牙（dmf-t或DMF-T）、简化牙龈指数、菌斑控制记录和社区牙周治疗需求指数。
与对照组相比，IBD患儿的dmf-t（2.95对0.91）或DMF-T（5.81对2.04）指数在统计学上显著更高（P<0.001），牙龈炎症也更严重（简化牙龈指数，40%对24%），尽管两组的菌斑指数无显著差异（菌斑控制记录，42%对41%）。此外，与对照组相比，社区牙周治疗需求也显著更高（P<0.001）；大多数IBD患者需要治疗牙龈炎（47%对4%），且无一例牙周健康（0%对69%）。
本病例对照研究结果表明，尽管口腔卫生状况相似，但IBD儿童和青少年的龋齿发生率更高，牙龈炎症的临床体征更多，牙周治疗需求增加。
