Epping Lisa, Miesbach Wolfgang, Nickles Katrin, Eickholz Peter
Department of Periodontology, Center for Dentistry and Oral Medicine (Carolinum), Johann Wolfgang Goethe-University Frankfurt/Main, Frankfurt/Main, Germany.
Department of Haemostaseology/Haemophilia Centre, Medical Clinic II/Institute for Transfusion Medicine, University Hospital Frankfurt, Frankfurt/Main, Germany.
PLoS One. 2018 Jan 25;13(1):e0191291. doi: 10.1371/journal.pone.0191291. eCollection 2018.
Von Willebrand disease (VWD) is the most common inherent bleeding disorder. Gingival bleeding is a frequently reported symptom of VWD. However, gingival bleeding is also a leading symptom of plaque-induced gingivitis and untreated periodontal disease. In type 1 VWD gingival bleeding was not increased compared to controls. Thus, this study evaluated whether type 2 and 3 VWD determines an increased susceptibility to gingival bleeding in response to the oral biofilm.
Twenty-four cases and 24 controls matched for age, sex, periodontal diagnosis, number of teeth and smoking were examined hematologically (VWF antigen, VWF activity, factor VIII activity) and periodontally (Gingival Bleeding Index [GBI]), bleeding on probing [BOP], Plaque Control Record [PCR], periodontal inflamed surface area [PISA], vertical probing attachment level).
BOP (VWD: 14.5±10.1%; controls: 12.3±5.3%; p = 0.542) and GBI (VWD: 10.5±9.9%; controls: 8.8±4.8%; p = 0.852) were similar for VWD and controls. Multiple regressions identified female sex, HbA1c, PCR and PISA to be associated with BOP. HbA1c and PCR were associated with GBI. Number of remaining teeth was negatively correlated with BOP and GBI.
Type 2 and 3 VWD are not associated with a more pronounced inflammatory response to the oral biofilm in terms of BOP and GBI.
血管性血友病（VWD）是最常见的遗传性出血性疾病。牙龈出血是血管性血友病常见的症状。然而，牙龈出血也是菌斑性牙龈炎和未经治疗的牙周病的主要症状。在1型血管性血友病中，与对照组相比牙龈出血并未增加。因此，本研究评估2型和3型血管性血友病是否会导致对口腔生物膜的牙龈出血易感性增加。
对24例患者和24名年龄、性别、牙周诊断、牙齿数量和吸烟情况相匹配的对照者进行血液学检查（血管性血友病因子抗原、血管性血友病因子活性、凝血因子VIII活性）和牙周检查（牙龈出血指数[GBI]、探诊出血[BOP]、菌斑控制记录[PCR]、牙周炎症表面积[PISA]、垂直探诊附着水平）。
血管性血友病组和对照组的探诊出血（血管性血友病组：14.5±10.1%；对照组：12.3±5.3%；p = 0.542）和牙龈出血指数（血管性血友病组：10.5±9.9%；对照组：8.8±4.8%；p = 0.852）相似。多元回归分析确定女性、糖化血红蛋白、菌斑控制记录和牙周炎症表面积与探诊出血有关。糖化血红蛋白和菌斑控制记录与牙龈出血指数有关。剩余牙齿数量与探诊出血和牙龈出血指数呈负相关。
就探诊出血和牙龈出血指数而言，2型和3型血管性血友病与对口腔生物膜更明显的炎症反应无关。
