Effects of periodontal treatment on primary sjogren's syndrome symptoms

Abstract The aim of this longitudinal prospective study was to evaluate the effects of periodontal treatment on the clinical, microbiological and immunological periodontal parameters, and on the systemic activity (ESSDAI) and subjective (ESSPRI) indexes in patients with primary Sjögren’s Syndrome (pSS). Twenty-eight female patients were divided into four groups: pSS patients with or without chronic periodontitis (SCP, SC, respectively), and systemically healthy patients with or without chronic periodontitis (CP, C, respectively). Periodontal clinical examination and immunological and microbiological sample collection were performed at baseline, 30 and 90 days after nonsurgical periodontal treatment (NSPT). Levels of interleukin IL-1β, IL-8 and IL-10 in saliva and gingival crevicular fluid (GCF) were evaluated by ELISA, as well as the expression of Porphyromonas gingivalis (Pg), Aggregatibacter actinomycetemcomitans, (Aa) Tannerella forsythia (Tf), and Treponema denticola (Td), by qPCR. Systemic activity and pSS symptoms were evaluated by ESSDAI and ESSPRI. NSPT resulted in improved periodontal clinical parameters in both SCP and CP groups (p>0.05). Pg, Aa, and Tf levels decreased after NSPT only in CP patients (p<0.05). Significantly greater levels of IL-10 in GCF were verified in both SCP and CP groups (p<0.05). SCP patients showed increased salivary flow rates and decreased ESSPRI scores after NSPT. In conclusion, NSPT in pSS patients resulted in improved clinical and immunological parameters, with no significant effects on microbiological status. pSS patients also showed increased salivary flow and lower ESSPRI scores after therapy. Therefore, it can be suggested that NSPT may improve the quality of life of pSS patients.

Correlation between gender, temporomandibular joint disc position and clinical findings in patients with temporomandibular disorder / Correlação entre sexo, posição do disco da articulação temporomandibular e os resultados clínicos em pacientes com disfunção temporomandibular

OBJECTIVE: The objective of this study was to assess gender differences in temporomandibular joint disc position using magnetic resonance imaging and to check for symptoms in patients with temporomandibular disorders. MATERIALS AND METHODS: Eighty-seven consecutive patients (70 females and 17 males) were evaluated. Bilateral magnetic resonance imaging was performed to determine the temporomandibular joint disc positions; these were divided into four diagnostic categories: no disc displacement, right disc displacement, left disc displacement and bilateral disc displacement. The clinical data assessed were pain on muscle and temporomandibular joint palpation. The data were analyzed using the Fisher's exact test, chi-square test or analysis of variance. Significance was set at p ≤ .05. RESULTS: The study population had more females (80.5%) than males (19.5%) and the mean age of females (31 ± 11 years) was lower than the mean age of males (41± 12 years). Bilateral disc displacement was significantly most frequent in females. Clinical examination showed more pain on muscle palpation for female than for male patients. CONCLUSION: Women had a higher frequency of temporomandibular joint disc displacement, as well as a larger number of painful points on muscle palpation than men.

RESUMO OBJETIVO: O objetivo deste estudo foi avaliar as diferenças de gênero na posição do disco da articulação temporomandibular usando ressonância magnética para verificar se há sintomas em pacientes com disfunção temporomandibular. MATERIAIS E MÉTODOS: Foram avaliados oitenta e sete pacientes consecutivos (70 mulheres e 17 homens); foi realizada ressonância magnética bilateral para determinar as posições do disco da articulação temporomandibular; estes foram divididos em quatro categorias diagnósticas: nenhum deslocamento de disco, deslocamento de disco a direita, deslocamento de disco a esquerda e deslocamento de disco bilateral. Os dados clínicos avaliados foram: dor a palpação no músculo e na articulação temporomandibular. Os dados foram analisados utilizando o teste exato de Fisher, teste do qui-quadrado ou análise de variância. Significância foi de p ≤ 0,05. RESULTADOS: A população do estudo tinha mais mulheres (80,5%) que homens (19,5%). O deslocamento blateral de disco foi significativamente mais frequente no sexo feminino. O exame clínico mostrou mais dor à palpação muscular para mulheres do que para homens. CONCLUSÃO: As mulheres apresentaram uma maior frequência de deslocamento de disco da articulação temporomandibular, bem como um maior número de pontos dolorosos à palpação muscular do que os homens.