Periodontal conditions of individuals with Sjögren's syndrome

J Periodontol. 2009 Mar;80(3):429-35. doi: 10.1902/jop.2009.080350.


Background: Sjögren's syndrome (SjS) is a systemic autoimmune disease that might lead to hyposalivation and negatively affect the oral environment. The evidence with regard to the periodontal conditions in this group of subjects is still controversial. This study aimed to evaluate the periodontal clinical conditions and inflammatory markers in gingival crevicular fluid (GCF) from patients with primary Sjögren's syndrome (SjS [P]) or secondary Sjögren's syndrome (SjS [S]) compared to a control group.

Methods: Nineteen individuals with SjS (11 SjS [P] and eight SjS [S]) and 19 controls, matched for gender, age, and tobacco exposure, were selected from two private clinics and a hospital. The groups were compared for stimulated whole saliva (SWS) flow rate, plaque index (PI), gingival index (GI), probing depth (PD), bleeding on probing (BOP), clinical attachment level (CAL), and total amount of interleukin (IL)-1beta and total elastase activity in the GCF. Generalized estimating equations were used for data analysis.

Results: Individuals with SjS had a significantly lower SWS flow rate and higher mean PI, GI, PD, CAL, and BOP than controls. After adjustment for plaque, GI remained significantly higher in patients with SjS. Patients with SjS (S) had significantly higher mean CAL and PD than patients with SjS (P), and CAL and BOP remained significantly higher in this subgroup after adjustment. No differences were observed with regard to the GCF inflammatory markers. After adjusting for PD, subjects with SjS (P) showed lower levels of IL-1beta compared to controls.

Conclusion: SjS seemed to negatively affect the periodontal condition because gingival inflammation was more evident in the individuals with SjS, particularly those with SjS (S).

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autoimmune Diseases / immunology
  • Case-Control Studies
  • Dental Plaque Index
  • Female
  • Gingival Crevicular Fluid / chemistry
  • Gingival Hemorrhage / etiology
  • Gingival Hemorrhage / immunology
  • Gingivitis / etiology
  • Gingivitis / immunology
  • Humans
  • Interleukin-1beta / analysis
  • Male
  • Middle Aged
  • Pancreatic Elastase / analysis
  • Periodontal Attachment Loss / etiology
  • Periodontal Attachment Loss / immunology
  • Periodontal Diseases / etiology*
  • Periodontal Diseases / immunology
  • Periodontal Index
  • Periodontal Pocket / etiology
  • Periodontal Pocket / immunology
  • Saliva / immunology
  • Saliva / metabolism
  • Secretory Rate / physiology
  • Sjogren's Syndrome / complications*
  • Sjogren's Syndrome / drug therapy
  • Sjogren's Syndrome / immunology
  • Smoking


  • Interleukin-1beta
  • Pancreatic Elastase