Enginar Ayşe Ünal, Daltaban Özlem, Kaçar Cahit, Tuncer Tiraje
Department of Rheumatology, Ordu State Hospital, Turkey.
Department of Periodontology, Faculty of Dentistry, Akdeniz University, Antalya, Turkey.
Reumatologia. 2021;59(1):35-40. doi: 10.5114/reum.2021.103643. Epub 2021 Feb 28.
Ankylosing spondylitis (AS) is a chronic inflammatory disease mainly affecting the spine and sacroiliac joints, characterized by enthesitis. Recent studies have investigated the relationship between AS and periodontitis. The aim of this study was to evaluate the periodontal status of patients with AS and to determine the factors affecting this.
The study included 200 AS patients, of which 129 were taking anti-tumour necrosis factor (TNF) drugs and 71 were taking non-steroid anti-inflammatory drugs (NSAID). Patients did not change their medication during the study. Disease activity was evaluated with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), mobility with the Bath Ankylosing Spondylitis Metrology Index (BASMI), functional status with the Bath Ankylosing Spondylitis Functional Index (BASFI), enthesitis with the integrated Maastricht Ankylosing Spondylitis Enthesitis Score (MASES), and quality of life with the Ankylosing Spondylitis Quality of Life (ASQoL) scale. Data related to erythrocyte sedimentation rate, and C-reactive protein were recorded from the hospital information system. The plaque index (PI), gingival index (GI), pocket depth (PD), attachment level (CAL) measurements, and bleeding index (BOP) were measured.
The results showed that 35.5% of the AS patients had periodontitis, at a lower rate in the anti-TNF group than in the NSAID group, but the difference was not statistically significant. Periodontitis-related factors were found to be age, BASFI and BASMI. A significant relationship was found between MASES and BOP and GI.
This suggests that periodontitis may be an enthesis in AS. Nevertheless, further studies are needed to explain the mechanism of periodontitis in AS patients.
强直性脊柱炎（AS）是一种主要影响脊柱和骶髂关节的慢性炎症性疾病，其特征为附着点炎。近期研究探讨了AS与牙周炎之间的关系。本研究旨在评估AS患者的牙周状况，并确定影响该状况的因素。
本研究纳入200例AS患者，其中129例正在使用抗肿瘤坏死因子（TNF）药物，71例正在使用非甾体抗炎药（NSAID）。患者在研究期间未改变用药。采用巴斯强直性脊柱炎疾病活动指数（BASDAI）评估疾病活动度，采用巴斯强直性脊柱炎测量指数（BASMI）评估活动度，采用巴斯强直性脊柱炎功能指数（BASFI）评估功能状态，采用马斯特里赫特强直性脊柱炎附着点炎综合评分（MASES）评估附着点炎，采用强直性脊柱炎生活质量（ASQoL）量表评估生活质量。从医院信息系统记录红细胞沉降率和C反应蛋白相关数据。测量菌斑指数（PI）、牙龈指数（GI）、牙周袋深度（PD）、附着水平（CAL）以及出血指数（BOP）。
结果显示，35.5%的AS患者患有牙周炎，抗TNF组的发生率低于NSAID组，但差异无统计学意义。发现与牙周炎相关的因素为年龄、BASFI和BASMI。MASES与BOP和GI之间存在显著相关性。
这表明牙周炎可能是AS中的一种附着点病变。然而，需要进一步研究来解释AS患者牙周炎的发病机制。
