Prediction of clinical response to anti-TNF treatment by oral parameters in Crohn's disease

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.

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.

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.

This indicates that the oral state parameters could provide a sound basis for predicting the response of patients to infliximab administration.