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Juvenile idiopathic arthritis activity and function ability: deleterious effects in periodontal disease?

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Abstract

The impact of juvenile idiopathic arthritis (JIA) in periodontal diseases is controversial probably due to gender and age heterogeneity. We therefore evaluated a homogeneous female post-pubertal JIA population for these conditions. Thirty-five JIA patients and 35 gender/age comparable healthy controls were evaluated according to demographic data, complete periodontal evaluation, fasting lipoproteins, and anti-lipoprotein lipase antibodies. JIA scores, laboratorial tests, X-rays, and treatment were also assessed. Current age was similar in JIA patients and controls (11.90 ± 2.0 vs. 12.50 ± 3.0 years, p = 0.289). Complete periodontal assessments revealed that gingival index, dental plaque, gingival bleeding, and clinical dental attachment indices were alike in JIA patients and controls (p > 0.05), except for gingival enlargement in former group (p < 0.0001). Further analysis of patients with and without gingivitis revealed that cyclosporine use was more often observed in JIA patients with gingivitis (37 vs. 0 %, p = 0.01), whereas no differences were evidenced in demographic, JIA scores, inflammatory markers, and lipid profile in both groups. Of note, two parameters of periodontal assessment were correlated with JIA scores [gingival index (GI) and Childhood Health Assessment Questionnaire (CHAQ) (r s  = +0.402, p = 0.020)] and plaque index (PI) and visual analog scale (VAS) physician (r s  = +0.430, p = 0.013). In addition, evaluation of dental assessment demonstrated that JIA activity scores had positive correlation with decayed, missing, and filled teeth (DMF-T) and junvenile athritis disease activity score (JADAS) (r s  = +0.364,p = 0.037), VAS physician (r s  = +0.401,p = 0.021) and VAS patient (r s  = +0.364,p = 0.037). We demonstrated, using rigorous criteria, that periodontal and dental condition in JIA is similar to controls. In spite of that, the finding of a correlation with disease parameters provides additional evidence that increased activity and reduced functional ability underlies the deleterious effect of JIA in oral health.

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Acknowledgments

We thank Dr. Ulysses Doria Filho for statistical analysis. This study was supported by grants from Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP 2008/58238-4 to CAS), Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq 305068/2014-8 to EB, 301805/2013-0 to RMRP, and 302724/2011-7 to CAS), Federico Foundation (to EB, RMRP, EFB and CAS), and by Núcleo de Apoio à Pesquisa “Saúde da Criança e do Adolescente” of Universidade de São Paulo (NAP-CriAd) to CAS.

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Authors and Affiliations

  1. Pediatric Rheumatology Unit, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Eneas Carvalho Aguiar, 647 - Cerqueira César, São Paulo, SP, 05403-000, Brazil

    Camila Pugliese, Roberta T. A. van der Vinne, Lucia M. A. Campos & Clovis A. Silva

  2. Division of Dentistry, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Eneas Carvalho Aguiar, 647 - Cerqueira César, São Paulo, SP, 05403-000, Brazil

    Priscila R. Guardieiro & Cynthia Saviolli

  3. Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Eneas Carvalho Aguiar, 647 - Cerqueira César, São Paulo, SP, 05403-000, Brazil

    Eloisa Bonfá, Rosa M. R. Pereira, Vilma S. Viana, Eduardo F. Borba & Clovis A. Silva

Authors
  1. Camila Pugliese
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  2. Roberta T. A. van der Vinne
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  3. Lucia M. A. Campos
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  4. Priscila R. Guardieiro
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  5. Cynthia Saviolli
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  6. Eloisa Bonfá
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  7. Rosa M. R. Pereira
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  8. Vilma S. Viana
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  9. Eduardo F. Borba
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  10. Clovis A. Silva
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Corresponding author

Correspondence to Clovis A. Silva.

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This study was approved by the local ethics committee of our university hospital and an age-appropriate written informed consent was obtained from all participants and their legal guardians.

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Pugliese, C., van der Vinne, R.T.A., Campos, L.M.A. et al. Juvenile idiopathic arthritis activity and function ability: deleterious effects in periodontal disease?. Clin Rheumatol 35, 81–91 (2016). https://doi.org/10.1007/s10067-015-3125-5

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  • DOI: https://doi.org/10.1007/s10067-015-3125-5

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