Investigating the relationship between gingivitis

disease and

Pemphigus vulgaris

in Razi hospital

Mandana Moradi Nejad

*, Mandana Khatibi

and Hadi Noori

Postgraduate Student, Department of Maxillofacial Radiology, Islamic Azad university, Isfahan- Khorasan-

Branch, Isfahan, Iran

Department of Oral Medicine, Dental Branch, Islamic Azad University, Tehran, Iran

Postgraduate Student, Department of Endodentology, Islamic Azad University, Isfahan- Khorasan- Branch,

Isfahan, Iran

ABSTRACT

One of the frequent protests, especially in the early stages of periodontal disease pemphigus vulgaris lesions to skin

protests. (1) Gingivitis Gingivitis is the most common form of periodontal disease. This study aimed to investigate the

relationship pemphigus vulgaris is the most common disease of periodontal disease gingivitis as was done in 2011-

2012 years.The Historical Cohort study on 40 cases, 40 patients (control group) were performed. The data, viewing,

clinical examination, patient interview and a visit to the medical records along with the completed forms were used.

Both groups were matched for age, sex, smoking and use of toothbrushing, matched. Clinical examination criteria

introduced by (CPITN) Community Periodontal Index and treatment need was carried out in which factors of dental

calculus, pocket depth, bleeding on probing were evaluated. SPSS software (version 16) was used to analyze the

results. 45% of the control group were diagnosed with periodontal disease, while 77.5% of cases the disease gingivitis

And the difference was statistically signi cant.The incidence of oral manifestations in pemphigus need to question

and search dentists and physicians noticed the symptoms in patients, because  nding some oral symptoms in the

early stages can be effective in prognosis through early treatment.

KEY WORDS: PEMPHIGUS VULGARIS, PERIODONTAL DISEASE, GINGIVITIS

ARTICLE INFORMATION:

*Corresponding Author: m.moradinejad1365@gmail.com

Received 3

Jan, 2017

Accepted after revision 28

March, 2017

BBRC Print ISSN: 0974-6455

Online ISSN: 2321-4007

Thomson Reuters ISI ESC and Crossref Indexed Journal

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Online Contents Available at: http//www.bbrc.in/

Biosci. Biotech. Res. Comm. Special Issue No 1:7-10 (2017)

8 INVESTIGATING THE RELATIONSHIP BETWEEN GINGIVITIS DISEASE BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS

Nejad, Khatibi and Noori

INTRODUCTION

One of the frequent protests, especially in the early

stages of periodontal disease pemphigus vulgaris lesions

to skin protests (Azizi, 2008). Gingivitis is the most com-

mon form of periodontal disease. In ammation con-

 ned to the soft tissues surrounding the teeth and den-

tal plaque after plaque accumulation occured (Shankar

et al. 2010). Glossy surface, spongy and bleeding on

probing the consistency of the clinical signs are con-

 ict free gum and gum adhesive (Esmaili et al. 2007).

Pemphigus vulgaris (PV) causes blisters and ulcers in the

mucosa and skin. The  rst symptom in 60% of cases

appear in the mouth and in 90-80% of cases, the lesions

spread over the course of the disease (Manoj Kumar

et al. 2010).

These lesions sometimes even up to 4 months earlier

skin symptoms appear (Akman, 2008). The prevalence

of oral lesions of pemphigus vulgaris in various studies,

between 90% - 50 have been reported (Yazdanfar, 2010).

Except gingivitis is multifactorial disease and systemic

disease, one of the these factors are considered (Javali

and Zainab, 2012). Also, patients with pemphigus vul-

garis in the form of long-term local and systemic ster-

oids or other immunosuppressive drugs that weaken the

body’s immune response to the pathogen are the factors

periodontics (Mitsohiro et al. 2010).

In a study entitled pemphigus limited to the gums

which was conducted in 2010 by Mitsuhiro et al.patients

with a history of gingival lesions was a year old, for his

 nal diagnosis was con rmed pemphigus vulgaris. In

this study, it was found pemphigus vulgaris can rarely

intact blisters that form on your gums show this may be

a delay in diagnosis of underlying disease (Ayoubian,

2008). In another study Manojkumar and colleagues in

2010 a study entitled “Impact of pemphigus vulgaris (PV)

periodontal health” performed. This study showed there

is no difference in the two groups (PV) and healthy sub-

jects assessed for indicators. But the amount of plaque

in the PV group was signi cantly different than the con-

trol group (Javali and Zainab, 2012). Based on the above

information gap that existed in this  eld in Iran, this

study aimed to investigate the relationship pemphigus

vulgaris is the most common disease of periodontal dis-

ease gingivitis as was done in 2011-2012.

MATERIALS AND METHODS

The Historical - cohort of all patients with pemphi-

gus vulgaris the control group eligible for pemphigus

vulgaris referred to Razi hospital in 2011-2012 were

enrolled after informed consent form  lling.Required

volume studies were at least 14 in each group. For data

collection, observation, clinical examination, the ques-

tion of referring the patient and medical record along

with the completed forms and laboratory methods such

as immuno uorescence test and biopsy were used.

Clinical examination criteria introduced by (CPITN)

Community Periodontal Index and treatment Need was

carried out in which the following variables were ana-

lyzed: dental calculus, pocket depth, bleeding on prob-

ing. These factors should be considered in their teeth

were 37, 36, 31, 41, 46, 47, 26, 21, 11, 16, 17. Factors

associated with periodontal diseases such as gingivitis

free and sticky around the teeth 21, 26, 27, 47, 46, 41,

31, 36, 37, 17, 16, 11 in terms of consistency (consist-

ency), colour, stippling view to verify gingivitis and also

the mass rally, bleeding on probing (BOP), pocket depth

(PD) were evaluated. The results were scored according

to criteria CPITN. According to the table, scoring was

done as follows:

1. The absence of any lesion: zero

2. Bleeding on probing mild: score 1

3. Oral offenses: score 2

4. There is less and equal to 5 mm pocket depth:

score 3

5. There are bags with a depth of more than 6 mm:

grade 4

SPSS software (version 16) was used to analyze the

results.

RESULTS

The study included 40 patients with pemphigus vulgaris

(PV) and 40 healthy subjects. In addition to the similarity

of the two groups in terms of socio - economic (referred

to a hospital) were similar in terms of synchronization.

The two groups in terms of sex, age, smoking, use of

toothbrushing and the lack of any other systemic disease

were similar and this difference was not statistically sig-

ni cant. (By taking the P-value = 0.05). (Table 1) 45%

of people with periodontal disease are not PV%, 77.5

patients with PV, had periodontal disease. Chi - Square

test showed that this difference was statistically signi -

cant (p=0.003), with mean if people, PV are with the

incidence of periodontal disease is almost 2 times more

than non-affected individuals.

Table 2. shows Distribution of patients with pemphi-

gus vulgaris and controls and patients with gingivitis

attending.

DISCUSSION AND CONCLUSION

In this study, the relationship between pemphigus vul-

garis disease and gingivitis in 40 samples and 40 control

subjects were studied as a result of 77.5% of patients

BIOSCIENCE BIOTECHNOLOGY RESEARCH COMMUNICATIONS INVESTIGATING THE RELATIONSHIP BETWEEN GINGIVITIS DISEASE 9

Nejad, Khatibi and Noori

Table 1. Distribution of patients with Pemphigus vulgaris and separate controls for confounding factors

Confounding

variable

Pemphigus

Type Age Smoking or other tobacco Use toothbrushing

Female Man Non-smoking Smoker Yes no

None (control) 28

person

2.50

32 2

Yes(case) 29

person

1.46

40 ___

Test result chi-square

0.807

Independent

simple t-test

0.647

Fisher exact

0.473

chi-square

0.478

Table 2. Distribution of patients with pemphigus vulgaris and controls the separation of

gingivitis disease in patients

Periodontal

disease

Pemphigus

Vulgaris

Bleeding

on probing

(BOP)

Pocket depth Dental plaque Gingivitis

Less or equal

to 5mm

Higher than

6mm

None (control) (42%)17 (62%)25 (37%)15 (40%)16 (42%)17

Yes(case) (80%)32 (27%)11 (72%)29 (70%)28 (82%)33

Test result chi-square

0.001

chi-square

0.002

chi-square

007.0

chi-square

P<0.001

with PV who has symptoms of gingivitis has no sig-

ni cant relationship was found between PV and disease

gingivitis. Study Mitsuhiro et al.(Esmaili et al. 2007),

which was conducted in 2010, a year-old man with a

history of gingival lesions were examined and the diag-

nosis was con rmed PV about him and it was concluded

that early detection and proper oral lesions initiation of

appropriate therapy, can prevent disease cutaneous pro-

tests. The study presented a case of pemphigus limited

to the gums and thus result we achieved is in line with

research in a study by Dr. Ayoubian (Manojkumar et

al. 2010) in 2008 as pemphigus vulgaris and general-

ized aggressive periodontitis were developed and pre-

sented a case report of 40 years old woman PV diseases

with severe alveolar bone resorption was generalized to

the lack of proper oral hygiene with the PV disease was

noted in the development of bone destruction. Progres-

sive periodontal involvement in this case is also in line

with the results. Oral lesions of pemphigus vesicles range

from small to large Bula. When Bula tear caused exten-

sive injuries. Almost every area of the mouth area may

be involved, but multiple lesions often occur in areas of

irritation or trauma. In cases of gum, erosive gingivitis

clinical diagnosis of oral pemphigus is sometimes as the

only manifestation (Akman et al. 2008). However, the

incidence of oral manifestations in pemphigus need to

question and search dentists and physicians noticed the

symptoms in patients, because  nding some oral symp-

toms in the early stages can be effective in prognosis

through early treatment.

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