Prediction of clinical response to anti-TNF treatment by oral parameters in Crohn's disease.
OBJECTIVE
The aim of our work was to predict the clinical response of Crohn's disease (CD) patients to anti-tumor necrosis factor (TNF) treatment by dental, periodontal, and oral mucosa parameters.


METHODS
In 5 patients with luminal CD and in 9 patients with fistulizing CD, oral symptoms and signs before drug administration were assessed by 27 parameters, including: a) Decayed-, missing-, filled -, healthy -, nonvital -, root canal filled -, total number of - and impacted teeth; b) Oral ulcers, swelling of lips and cheeks, recurrent oral aphthae and hyperplasia of the mucosa; c) Width of keratinized gingiva, probing depth, gingival margin, clinical attachment level, bleeding on probing, plaque index, gingival index and gingival crevicular fluid (GCF) volume; d) The percentage of 8 morphotypes of subgingival plaque detected by darkfield microscopy (DFM), with the total number of bacteria examined. A new statistical prediction method has been introduced.


RESULTS
At time lapse of 8 weeks after infliximab administration the prediction quality estimated from 8 optimal parameters attained a value of 0.63. However, with time lapse increasing to 3 months, the prediction quality decreased to 0.21, indicating that oral and response parameters became more statistically independent.


CONCLUSIONS
This indicates that the oral state parameters could provide a sound basis for predicting the response of patients to infliximab administration.
Department of Dental Medicine, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
Dusan
D
Groselj
Igor
I
Grabec
Katja
K
Seme
Alojz
A
Ihan
Ivan
I
Ferkolj
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D003424:Crohn Disease / Q000150:complications* / Q000188:drug therapy*; D003773:Dental Plaque / Q000209:etiology / Q000382:microbiology; D005260:Female; D006801:Humans; D000069285:Infliximab; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009059:Mouth Diseases / Q000209:etiology*; D010512:Periodontal Index; D011379:Prognosis; D012074:Remission Induction; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
D000893:Anti-Inflammatory Agents; D000911:Antibodies, Monoclonal; D014409:Tumor Necrosis Factor-alpha; D000069285:Infliximab