Gingival capillary changes and oral motor weakness in juvenile dermatomyositis


Autoria(s): SAVIOLI, Cynthia; SILVA, Clovis A. A.; FABRI, Gisele M. C.; KOZU, Katia; CAMPOS, Lucia M. A.; BONFA, Eloisa; SALLUM, Adriana M. E.; SIQUEIRA, Jose T. T. de
Contribuinte(s)

UNIVERSIDADE DE SÃO PAULO

Data(s)

19/10/2012

19/10/2012

2010

Resumo

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.

Fundacao de Amparo a Pesquisa do Estado de Sao Paulo - FAPESP[08/58238-4]

Conselho Nacional de Desenvolvimento Cientifico e Tecnologico - CNPQ[301411/2009-3]

Conselho Nacional de Desenvolvimento Cientifico e Tecnologico - CNPQ[300248/2008-3]

Federico Foundation

Identificador

RHEUMATOLOGY, v.49, n.10, p.1962-1970, 2010

1462-0324

http://producao.usp.br/handle/BDPI/21705

10.1093/rheumatology/keq189

http://dx.doi.org/10.1093/rheumatology/keq189

Idioma(s)

eng

Publicador

OXFORD UNIV PRESS

Relação

Rheumatology

Direitos

restrictedAccess

Copyright OXFORD UNIV PRESS

Palavras-Chave #Oral health #Gingiva #Temporomandibular disorders #Juvenile dermatomyositis #IDIOPATHIC INFLAMMATORY MYOPATHIES #VALIDATED DISEASE-ACTIVITY #DAMAGE INDEXES #HEALTH #MUSCLE #POLYMYOSITIS #ADOLESCENTS #CHILDHOOD #CHILDREN #Rheumatology
Tipo

article

original article

publishedVersion