title: [Periodontal disease in pediatric rheumatic diseases].
abstract: Gingivitis and periodontitis are immunoinflammatory periodontal diseases characterized by chronic localized infections usually associated with insidious inflammation This narrative review discusses periodontal diseases and mechanisms influencing the immune response and autoimmunity in pediatric rheumatic diseases (PRD), particularly juvenile idiopathic arthritis (JIA), childhood-onset systemic lupus erythematosus (C-SLE) and juvenile dermatomyositis (JDM). Gingivitis was more frequently observed in these diseases compared to health controls, whereas periodontitis was a rare finding. In JIA patients, gingivitis and periodontitis were related to mechanical factors, chronic arthritis with functional disability, dysregulation of the immunoinflammatory response, diet and drugs, mainly corticosteroids and cyclosporine. In C-SLE, gingivitis was associated with longer disease period, high doses of corticosteroids, B-cell hyperactivation and immunoglobulin G elevation. There are scarce data on periodontal diseases in JDM population, and a unique gingival pattern, characterized by gingival erythema, capillary dilation and bush-loop formation, was observed in active patients. In conclusion, gingivitis was the most common periodontal disease in PRD. The observed association with disease activity reinforces the need for future studies to determine if resolution of this complication will influence disease course or severity.
authors: Divisão de Odontologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil; Faculdade de Odontologia, Universidade Federal de Juiz de Fora, MG, Brasil.
authors: Gisele M C
authors: GM
authors: Fabri
authors: Divisão de Odontologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors: Cynthia
authors: C
authors: Savioli
authors: Divisão de Odontologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors: José T
authors: JT
authors: Siqueira
authors: Unidade de Reumatologia Pediátrica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors: Lucia M
authors: LM
authors: Campos
authors: Divisão de Reumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil.
authors: Eloisa
authors: E
authors: Bonfá
authors: Unidade de Reumatologia Pediátrica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil; Divisão de Reumatologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil. Electronic address: clovis.silva@hc.fm.usp.br.
authors: Clovis A
authors: CA
authors: Silva
mesh_terms: D000293:Adolescent; D002648:Child; D006801:Humans; D010510:Periodontal Diseases / Q000150:complications*; D012216:Rheumatic Diseases / Q000150:complications*
keywords: Artrite idiopática juvenil; Childhood‐onset systemic lupus erythematosus; Dermatomiosite juvenil; Doenças periodontais; Gengivite; Gingivitis; Juvenile dermatomyositis; Juvenile idiopathic arthritis; Lúpus eritematoso sistêmico juvenil; Periodontal diseases; Periodontite; Periodontitis