Erdemir U, Okan G, Gungor S, Tekin B, Yildiz S O, Yildiz E
Department of Operative Dentistry, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
Department of Dermatology, Medical Park Bahcelievler Hospital, Bahcelievler, Turkey.
Niger J Clin Pract. 2017 Jul;20(7):860-866. doi: 10.4103/1119-3077.183248.
Isotretinoin is the most effective therapy to treat severe acne vulgaris and its systemic adverse effects have been well documented, but little is known on dental side effects over the course of treatment.
This prospective case-control study aimed to evaluate the oral adverse effects of isotretinoin in Turkish patients with acne vulgaris; compare oral conditions between patients and normal controls; and investigate the association between salivary parameters and International Caries Detection and Assessment System (ICDAS) scores.
For 6 months, the patients (n = 45) received isotretinoin daily (0.5 mg/kg). The age-matched untreated controls (n = 45) were patients without acne. Both groups were examined before the study and at 6 months for salivary flow, buffer capacity, microbiologic tests, and caries status (based on the ICDAS). Salivary parameters and ICDAS scores were analyzed by Spearman's rank correlations. Data were statistically analyzed by the Mann-Whitney U test, Wilcoxon signed rank tests, and McNemar's Chi-square tests (P < 0.05).
Twenty-two isotretinoin-treated patients and 18 controls completed the study. At baseline, the groups were not significantly different in the evaluated parameters (P > 0.05). At 6 months in the isotretinoin-treated group, salivary flow and buffer capacity significantly decreased, and the ICDAS scores significantly increased (P < 0.05). The changes in these criteria from baseline were insignificant in the controls (P > 0.05). Intraoral pathogen counts were not significantly different between the groups, compared to baseline (P > 0.05). Stimulated salivary parameters in both groups were not correlated significantly with the ICDAS scores.
Isotretinoin significantly affected salivary flow, buffer capacity, caries lesion activity scores for 6 months. However, salivary parameters and caries lesion activity scores had no significant correlations.
异维A酸是治疗重度寻常痤疮最有效的疗法，其全身不良反应已有充分记录，但治疗过程中对牙齿副作用的了解甚少。
这项前瞻性病例对照研究旨在评估异维A酸对土耳其寻常痤疮患者的口腔不良反应；比较患者与正常对照者的口腔状况；并研究唾液参数与国际龋病检测与评估系统（ICDAS）评分之间的关联。
45例患者连续6个月每日服用异维A酸（0.5mg/kg）。年龄匹配的未治疗对照者（45例）为无痤疮患者。两组在研究前及6个月时均接受唾液流量、缓冲能力、微生物检测及龋病状况（基于ICDAS）检查。唾液参数和ICDAS评分采用Spearman等级相关性分析。数据采用Mann-Whitney U检验、Wilcoxon符号秩检验和McNemar卡方检验进行统计学分析（P<0.05）。
22例接受异维A酸治疗的患者和18例对照者完成了研究。基线时，两组在评估参数方面无显著差异（P>0.05）。在异维A酸治疗组6个月时，唾液流量和缓冲能力显著降低，ICDAS评分显著升高（P<0.05）。对照组这些指标相对于基线的变化不显著（P>0.05）。与基线相比，两组口腔内病原体计数无显著差异（P>0.05）。两组的刺激性唾液参数与ICDAS评分均无显著相关性。
异维A酸在6个月内对唾液流量、缓冲能力、龋损活动评分有显著影响。然而，唾液参数与龋损活动评分无显著相关性。
