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Periodontal condition is associated with disease duration and motoric disabilities in patients with ankylosing spondylitis: results of a cross-sectional study

  • Observational Research
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Abstract

Objective

Recent literature reveals worse periodontal health condition in ankylosing spondylitis (AS). However, roles of AS-related parameters, periodontal condition, and their association appear unclear. This cross-sectional study aimed at investigating dental and periodontal health as well as potentially periodontal pathogenic bacteria in patients with AS compared to healthy control subjects (HC).

Methods

Dental examination comprised dental findings (DMF-T), periodontal probing depth (PPD), bleeding on probing, clinical attachment loss (CAL), papillary bleeding index, and microbiological analysis based on polymerase chain reaction of selected potentially periodontal pathogenic bacteria. Classification of periodontitis severity was based on PPD and/or CAL and divided into no/mild, moderate, and severe periodontitis.

Results

52 participants with AS and 52 HC were included. 96% of the AS group and 75% of HC had moderate to severe periodontitis (moderate: AS = 26, HC = 34; severe: AS = 23, HC = 5; p < 0.01). Furthermore, a higher number of decayed teeth (D-T) were found in AS compared to HC (p = 0.02). A significant difference between AS und HC was detected for the prevalences of Parvimonas micra (AS = 92%, HC = 71%; p = 0.01), Eubacterium nodatum (AS = 35%, HC = 17%; p = 0.05), and Eikenella corrodens (AS = 96%, HC = 77%; p = 0.01). Bath Ankylosing Spondylitis Metrology Index (BASMI) and disease duration showed significant associations to PPD and CAL (p < 0.01).

Conclusion

Patients with AS show worse dental and periodontal conditions compared to HC. Thereby, prevalence of bacteria related to insufficient oral hygiene was higher in AS. BASMI and duration of AS affect periodontal burden. Accordingly, particular attention considering dental care and oral hygiene in AS patients seems to be reasonable.

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Acknowledgements

We thank M. Hoch (Dept. of Preventive Dentistry, Periodontology, and Cariology, University Medical Center Goettingen, Germany) for the support in the laboratory microbiological analysis, Dr. Tanja Kottmann (Clinical Research Organization Hamm, Germany) for statistical analysis and Maria Vogt (Dept. of Nephrology and Rheumatology, University Medical Centre Goettingen, Germany) for supporting us in organizing patient recruitment and study course.

Funding

The study was not financial supported.

Author information

Author notes

  1. Dirk Ziebolz and David Douglas have contributed equally to the work.

Authors and Affiliations

  1. Department of Cariology, Endodontology and Periodontology, University Leipzig, Liebigstr. 12, 04103, Leipzig, Germany

    Dirk Ziebolz, David Douglas, Donya Douglas, Jan Schmickler, Rainer Haak, Jana Schmidt & Gerhard Schmalz

  2. Department of Cardiology, Pulmology, Angiology and Nephrology, Brandenburg Medical School, University Hospital Brandenburg, Brandenburg, Germany

    Daniel Patschan

  3. Department of Nephrology and Rheumatology, University Medical Centre Goettingen, Goettingen, Germany

    Gerhard A. Müller & Susann Patschan

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  1. Dirk Ziebolz
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Contributions

All listed authors had a significant proportion in this manuscript and should therefore be considered in the author list: DZ was dental head of the study, designed research, supervised data analysis and interpreted the data, as well as wrote the manuscript. DD performed dental and oral examination of all patients, made the data analysis and reviewed the manuscript. DD performed medical examination, survey of the participants, and data collection of the patients medical record of all patients, made data analysis and reviewed the manuscript. JS was involved in performance of the research and data management. DP was involved in performance of the research, reviewed the manuscript and gave final approval. GAM was clinical supervisior of all SA patients, participated in data interpretation and gave final approval. RH participated in data interpretation, reviewed manuscript and gave final approval. JS participated in data interpretation, reviewed the manuscript and gave final approval. GS participated in data analysis and interpretation, reviewed manuscript and gave final approval. SP was rheumatologist head of the study, designed research, did the medical care and supervised data acquisition for the SA patients, as well as reviewed manuscript.

Corresponding author

Correspondence to Dirk Ziebolz.

Ethics declarations

Ethical approval

The study was reviewed and approved by the ethics committee of the medical faculty of the Georg-August-University, Goettingen, Germany (application number 14/2/13).

Informed consent

Patients were informed verbally and in writing about the study and gave written informed consent.

Conflict of interest

The authors declare that they have no conflict of interests: The authors assure that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

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Ziebolz, D., Douglas, D., Douglas, D. et al. Periodontal condition is associated with disease duration and motoric disabilities in patients with ankylosing spondylitis: results of a cross-sectional study. Rheumatol Int 38, 855–863 (2018). https://doi.org/10.1007/s00296-018-4012-6

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