Primer sjögren sendromlu hastalarda periodontal durumun değerlendirilmesi
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Dosyalar
Tarih
2016
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi Diş Hekimliği Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Sjögren sendromu (SS) tükürük bezlerinin, lenfositik infiltrasyona bağlı yıkımı sonucunda tükürük salgısının azalmasıyla karakterize, sistemik otoimmün bir hastalıktır. Bu çalışmanın amacı, primer SS (pSS)'li hastalar ile sistemik olarak sağlıklı bireyleri klinik parametreler, DOS ve tükürükte bulunan pro/antienflamatuvar sitokinler, çürük ve periodontal hastalıkla ilişkili patojen mikroorganizmalar açısından kıyaslanmasıdır. Çalışmaya 17 pSS'li hasta ve yaş/cinsiyet uyumlu sistemik olarak sağlıklı 16 birey kontrol olarak dahil edildi. Klinik parametreler; plak indeksi (Pİ), gingival indeks (Gİ), sondlama cep derinliği (SCD), sondlamada kanama indeksi (SKİ), klinik ataçman seviyesi (KAS), vücut kitle indeksi (VKİ), çürük, kayıp, dolgulu diş (DMTF) indeksi kaydedildi. DOS ve tükürük örneklerindeki interlökin (IL)- 1β, IL-6, IL-8, IL-10, tümör nekroz faktör (TNF)-α ve yüksek sensitiviteli C-reaktif protein (hs-CRP) seviyeleri ELISA yöntemiyle analiz edildi. Supragingival plak örneklerinde Streptococcus mutans ve subgingival plak örneklerinde Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola miktarı kantitatif polimeraz zincir reaksiyonu (PCR) ile tespit edildi. Uyarılmamış tükürük akış hızı gruplar arasında karşılaştırıldı. İstatistiksel analizlerde normal dağılım gösteren veriler için t-testi ve normal dağılım göstermeyen veriler için Mann Whitney U testi kullanıldı. Çalışmanın sonucunda SCD, KAS, Pİ, Gİ, SKY, VKİ ve DMFT indeksleri açısından gruplar arasında istatistiksel olarak anlamlı bir fark olmadığı görüldü. Uyarılmamış tükürük akış hızı pSS'li grupta kontrol grubuna göre anlamlı derecede düşük tespit edildi. Dişeti oluğu sıvısındaki pro/antienflamatuvar sitokin seviyeleri açısından gruplar arasında önemli bir farklılık saptanmadı. Sitokinlerin uyarılmamış tükürük örneklerindeki total miktarları gruplar arasında farklılık göstermezken, konsantrasyon miktarları, hs-CRP hariç, pSS'li grupta kontrol grubuna göre istatistiksel olarak anlamlı derecede yüksek tespit edildi. İki grup arasında Streptococcus mutans seviyeleri benzerlik gösterirken, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola seviyelerinin pSS'li grupta, kontrol grubuna kıyasla daha yüksek olduğu izlendi. Bu çalışmanın bulguları, DOS'taki sitokin profilleri arasında fark izlenmezken, tükürükteki sitokin konsantrasyon seviyelerinin, pSS'li grupta kontrol grubuna göre daha yüksek olduğunu gösterdi. Sitokinlerin konsantrasyon düzeyindeki artışının, pSS'li hastalardaki azalmış tükürük akış hızına bağlı olduğu düşünülmektedir. Primer SS'li hastalarda subgingival periodontopatojen miktarının yüksek seviyede olması, bu hastaların mikroorganizmaların uzaklaştırılması için düzenli kontrol altında tutulması gerektiğini düşündürmektedir.
Sjögren's syndrome (SS) is a systemic autoimmune disease which is characterized by the destruction of salivary glands with the lymphocytes infiltration and consequently the decrease of saliva production. The aim of this study was to compare the clinical parameters, pro/antiinflammatory cytokines in gingival crevicular fluid (GCF)/saliva and caries related and periodontopathogen microorganisms of the primary SS (pSS) patients and systemically healthy controls. Seventeen pSS patients and 16 systemically healthy gender and age matched-control patients were included into this study. Clinical parameters including plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), Decayed, Missed, Filled Teeth (DMFT) index and body mass index (BMI) were recorded. Interleukin (IL)-1β, IL-6, IL- 8, IL-10, Tumor Necrosis Factor (TNF)-α and high sensitivity C-reactive protein (hs-CRP) levels were evaluated in GCF and unstimulated whole saliva (UWS) with ELISA. Amount of Streptococcus mutans in supragingival plaque samples and Porphyromonas gingivalis, Tanneralla forsythia and Treponema denticola in subgingival plaque samples were measured using quantitative Polymerase Chain Reaction (PCR). Flow rate of UWS was compared. Statistical analysis was performed conducting t-test for parametric and Mann Whitney U tests for non-parametric analysis. Results demonstrated that there was no statistically significant difference for PI, GI, PD, CAL, BOP, BMI, DMFT index between pSS and systemically healthy individuals. Flow rate of saliva was significantly lower in patients with pSS than controls. No significant difference was noted for pro/anti inflammatory cytokines in GCF. While, total amounts of the cytokines were not different in groups; the concentrations of cytokines in UWS were remarkably higher in pSS patients when compared to systemically healthy controls except for hs-CRP. Whereas, no significant difference was found in S. mutans levels, higher P.gingivalis, T.forsythia and T.denticola levels were observed in primary SS patients in comparison to control group. The findings of this study revealed that however cytokine profiles of pSS and control groups were not different in GCF, concentrations of these cytokines in saliva were higher in pSS group. Lower saliva flow rate of pSS might be the reason of higher levels cytokines concentrations. Increased level of subgingival periodontopathogens suggested that pSS patients should be followed regularly to eliminate these microorganisms from periodontal tissues.
Sjögren's syndrome (SS) is a systemic autoimmune disease which is characterized by the destruction of salivary glands with the lymphocytes infiltration and consequently the decrease of saliva production. The aim of this study was to compare the clinical parameters, pro/antiinflammatory cytokines in gingival crevicular fluid (GCF)/saliva and caries related and periodontopathogen microorganisms of the primary SS (pSS) patients and systemically healthy controls. Seventeen pSS patients and 16 systemically healthy gender and age matched-control patients were included into this study. Clinical parameters including plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), Decayed, Missed, Filled Teeth (DMFT) index and body mass index (BMI) were recorded. Interleukin (IL)-1β, IL-6, IL- 8, IL-10, Tumor Necrosis Factor (TNF)-α and high sensitivity C-reactive protein (hs-CRP) levels were evaluated in GCF and unstimulated whole saliva (UWS) with ELISA. Amount of Streptococcus mutans in supragingival plaque samples and Porphyromonas gingivalis, Tanneralla forsythia and Treponema denticola in subgingival plaque samples were measured using quantitative Polymerase Chain Reaction (PCR). Flow rate of UWS was compared. Statistical analysis was performed conducting t-test for parametric and Mann Whitney U tests for non-parametric analysis. Results demonstrated that there was no statistically significant difference for PI, GI, PD, CAL, BOP, BMI, DMFT index between pSS and systemically healthy individuals. Flow rate of saliva was significantly lower in patients with pSS than controls. No significant difference was noted for pro/anti inflammatory cytokines in GCF. While, total amounts of the cytokines were not different in groups; the concentrations of cytokines in UWS were remarkably higher in pSS patients when compared to systemically healthy controls except for hs-CRP. Whereas, no significant difference was found in S. mutans levels, higher P.gingivalis, T.forsythia and T.denticola levels were observed in primary SS patients in comparison to control group. The findings of this study revealed that however cytokine profiles of pSS and control groups were not different in GCF, concentrations of these cytokines in saliva were higher in pSS group. Lower saliva flow rate of pSS might be the reason of higher levels cytokines concentrations. Increased level of subgingival periodontopathogens suggested that pSS patients should be followed regularly to eliminate these microorganisms from periodontal tissues.
Açıklama
Anahtar Kelimeler
Gingiva, Gingival crevicular sıvı, Gingival crevicular fluid, Periodontal hastalıklar, Periodontal diseases, Sitokinler, Cytokines, Sjögren sendromu, Sjogren's syndrome, Tükürük, Saliva
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Güdük, S. K. (2016). Primer sjögren sendromlu hastalarda periodontal durumun değerlendirilmesi. Selçuk Üniversitesi, Yayımlanmış uzmanlık tezi, Konya.
