Ambrósio Lucas Macedo Batitucci, Rovai Emanuel da Silva, França Bruno Nunes de, Balzarini Danilo Andrés, Abreu Ieda Santos, Lopes Sheyla Batista Bologna, Nunes Thaís Borguezan, Lourenço Silvia Vanessa, Pasoto Sandra Gofinet, Saraiva Luciana, Holzhausen Marinella
Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, Discipline of Periodontology, São Paulo, SP, Brazil.
Universidade de São Paulo - USP, School of Dentistry, Department of Stomatology, Discipline of General Pathology, São Paulo, SP, Brazil.
Braz Oral Res. 2017 Jan 16;31:e8. doi: 10.1590/1807-3107BOR-2017.vol31.0008.
The aim of this longitudinal prospective study was to evaluate the effects of periodontal treatment on the clinical, microbiological and immunological periodontal parameters, and on the systemic activity (ESSDAI) and subjective (ESSPRI) indexes in patients with primary Sjögren's Syndrome (pSS). Twenty-eight female patients were divided into four groups: pSS patients with or without chronic periodontitis (SCP, SC, respectively), and systemically healthy patients with or without chronic periodontitis (CP, C, respectively). Periodontal clinical examination and immunological and microbiological sample collection were performed at baseline, 30 and 90 days after nonsurgical periodontal treatment (NSPT). Levels of interleukin IL-1β, IL-8 and IL-10 in saliva and gingival crevicular fluid (GCF) were evaluated by ELISA, as well as the expression of Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans, (Aa) Tannerella forsythia (Tf), and Treponema denticola (Td), by qPCR. Systemic activity and pSS symptoms were evaluated by ESSDAI and ESSPRI. NSPT resulted in improved periodontal clinical parameters in both SCP and CP groups (p>0.05). Pg, Aa, and Tf levels decreased after NSPT only in CP patients (p<0.05). Significantly greater levels of IL-10 in GCF were verified in both SCP and CP groups (p<0.05). SCP patients showed increased salivary flow rates and decreased ESSPRI scores after NSPT. In conclusion, NSPT in pSS patients resulted in improved clinical and immunological parameters, with no significant effects on microbiological status. pSS patients also showed increased salivary flow and lower ESSPRI scores after therapy. Therefore, it can be suggested that NSPT may improve the quality of life of pSS patients.
这项纵向前瞻性研究的目的是评估牙周治疗对原发性干燥综合征（pSS）患者的临床、微生物学和免疫学牙周参数，以及全身活动度（ESSDAI）和主观（ESSPRI）指标的影响。28名女性患者被分为四组：患有或不患有慢性牙周炎的pSS患者（分别为SCP、SC），以及患有或不患有慢性牙周炎的全身健康患者（分别为CP、C）。在非手术牙周治疗（NSPT）前、治疗后30天和90天进行牙周临床检查以及免疫和微生物样本采集。通过酶联免疫吸附测定（ELISA）评估唾液和龈沟液（GCF）中白细胞介素IL-1β、IL-8和IL-10的水平，以及通过定量聚合酶链反应（qPCR）评估牙龈卟啉单胞菌（Pg）、伴放线聚集杆菌（Aa）、福赛坦氏菌（Tf）和齿垢密螺旋体（Td）的表达。通过ESSDAI和ESSPRI评估全身活动度和pSS症状。NSPT使SCP组和CP组的牙周临床参数均得到改善（p>0.05）。仅CP患者在NSPT后Pg、Aa和Tf水平降低（p<0.05）。在SCP组和CP组中均证实GCF中IL-10水平显著升高（p<0.05）。NSPT后，SCP患者的唾液流速增加且ESSPRI评分降低。总之，pSS患者的NSPT导致临床和免疫参数改善，对微生物状态无显著影响。治疗后，pSS患者的唾液流速也增加且ESSPRI评分降低。因此，可以认为NSPT可能改善pSS患者的生活质量。
