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. 2023 Dec 12;59(12):2154.
doi: 10.3390/medicina59122154.

Association of Periodontal Disease with Activity of Crohn's Disease

Miloš Živić  1 , Nebojša Zdravković  2 , Bojan Stojanović  3   4 , Bojan Milošević  3   4 , Željko Todorović  5   6 , Miljan Adamović  7 , Nataša Zdravković  5   8
Affiliations

Association of Periodontal Disease with Activity of Crohn's Disease

Miloš Živić et al. Medicina (Kaunas). .

Abstract

Introduction: Crohn's disease (CD) is a chronic inflammatory granulomatous disease that can affect the entire gastrointestinal tract. It is characterized by various extraintestinal manifestations (EIMs), of which oral manifestations (OMs) are often possible. One of the possible OMs is periodontal disease (PD), a chronic inflammatory condition of the supporting tissues of the teeth. This study aimed to show the existence of a mutual relationship between the clinical activity of PD and the clinical and endoscopic activity of CD.

Materials and methods: One clinical and two endoscopic indexes were used for the assessment of CD activity and clinical attachment loss (CAL), bleeding on probing (BOP), pocket probing depth (PPD), and radiographic bone loss (RBL) in a dental panoramic tomogram to assess PD in CD patients.

Results: A total of 38 patients underwent the entire study process, of which 20 patients had CD and 18 patients had CD and PD. Considering all CD activity scores, there were 26 patients with active disease; half of them had PD, and 85.7% of operated patients had active CD. The values of CAL, PPD, BOP, and RBL were higher in active CD patients than those in remission, except for BOP when comparing to the CDAI score, which was higher in those in remission of CD.

Conclusion: The results of this study indicate that there is a connection between the activity of CD and worse conditions of the supporting tissues of the gums in the oral cavity, so it is important to keep in mind the necessity of referring patients with CD to a dentist for timely and adequate therapeutic measures.

Keywords: Crohn’s disease; Crohn’s disease activity indexes; periodontal disease; periodontal indexes.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
An example of measuring radiographic bone loss using a Schei ruler, where the red arrow indicates the line tangent to the cementoenamel junction, the yellow arrow indicates the line tangent to the highest point of the crown, and the blue line represents approximately 1.5 fields between the cementoenamel junction and the alveolar bone level.
Figure 2
Figure 2
Average values of CAL, PPD, BOP, and RBL according to CD activity scores and statistical significance of the obtained values using the independent sample t-test (red—active disease; blue—remission; yellow—statistical significance (p < 0.05)).
Figure 3
Figure 3
ROC curves showing the sensitivity and the specificity of BOP, CAL, and PPD in prediction of oral manifestations. These ROC curves show that all three are good predictors of belonging to the group that developed oral manifestations.
See this image and copyright information in PMC

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