Gingival capillary changes and oral motor weakness in juvenile dermatomyositis
Identifieur interne : 001642 ( Main/Exploration ); précédent : 001641; suivant : 001643Gingival capillary changes and oral motor weakness in juvenile dermatomyositis
Auteurs : Cynthia Savioli [Brésil] ; Clovis A. A. Silva [Brésil] ; Gisele M. C. Fabri [Brésil] ; Katia Kozu [Brésil] ; Lucia M. A. Campos [Brésil] ; Eloisa Bonfá [Brésil] ; Adriana M. E. Sallum [Brésil] ; José T. T. De Siqueira [Brésil]Source :
- Rheumatology [ 1462-0324 ] ; 2010.
Abstract
Objective. We assessed the orofacial involvement in JDM, and evaluated the possible association of gingival and mandibular mobility alterations with demographic data, periodontal indices, clinical features, muscle enzyme levels, JDM scores and treatment. Methods. Twenty-six JDM patients were studied and compared with 22 healthy controls. Orofacial evaluation included clinical features, dental and periodontal assessment, mandibular function and salivary flow. Results. The mean current age was similar in patients with JDM and controls (P > 0.05). A unique gingival alteration characterized by erythema, capillary dilation and bush-loop formation was observed only in JDM patients (61 vs 0%, P = 0.0001). The frequencies of altered mandibular mobility and reduced mouth opening were significantly higher in patients with JDM vs controls (50 vs 14%, P = 0.013; 31 vs 0%, P = 0.005). Comparison of the patients with and without gingival alteration showed that the former had lower values of median of cementoenamel junction (−0.26 vs −0.06 mm, P = 0.013) and higher gingival bleeding index (27.7 vs 14%, P = 0.046). This pattern of gingival alteration was not associated with periodontal disease [plaque index (P = 0.332) and dental attachment loss (P = 0.482)]. The medians for skin DAS and current dose of MTX were higher in JDM with gingival alteration (2.5 vs 0.5, P = 0.029; 28.7 vs 15, P = 0.012). A significant association of lower median manual muscle testing with a reduced ability to open the mouth was observed in patients with JDM than those without this alteration (79 vs 80, P = 0.002). Conclusions. The unique gingival pattern associated with cutaneous disease activity, distinct from periodontal disease, suggests that gingiva is a possible target tissue for JDM. In addition, muscle weakness may be a relevant factor for mandibular mobility.
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DOI: 10.1093/rheumatology/keq189
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A." last="Campos">Lucia M. A. 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E." last="Sallum">Adriana M. E. Sallum</name><affiliation wicri:level="4"><country xml:lang="fr">Brésil</country><wicri:regionArea>Dentistry Division, Paediatric Rheumatology Unit and Rheumatology Division, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo</wicri:regionArea><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName><orgName type="university">Université de São Paulo</orgName></affiliation></author><author><name sortKey="De Siqueira, Jose T T" sort="De Siqueira, Jose T T" uniqKey="De Siqueira J" first="José T. T." last="De Siqueira">José T. T. De Siqueira</name><affiliation wicri:level="4"><country xml:lang="fr">Brésil</country><wicri:regionArea>Dentistry Division, Paediatric Rheumatology Unit and Rheumatology Division, Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo</wicri:regionArea><placeName><settlement type="city">São Paulo</settlement><region type="state">État de São Paulo</region></placeName><orgName type="university">Université de São Paulo</orgName></affiliation><affiliation wicri:level="1"><country wicri:rule="url">Brésil</country></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Rheumatology</title><idno type="ISSN">1462-0324</idno><idno type="eISSN">1462-0332</idno><imprint><publisher>Oxford University Press</publisher><date when="2010-10">2010</date><date type="e-published" when="2010-06-29">2010</date><biblScope unit="vol">49</biblScope><biblScope unit="issue">10</biblScope><biblScope unit="page" from="1962">1962</biblScope><biblScope unit="page" to="1970">1970</biblScope></imprint><idno type="ISSN">1462-0324</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1462-0324</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Objective. We assessed the orofacial involvement in JDM, and evaluated the possible association of gingival and mandibular mobility alterations with demographic data, periodontal indices, clinical features, muscle enzyme levels, JDM scores and treatment. Methods. Twenty-six JDM patients were studied and compared with 22 healthy controls. Orofacial evaluation included clinical features, dental and periodontal assessment, mandibular function and salivary flow. Results. The mean current age was similar in patients with JDM and controls (P > 0.05). A unique gingival alteration characterized by erythema, capillary dilation and bush-loop formation was observed only in JDM patients (61 vs 0%, P = 0.0001). The frequencies of altered mandibular mobility and reduced mouth opening were significantly higher in patients with JDM vs controls (50 vs 14%, P = 0.013; 31 vs 0%, P = 0.005). Comparison of the patients with and without gingival alteration showed that the former had lower values of median of cementoenamel junction (−0.26 vs −0.06 mm, P = 0.013) and higher gingival bleeding index (27.7 vs 14%, P = 0.046). This pattern of gingival alteration was not associated with periodontal disease [plaque index (P = 0.332) and dental attachment loss (P = 0.482)]. The medians for skin DAS and current dose of MTX were higher in JDM with gingival alteration (2.5 vs 0.5, P = 0.029; 28.7 vs 15, P = 0.012). A significant association of lower median manual muscle testing with a reduced ability to open the mouth was observed in patients with JDM than those without this alteration (79 vs 80, P = 0.002). Conclusions. The unique gingival pattern associated with cutaneous disease activity, distinct from periodontal disease, suggests that gingiva is a possible target tissue for JDM. In addition, muscle weakness may be a relevant factor for mandibular mobility.</div></front></TEI><affiliations><list><country><li>Brésil</li></country><region><li>État de São Paulo</li></region><settlement><li>São Paulo</li></settlement><orgName><li>Université de São Paulo</li></orgName></list><tree><country name="Brésil"><region name="État de São Paulo"><name sortKey="Savioli, Cynthia" sort="Savioli, Cynthia" uniqKey="Savioli C" first="Cynthia" last="Savioli">Cynthia Savioli</name></region><name sortKey="Bonfa, Eloisa" sort="Bonfa, Eloisa" uniqKey="Bonfa E" first="Eloisa" last="Bonfá">Eloisa Bonfá</name><name sortKey="Campos, Lucia M A" sort="Campos, Lucia M A" uniqKey="Campos L" first="Lucia M. A." last="Campos">Lucia M. A. Campos</name><name sortKey="De Siqueira, Jose T T" sort="De Siqueira, Jose T T" uniqKey="De Siqueira J" first="José T. T." last="De Siqueira">José T. T. De Siqueira</name><name sortKey="De Siqueira, Jose T T" sort="De Siqueira, Jose T T" uniqKey="De Siqueira J" first="José T. T." last="De Siqueira">José T. T. De Siqueira</name><name sortKey="Fabri, Gisele M C" sort="Fabri, Gisele M C" uniqKey="Fabri G" first="Gisele M. C." last="Fabri">Gisele M. C. Fabri</name><name sortKey="Kozu, Katia" sort="Kozu, Katia" uniqKey="Kozu K" first="Katia" last="Kozu">Katia Kozu</name><name sortKey="Sallum, Adriana M E" sort="Sallum, Adriana M E" uniqKey="Sallum A" first="Adriana M. E." last="Sallum">Adriana M. E. Sallum</name><name sortKey="Silva, Clovis A A" sort="Silva, Clovis A A" uniqKey="Silva C" first="Clovis A. A." last="Silva">Clovis A. A. Silva</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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