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DEFICIENT DENTAL HYGIENE IN PATIENTS WITH CHRONIC AUTOIMMUNE THYROIDITIS AND PERIODONTAL DISEASE – PATHOLOGICAL CORRELATIONS
Abstract
Backgroud: The autoimmune process presents lesional similarities between chronic autoimmune thyroiditis and chronic periodontitis. The development of non-specific autoimmunity in periodontal disease is correlated with microbial aggression in the periodontal plaque. The increased incidence of periodontal lesions found in patients with chronic autoimmune thyroiditis suspects pathogenic intercorelation. Methods: The study included patients of both sexes with periodontal disease: group 1 - associating chronic autoimmune thyroiditis (CAT); group 2 - without thyroid involvement. Periodontal status was assessed differently: incipient, medium, advanced. Simplified oral hygene index (OHI-S) was interpreted in the range of values: 0.1 - 1.2; 1,3 - 3; 3.1 - 6. Statistically correlated variables: simplified oral hygiene index (OHI-S), periodontitis severity, patient sex, TSH serum level, autoimmunity involvement - antithyroid peroxidase (ATPO) - antithyroglobulin (ATG) - antinuclear (ANA) – antibody (Ab). Results: The severe periodontal disease: is more common in group 1 (p=0.043), not influenced by the sex of the patients; the presence of ANA mainly in the female sex (58.4%) is not correlated with the severity of periodontal disease (p = 0,44). Linear monofactorial regression: mean interdependence between s-OHI and patient age (r=0.63; p=0.018), thyroid stimulating hormone (TSH) respectively (r = 0.55, p = 0.0003). Linear multifactorial regression: direct proportional relationship between OHI-S and TSH, ATPO, ATG (r=0.56; p=0.001) and intensified with age (r = 0.78; p <0.001). The effect of autoimmunity on s-OHI (ANOVA test applied for both study groups): for ATPO (Pr=78.66%; r =0.73; p=0.05); for ATG (Pr = 94.06%; r = 0.73; p = 0.042); both antibodies (Pr=96.28%; r =0.87; p=0.003); correlated with age (r=0.99; p <0.001). Conclusions: The implication of thyroid autoimmunity and dysfunction on dental plaque index and the severity of the evolutionary stage of periodontitis, raises the suspicion of etiopathogenic and evolutionary intercorrelations of the two diseases.
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