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Evaluating the relationship between ankylosing spondylitis and periodontal disease: a case–control study

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Abstract

Objectives

This study aimed to determine the possible relationship between periodontal disease and ankylosing spondylitis (AS) by evaluating clinical periodontal measurements and gingival crevicular fluid (GCF) levels of sclerostin, interleukin-1β (IL-1ß), and matrix metalloproteinase-8 (MMP-8) levels.

Materials and methods

Twenty-eight patients with AS (AS group) and 28 systemically healthy controls (C group) were enrolled in this study. Full-mouth periodontal measurements: plaque index, bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level (CAL) measurements were obtained from all patients. AS-related parameters were included in the data analyses. An enzyme-linked immunosorbent assay determined GCF IL-1β, MMP-8, and sclerostin levels.

Results

There were no significant differences in the clinical periodontal measurements between the two groups (p > 0.05). Interestingly, patients with AS had significantly lower GCF sclerostin levels than the C group (p < 0.05). But there were no statistical differences in the GCF levels of IL-1ß and MMP-8 between the two groups (p > 0.05). Serum C-reactive protein (CRP) levels strongly correlated with both BOP (r = 0.497, p < 0.05) and PPD (r = 0.570, p < 0.05) in the AS group. Bath AS Metrology Index (BASMI) also positively correlated with both BOP (r = 0.530, p < 0.05) and CAL (r = 0.568, p < 0.05). Similarly, Maastrıcht Ankylosing Spondylitis Enthesis Score (MASES) strongly correlated with both BOP (r = 0.487, p < 0.05) and CAL (r = 0.522, p < 0.05).

Conclusion

These results suggest that the patient’s systemic condition may influence local sclerostin levels in GCF, and the strong correlations between periodontal measurements and AS-related parameters may indicate an interrelationship between inflammatory periodontal disease and AS.

Clinical relevance

The present study provides important information concerning the relationship between periodontal disease and ankylosing spondylitis.

Trial registration

Thai Clinical Trials.gov (TCTR20200908001) (08. September 2020).

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Acknowledgements

The authors thank Sema Hancı (the nurse of the Department of Physical Therapy and Rehabilitation), Ulviye Kaplan (the nurse of the Department of Periodontology), and Ahmet Özmen and Halil Turgut (the medical staff of the Periodontology clinic) for their great assistance during the study.

Funding

This study was funded by the authors.

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Authors and Affiliations

  1. Department of Periodontology, Akdeniz University, Faculty of Dentistry, 07058, Antalya, Turkey

    Özlem Daltaban, Kemal Üstün & Mükerrem Hatipoğlu

  2. Department of Rheumatology, Ordu State Hospital, Ordu, Turkey

    Ayşe Ünal Enginar

  3. Department of Physical Medicine Rehabilitation and Rheumatology, Akdeniz University, Faculty of Medicine, 07058, Antalya, Turkey

    Cahit Kaçar & Tiraje Tuncer

Authors
  1. Özlem Daltaban
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  2. Ayşe Ünal Enginar
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  3. Kemal Üstün
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  6. Tiraje Tuncer
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Contributions

Özlem Daltaban: designed the study, performed the clinical examinations, and wrote the manuscript; Ayşe Ünal Enginar performed the rheumatological assessments and contributed data analysis; Tiraje Tuncer contributed to study design and literature review and wrote the manuscript; Kemal Üstün: contributed to the literature review and manuscript writing; Mükerrem Hatipoğlu: contributed to literature review and analysis and interpretation of the findings and Cahit Kaçar: contributed to study design and manuscript writing and supervision. All authors critically revised the manuscript, gave final approval, and agreed to be accountable for all aspects of the work ensuring integrity and accuracy.

Corresponding author

Correspondence to Özlem Daltaban.

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This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Akdeniz Univesity (70904504/673).

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Informed consent was obtained from all individual participants included in the study.

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Daltaban, Ö., Enginar, A.Ü., Üstün, K. et al. Evaluating the relationship between ankylosing spondylitis and periodontal disease: a case–control study. Clin Oral Invest 27, 411–420 (2023). https://doi.org/10.1007/s00784-022-04776-4

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