Impact of Behcet’s Disease on the Periodontitis and Gingivitis- A Case-Control Study

Abstract

Abstract Objective Behcet’s disease (BD) is a chronic ‘autoinflammatory’ disorder, characterized by the triad of oral and genital apthous ulcerations and iritis. We hypothesized that BD patients might have different immunological responses towards bacterial inflammation in their periodontal tissues due to their disease status, as well as medical treatment and this immunological differences might lead to clinical consequences. Materials and Methods Forty BD patients with gingivitis (BG) or periodontitis (BP) and 47 systemically healthy patients with either gingivitis (HG) or periodontitis (HP) were studied. Periodontal status was recorded with routine clinical indexes. Gingival crevicular fluid (GCF) and saliva samples were obtained. Nitric oxide (NO), interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) levels were analyzed using colorimetric assay, EIA and ELISA. Current BD symptoms and medications usage were recorded. Results Mean probing pocket depths and clinical attachment levels were significantly lower in BG compared to HG subjects. Moreover, mean salivary IL-1β, TNF-α levels were elevated, and mean NO levels were decreased in BG compared to HG patients (p < 0.05 for IL-1β, TNF-α, p < 0.001 for NO). In contrast, mean NO levels in GCF were higher in BP group than in HP group (p < 0.01). While the BD patients with and without vascular involvement were compared, the salivary NO level was lower in patients with vascular involvement (p < 0.001). Conclusions Our results suggest that BD might have profound effects on the pathogenetic mechanisms of the gingivitis and periodontitis. Clinical Relevance The chronic inflammatory nature of both diseases, Behçet and periodontal disease, and the close relationship of proinflammatory cytokines with both disease activities suggested that there may be a bidirectional interaction between them.