Piras Vanessa, Usai Paolo, Mezzena Silvia, Susnik Marta, Ideo Francesca, Schirru Elia, Cotti Elisabetta
Department of Conservative Dentistry and Endodontics, School of Dentistry, University of Cagliari, Cagliari, Italy.
Department of Gastroenterology, School of Medicine, University of Cagliari, Cagliari, Italy.
J Endod. 2017 Mar;43(3):389-394. doi: 10.1016/j.joen.2016.11.004.
We evaluated the prevalence of apical periodontitis (AP) and the oral health status in patients with inflammatory bowel diseases (IBDs) treated with immunomodulators, with particular attention to biologic medications (BMs).
One hundred ten patients, 49 men and 61 women (average age, 46 ± 13.8 years), from the Gastroenterology Unit of the University Hospital with IBDs who were treated with BMs or corticosteroids were included in the study. One hundred ten patients who registered for a dental check-up at the Dental Clinic were matched for age, sex, and physical characteristics with the study group without systemic diseases and not taking medications who were the control. Patients underwent a complete oral, dental, and radiographic examination. Decayed, missing, and filled teeth and periapical index score indexes were recorded. Student t test, χ, and Mann-Whitney U test were used as appropriate.
The prevalence of AP was 64% in IBD patients and 59% in the control; according to the gender-stratified analysis, the difference was not significant among the male groups, whereas the number of teeth with AP was significantly higher in female patients with IBDs than in the controls (P ≤ .05). The prevalence of AP in patients treated with BMs was 65%; women showed 69% higher risk for AP and presented a significantly higher number of teeth with AP (P ≤ .05). Decayed, missing, and filled teeth index was similar in both groups, whereas patients with IBDs had a higher periapical index score than the controls.
Women with IBDs and taking immunomodulators had a higher prevalence of AP. All patients with IBDs had larger lesions than healthy subjects. These data emphasize the influence of the status of the immune system in the onset of AP and the need for further studies to confirm these findings.
我们评估了接受免疫调节剂治疗的炎症性肠病（IBD）患者根尖周炎（AP）的患病率及口腔健康状况，尤其关注生物制剂（BM）。
本研究纳入了大学医院胃肠病科110例IBD患者，其中男性49例，女性61例（平均年龄46±13.8岁），这些患者接受了BM或皮质类固醇治疗。110例在牙科诊所登记进行牙科检查的患者，按照年龄、性别和身体特征与无全身性疾病且未服用药物的对照组进行匹配。患者接受了全面的口腔、牙齿和影像学检查。记录龋失补牙数和根尖指数评分指标。根据情况适当使用学生t检验、χ检验和曼-惠特尼U检验。
IBD患者中AP的患病率为64%，对照组为59%；根据性别分层分析，男性组之间差异不显著，而IBD女性患者中患AP的牙齿数量显著高于对照组（P≤0.05）。接受BM治疗的患者中AP的患病率为65%；女性患AP的风险高69%，且患AP的牙齿数量显著更多（P≤0.05）。两组的龋失补牙指数相似，而IBD患者的根尖指数评分高于对照组。
患有IBD且服用免疫调节剂的女性AP患病率更高。所有IBD患者的病变均比健康受试者更大。这些数据强调了免疫系统状态对AP发病的影响，以及需要进一步研究来证实这些发现。
