Department of Dermatology, University of Lübeck, Lübeck, Germany.
Eisenhower Medical Center, Rancho Mirage, California.
J Am Acad Dermatol. 2017 May;76(5):975-978.e3. doi: 10.1016/j.jaad.2016.10.028. Epub 2016 Dec 28.
Periodontitis and autoimmune bullous diseases, including pemphigus vulgaris and mucous membrane pemphigoid, are immunoinflammatory disorders leading to microbial plaque- and autoantibody-elicited tissue injury of the oral cavity, respectively. Evidence indicates that these autoimmune conditions may represent a risk factor for periodontitis, but no systematic evaluation exists to corroborate this assumption. A systematic literature review of periodontal status in pemphigus and pemphigoid was conducted. Electronic searches using PubMed from inception to July 2016 identified 10 studies meeting predetermined inclusion and exclusion criteria. Most reported some correlation between poor periodontal health and both oral pemphigus vulgaris and mucous membrane pemphigoid. Some demonstrated beneficial effects of oral hygiene procedures on periodontal parameters and clinical disease severity of the established blistering diseases. Inconsistent results were found between studies and within analyzed patient cohorts, likely because of methodological shortcomings. This review preliminarily suggests that patients with oral pemphigus vulgaris and mucous membrane pemphigoid appear somewhat more susceptible to periodontitis, which in turn may potentially trigger the bullous disorders. These patients should be encouraged by dermatologists to pursue collaborative professional periodontal follow-up with dentists. The true relationship and mutual interaction between both diseases needs to be more comprehensively addressed in well-designed prospective studies.
牙周炎和自身免疫性大疱性疾病，包括寻常型天疱疮和黏膜类天疱疮，分别是导致口腔微生物斑块和自身抗体引起组织损伤的免疫炎症性疾病。有证据表明，这些自身免疫性疾病可能是牙周炎的一个危险因素，但没有系统的评估来证实这一假设。对寻常型天疱疮和黏膜类天疱疮的牙周状况进行了系统的文献回顾。从创建到 2016 年 7 月，使用 PubMed 进行电子搜索，确定了 10 项符合预定纳入和排除标准的研究。大多数研究报告了不良牙周健康与口腔寻常型天疱疮和黏膜类天疱疮之间存在某种相关性。一些研究表明，口腔卫生程序对已确立的水疱性疾病的牙周参数和临床疾病严重程度有有益影响。研究之间和分析的患者队列内发现结果不一致，可能是由于方法学上的缺陷。这篇综述初步表明，口腔寻常型天疱疮和黏膜类天疱疮患者似乎更容易患牙周炎，而牙周炎又可能潜在地引发大疱性疾病。皮肤科医生应鼓励这些患者与牙医进行协作的专业牙周随访。需要在精心设计的前瞻性研究中更全面地解决这两种疾病之间的真实关系和相互作用。
