Association between Systemic Lupus Erythematosus and Periodontitis: A Systematic Review and Meta-analysis

Abstract

BackgroundSystemic lupus erythematosus (SLE) is a chronic systemic inflammatory autoimmune disease, the etiology of which remains only partially characterized. Strong evidence implicates chronic infections in the development and chronicity of autoimmune conditions. Recently, an association has been demonstrated between periodontitis and rheumatoid arthritis. Such observations have led to the investigation of the possible role of periodontitis and oral dysbiosis in other systemic inflammatory conditions, including SLE. The aim of this study was to examine whether there is an association between SLE and periodontitis.MethodsMEDLINE via OVID, EMBASE via OVID, and PsycINFO via OVID databases were searched to identify eligible studies, screened by two independent authors and verified by a third. Studies comparing presence of periodontitis in SLE cases to controls without SLE were included. Data were extracted using a predefined table and papers were appraised using Down’s and Black tool. Mantel–Haenszel meta-analysis was performed using RevMan.ResultsEight case–control studies were included, with 487 SLE cases and a total of 1,383 participants. On meta-analysis of four studies, risk of periodontitis in SLE cases compared to controls was significantly greater with a risk ratio of 1.76 (95% CI 1.29–2.41, p = 0.0004). No statistical difference was found in individual measures of periodontitis, such as probing depth or clinical attachment loss, between SLE cases and controls.ConclusionOur study found a statistically significant increased risk of periodontitis in patients with SLE compared to controls. This finding suggests a possible association between these two conditions. Larger longitudinal studies are needed to confirm this possible association.

Oral Manifestations of Systemic Lupus Erythematosus Patients in Qatar: A Pilot Study

“…Oral manifestations of SLE are frequently encountered [ 13 ] and may include oral ulceration, honeycomb plaque, raised keratotic plaque, nonspecific erythema, purpura, petechiae, and cheilitis [ 14 ]. Research shows that 25% of SLE patients have oral mucous membrane and lip involvement with possible petechiae.…”

“…A high prevalence of oral complaints such as dysphagia, dysgeusia, and glossodynia was also present [ 15 ]. A recent systematic review reported a significant association between periodontitis and SLE [ 13 ].…”

Periodontal disease defects and mandibular cortical index in lupus patients

“…As lupus patients has elevated levels of pro-inflammatory cytokines [37], is expected that they have higher risk to develop periodontal disease. The significant increase in periodontitis in patients with lupus might be related to their susceptibility to periodontal disease by its inherent host response due to the disease itself [38,39].…”

D-Mannose Enhanced Immunomodulation of Periodontal Ligament Stem Cells via Inhibiting IL-6 Secretion

“…Periodontitis is one of chronic infectious diseases destructing the alveolar bone and the supportive tissue of the teeth; it is also associated with a variety of systemic diseases such as diabetes, cardiovascular disease, and premature low birth weight [ 17 – 19 ]. The periodontal ligament comes from dental follicle, derived from neural crest cells, and PDLSCs play critical roles in periodontal ligament.…”