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Anti-Tumor Necrosis Factor-α Treatment in Periodontal Disease – a literature review
Umeå University, Faculty of Medicine, Department of Odontology.
Umeå University, Faculty of Medicine, Department of Odontology.
2016 (English)Independent thesis Advanced level (professional degree), 20 credits / 30 HE creditsStudent thesis
Abstract [en]

The aim of this literature review was to summarize human studies on the effects of tumor necrosis factor-α (TNF-α) inhibitors on periodontal status. Today TNF-α inhibitors is an established treatment method with positive effects in Rheumatoid arthritis (RA) a disease similar to periodontitis. TNF-α inhibitors have in animal studies demonstrated positive results in experimental periodontitis.

 Literature search was made in PubMed. Included articles were clinical human studies examining the effects on bleeding on probing (BOP), gingival index (GI) or modified gingival index (MGI), clinical attachment level (CAL) and periodontal probing depth (PPD) in patients with autoimmune diseases and treated with TNF-α inhibitors. Animal studies and studies in languages other than English were excluded. The guidelines of The Swedish Council on Technology Assessment in Health Care (SBU) were used to evaluate the level of evidence in the included articles and they were graded according to the GRADE system.

The search rendered 264 articles of which 17 were selected for abstract reading. Eight of these were read in full-text; one randomized clinical trial (RCT) of moderate quality, two cross-sectional studies and five longitudinal studies of low evidence.  Patients treated with anti-TNF-α compared to the untreated reference groups in the two cross-sectional studies demonstrated lower BOP and GI, while diverging results on attachment loss were shown. The longitudinal studies demonstrated diverging effects of anti-TNF-α treatment on all periodontal parameters. The RCT showed that anti-TNF-α as a complement to conventional periodontal treatment had positive effects on CAL, PPD, BOP and GI while anti-TNF-α treatment alone lacked significant effects on these parameters. There are limited publications within the field and the studies show heterogeneity in terms of study design. Anti-TNF-α treatment showed small significant positive effects on the periodontal parameters in some studies but diverging results were noted. Studies of sufficient scientific quality specifically addressing the effect of anti-TNF-α treatment on periodontitis are needed to elucidate the effects of anti-TNF-α treatment in periodontitis.

Place, publisher, year, edition, pages
2016.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:umu:diva-131247OAI: oai:DiVA.org:umu-131247DiVA: diva2:1073124
External cooperation
VLL
Educational program
Dentistry Programme
Supervisors
Examiners
Available from: 2017-02-09 Created: 2017-02-09 Last updated: 2017-02-09Bibliographically approved

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