Hashimoto Tiroiditi Olan Adölesanlarda Periodontal Sağlık Durumu

Yıl 2022, Cilt: 13 Sayı: 1, 30 - 39, 11.04.2022

Prof. Dr. Zuhal Yetkin Ay , Ayşegül Tekneci Aykut Tan , Ayşe Rabia Işık , Özgür Pirgon

https://doi.org/10.22312/sdusbed.1028196

Öz

Amaç: Hashimoto tiroiditi (HT) ile periodontal hastalık arasındaki ilişkiye ilişkin olası mekanizmaların otoimmün mekanizmalar olduğu öne sürülmüştür. Amaç, HT' li bir adölesan örnekleminin ağız ve diş sağlığı durumunu bildirmek; ve HT'li olan ve olmayan adölesanların klinik periodontal ve metabolik parametreleri arasındaki korelasyonları incelemektir.
Materyal-metot: Çalışma popülasyonunu 12-18 yaş arası (ortalama±SS: 15.03±2.05 yıl) HT (n = 30) ve kontrol (C, n = 30) gruplarından oluşan toplam 60 kız adölesan oluşturdu. Metabolik parametrelerin incelendiği endokrinolojik incelemelerin yanı sıra hastaların ağız dışı ve periodontal muayeneyi içeren (sondlamada kanama yüzdesi (SK%), gingival indeks (GI), plak indeksi (Pİ) ve cep derinliği (CD)) ağız içi muayeneleri de yapılarak kaydedildi.
Bulgular: HT grubunda C grubuna göre anlamlı olarak daha yüksek anti-tiroid peroksidaz (Anti-TPO) değerleri (P = 0.001) dışında, metabolik parametrelerin hiçbiri anlamlı farklılık göstermedi (P > 0,05). Deneklerin tamamında gingivitis vardı. Periodontal parametreler istatistiksel açıdan anlamlı farklı bulunmadı (P > 0,05). Tükürük akış hızı (SFR) Anti-TPO ile negatif anlamlı (r = -0.367, P = 0,046) ve kortizol düzeyi cep derinliği (CD) ile negatif anlamlı korelasyona sahipti (r = -0.378, P = 0,040).
Sonuç: Gingival indeks (GI) ve fT4 ile PD ve fT4 arasındaki önemli korelasyonlar, periodontal inflamasyonun HT ile ilişkili olabileceğini düşünmemize yol açmıştır. Çalışma popülasyonunun tamamında görülen gingivitis varlığının ergenlik döneminde dental plağa karşı oluşan aşırı konak yanıtı ile ilgili olabileceği de akılda tutulmalıdır.

Anahtar Kelimeler

Hashimoto tiroiditi, diş eti iltihabı, tükürük akış hızı, çocuk, otoimmün tiroidit

Destekleyen Kurum

Bu çalışma Süleyman Demirel Üniversitesi Bilimsel Araştırma Projeleri Koordinasyon Birimi tarafından desteklenmiştir.

Proje Numarası

TTU-2018-6815

Periodontal Health Status of Adolescents with Hashimoto Thyroiditis

Öz

Objective: Possible mechanisms regarding the relationship between Hashimoto’ thyroiditis (HT) and periodontal disease were suggested to be the autoimmune mechanisms. The aim is to report the oral and periodontal health status of a sample of adolescents with HT; and to evaluate the factors affecting the oral and periodontal health of the adolescents with HT.
Material- Method: Sixty adolescent girls aged between 12-18 years (mean±SD: 15.03±2.05 years) have participated. The study population was comprised of HT (n = 30) and control (C, n = 30) groups. In addition to the endocrinologic evaluations (metabolic parameters) and intra- and extra-oral examinations, periodontal examination including the recording of percentage of bleeding on probing (BOP %), gingival index (GI), plaque index (PI), and pocket depth (PD) was made.
Results: Except the significantly higher anti-thyroid peroxidase (Anti-TPO) values in HT group than the C group (P = 0.001), none of the metabolic parameters have shown significant differences (P > 0.05). All of the subjects had gingivitis. The periodontal parameters were found not significantly different (P > 0.05). Salivary flow rate (SFR) has negative significant correlation with Anti-TPO (r = -0.367, P = 0.046), and cortisol has negative significant correlation with pocket depth (PD) (r = -0.378, P = 0.040).
Conclusions: Significant correlations between gingival index (GI) and fT4, and PD and fT4 have led us to consider that the periodontal inflammation might relate to HT. The adolescence period should also kept in mind; which results in exaggerated host response to the dental plaque, and projected with the presence of gingivitis in the whole study population.

Anahtar Kelimeler

Hashimoto thyroiditis, gingivitis, salivary flow rate, children, autoimmune thyroiditis

Proje Numarası

TTU-2018-6815

Kaynakça

• [1] Hegde, R., Awan, K.H. 2019. Effects of periodontal disease on systemic health. Disease-a-month: DM, 65[6],185-92.
• [2] Jin, L., Chiu, G., Corbet, E. 2003. Are periodontal diseases risk factors for certain systemic disorders-What matters to medical practitioners? Hong Kong Medical Journal, 9[1]:31-7.
• [3] Nylund, K.M., Meurman, J.H., Heikkinen, A.M., Honkanen, E., Vesterinen, M., Furuholm, J.O. 2015. Periodontal inflammatory burden and salivary matrix metalloproteinase‐8 concentration among patients with chronic kidney disease at the predialysis stage. Journal of Periodontology, 86[11],1212-20.
• [4] Srinivasa, T., Agrawal, P., Goyal, P., Farista, S., Sowmya, N., Deonani, S. 2015. Comparative clinical evaluation of glycosylated haemoglobin level in healthy and chronic periodontitis patients: A chairside diagnostic method. Indian Journal of Dental Research, 26[5], 504-7.
• [5] Araújo, M.V., Hong, B.Y., Fava, P.L., Khan, S., Burleson, J.A., Fares, G. 2015. End stage renal disease as a modifier of the periodontal microbiome. BioMed Central Nephrology, 16, 80.
• [6] Zhou, X., Han, J., Liu, Z., Song, Y., Wang, Z., Sun, Z. 2014. Effects of periodontal treatment on lung function and exacerbation frequency in patients with chronic obstructive pulmonary disease and chronic periodontitis: A 2‐year pilot randomized controlled trial. Journal of Clinical Periodontology, 41[6], 564-72.
• [7] Jindal, A., Parihar, A.S., Sood, M., Singh, P., Singh, N. 2015. Relationship between severity of periodontal disease and control of diabetes (glycated hemoglobin) in patients with type 1 diabetes mellitus. Journal of International Oral Health, 7[suppl 2], 17–20.
• [8] Jenkins, R.C.W.A. 2002. Disease associations with autoimmune thyroid disease. Thyroid, 12[11], 977-88.
• [9] Ohye, H., Nishihara, E., Sasaki, I., Kubota, S., Fukata, S., Amino, N. 2006. Four cases of Graves’ disease which developed after painful Hashimoto’s thyroiditis. Internal Medicine, 45[6], 385-9.
• [10] Patil, B.S.P.S., Gururaj, T.R. 2011. Probable autoimmune causal relationship between periodontitis and Hashimotos thyroidits: a systemic review. Nigerian Journal of Clinical Practice, 14[3], 253-61. [11] Scardina, G.A., Messina, P., 2007. Microvascular periodontal alterations: a possible relationship between periodontitis and rheumatoid arthritis. Clinical Hemorheology and Microcirculation, 37[3], 229–35.
• [12] Yard, B.A., Wille, A.I,. Haak, M., van der Woude, F.J., 2002. Human proteinase 3 can inhibit LPS-mediated TNF-alpha production through CD14 degradation: Lack of influence of antineutrophil cytoplasmic antibodies. Clinical Experimental Immunology,128 [3], 444-52.
• [13] Zadeh, H.H., Kreutzer, D.L. 1996. Evidence for involvement of superantigens in human periodontal diseases: Skewed expression of T cell receptor variable regions by gingival T cells. Oral Microbiology and Immunology, 11[2], 88-95.
• [14] Taddei, S., Caraccio, N., Virdis, A., Dardano, A., Versari, D., Ghiadoni, L., Ferrannini, E., Solvetti, A., Monzani, F., 2006. Low-grade systemic inflammation causes endothelial dysfunction in patients with Hashimoto’s thyroiditis. Journal of Clinical Endocrinology and Metabolism, 91[12], 5076–82.
• [15] Burman, K.D. M.-G.L. 2006. Dermatologic aspects of thyroid disease. Clinical Dermatology, 24[4], 247-55.
• [16] Pizzorni, C.S.A., Craviotto, C., Tuccio, M., Seriolo, B., Cutolo, M. 2003. Diagnostic perspectives in the rheumatological vasculitis: The role of the videocapillaroscopy. Reumatismo, 54[2], 99-104. [17] Chang, C.P., Shiau, Y.C., Wang, J.J., Ho, S.T., Kao, C.H. 2003. Decreased salivary gland function in patients with autoimmune thyroiditis. Head and Neck, 25[2], 132-7.
• [18] Pinyerd, B., Zipf, W.B. 2005. Puberty—timing is everything! Journal of Pediatric Nursery, 20[2], 75-82.
• [19] Ozturk, A., Mazicioglu, M.M., Hatipoglu, N., Budak, N., Keskin, G., Yazlak, Z. 2008. Reference body mass index curves for Turkish children 6 to 18 years of age. Journal of Pediatric Endocrinology & Metabolism, 21[9],827–36.
• [20] Weerheijm, K.L.J.B., Alaluusua, S. 2001. Molar incisor hypomineralization. Caries Research, 35[5],390-1.
• [21] Lobene, R.R., Weatherford, T., Ross, N.M., Lamm, R.A., Menaker, L. 1986. A modified gingival index for use in clinical trials. Clinical Preventive Dentistry, 8[1], 3-6. [22] Löe, H. 1967. The gingival index, the plaque index and the retention index systems. Journal of Periodontology, 38[6], 610-6.
• [23] Löe, H., Silness, J. 1963. Periodontal disease in pregnancy I. Prevalence and severity. Acta Odontologica Scandnavica, 21, 533-51.
• [24] Trombelli, L., Farina, R., Silva, C.O., Tatakis, D.N. 2018. Plaque-induced gingivitis: Case definition and diagnostic considerations. Journal of Periodontology, 89[Suppl 1], S46–S73.
• [25] Navazesh, M., Kumar, S.K.S. 2008. Measuring salivary flow challenges and opportunities. Journal of American Dental Association, 139, 35S-40S.
• [26] Baker, S.R., Mat, A., Robinson, P.G. 2010. What psychosocial factors influence adolescents’ oral health? Journal of Dental Research, 89[11], 1230-5.
• [27 Yu, S.M., Bellamy, H.A., Schwalberg, R.H., Drum, M.A. 2001. Factors associated with use of preventive dental and health services among U.S. adolescents. Journal of Adolescent Health, 29[6], 395-405.
• [28] Patil, B.S., Giri, G.R. 2012. A clinical case report of Hashimoto’s thyroiditis and its impact on the treatment of chronic periodontitis. Nigerian Journal of Clinical Practice, 15[1], 112-4.
• [29] Patil, B.S., Patil, S., Gururaj, T.R. 2011. Probable autoimmune causal relationship between periodontitis and Hashimotos thyroidits: A systemic review. Nigerian Journal of Clinical Practice, 14[3], 253-61.
• [30 Agha-Hosseini F, Shirzad N, Moosavi MS. 2016. Evaluation of Xerostomia and salivary flow rate in Hashimoto's Thyroiditis. Medicina Oral, Patología Oral y Cirurgía Bucal, 21[1], e1-e5.
• [31] Delaney, J.E., Ratzan, S.K., Kornman, K.S. 1986. Subgingival microbiata associated with puberty: studies of pre‐, circum‐, postpubertal human females. Pediatric Dentistry, 8[4], 268–75.
• [32] Mombelli, A., Gusterbi, F.A., van Osten, M.A.C., Lang, N.P. 1989. Gingival health and gingivitis development during puberty. A 4‐year longitudinal study. Journal of Clinical Periodontology, 16[7], 451–6.
• [33] Hall, R.K. 1989. The prevalence of developmental defects of tooth enamel [DDE] in a paediatric hospital department of dentistry population (part I). Advanced Dental Research, 3[2], 114-9.
• [34] Venkatesh Babu, N.S., Patel, P.B. 2016. Oral health status of children suffering from thyroid disorders. Journal of Indian Society of Pedodontics and Preventive Dentistry, 34[2], 139-44.