Phenotype of Crohn’s disease according to the Montreal classification in relation to dental health status

Figures & data

Table 1. Inclusion and exclusion criteria for participants in the study.

Inclusion

1: Treated for a diagnosis of Crohn’s Disease K50.0 & K50.9 (ICD 10)

2: Between 20 and 60 years of age at time of inclusion to the study

Exclusion

1: Autoimmune disease that causes dry mouth (e.g., Sjögrens syndrome, Mb Bechterew’s disease, Celiac disease)

2: Receiving immunosuppressive therapy (other than corticosteroids) - not to be included in the biopsy group

3: Anti-cholinergic medication

4: Radiotherapy to the head and neck region.

5: Haemophilia (not in the biopsy group)

Table 2. Description of data at baseline in the group clinico-pathological characteristics of the study participants.

	Age at diagnosis—Montreal classification
	A1	A2	A3	Total N	p-Value^a
Gender
Male	1	10	7	18	.09
Female	6	18	6	30
Age (mean ± SD) in years	42 ± 13	46 ± 9	57 ± 2	47
Disease duration (years)	23 ± 11	20 ± 11	9 ± 6	47
Family history of IBD (N)	2	8	1	11	.3
Smoker
No	3	12	5	20
Quit	2	7	4	15	.95
Yes	1	10	4	15
Number of teeth	26 ± 6	26 ± 6	26 ± 5	47	.89
BMI	25 ± 3	27 ± 3	26 ± 2	47	.56
Saliva buffer strip blue (N)	4	18	7	29	.77
Green (N)	2	5	4	11
Yellow (N)	0	4	1	5
Stimulated saliva
Secretion units	1.0 ± 0.6	1.4 ± 0.8	1.4 ± 0.9	47	.51
Location
L1 (L1,4)	0	2 (0)	1 (0)	3 (0)
L2 (L2,4)	0	5 (0)	2 (0)	7 (0)
L3 (L3,4)	6 (0)	21 (0)	10 (0)	37 (0)
L4	0	0	0	0	.92
Crohn’s disease behaviour (perianal involvement)
B1 (B1p)	2 (1)	12 (1)	5 (0)	19 (2)
B2 (B2p)	2 (0)	9 (1)	3 (0)	14 (1)
B3 (B3p)	0 (0)	1 (1)	2 (1)	3 (2)
B2 + B3 ((B2 + B3) + p)	2 (2)	6 (1)	3 (1)	11 (4)	.88
Patient treated with (currently using)
Steroids	2 (2)	8 (6)	5 (3)	15 (11)	.75
5-ASA	3 (3)	13 (13)	6 (6)	22 (22)	1.00
Immunosuppressive drugs	2 (2)	17 (8)	8 (5)	27 (15)	.54
Abdominal surgery	4	14	6	24	.71
Anti-diuretics	4 (4)	9 (9)	4 (4)	17 (17)	.13

A1; age <16 years; A2; age 17–40 years; A3; age >40 years.

Location of Crohn’s disease: L1, ileal; L2, colonic; L3, ileo-colonic; L4, upper GI tract disease.

Behaviour of Crohn’s disease: B1, non-stricturing; non-penetrating; B2, stricturing; B3, penetrating; p, perianal.

^aFisher’s exact test.

Table 3. Association between the different Montreal classes and the three dental variables.

Montreal class (N)	No. of teeth	Decayed plus filled %	Mean pocket depth
A1 (6)	25.8 ± 5.9	34.4 ± 31.5	2.18 ± 0.46
A2 (28)	26.5 ± 4.4	46.7 ± 27.7	2.19 ± 0.36
A3 (13)	25.9 ± 4.6	57.1 ± 23.3	2.66 ± 0.77
p-Value
ANOVA	.893	.231	.026
After controlling*	.703	.733	.378
L1 (3)	27.3 ± 2.1	47.0 ± 14.7	3.04 ± 1.20
L2 (7)	29.6 ± 3.0	42.1 ± 25.6	2.14 ± 0.30
L3 (37)	25.5 ± 4.7	49.2 ± 28.8	2.30 ± 0.49
p-Value
ANOVA	.085	.825	.047
After controlling*	.061	.754	<.001
B1 (19)	27.1 ± 2.6	43.0 ± 24.2	2.22 ± 0.62
B2 (14)	27.4 ± 2.8	45.0 ± 31.0	2.21 ± 0.25
B3 (3)	27.0 ± 7.8	62.5 ± 23.0	2.76 ± 0.65
B2 + 3 (11)	23.1 ± 6.8	56.4 ± 28.9	2.52 ± 0.60
p-Value
ANOVA	.070	.457	.195
After controlling*	.318	.830	.619
B non-p (39)	27.2 ± 3.8	44.1 ± 25.3	2.28 ± 0.55
B p (8)	21.8 ± 5.5	67.0 ± 30.8	2.49 ± 0.51
p-Value
ANOVA	.001	.029	.334
after controlling*	.007	.039	.750

Values shown are mean and SD for each measure. ANOVA and multivariate GLM were used to test if any classification was statistically significantly associated with any of the dental variables. Significant p-values are presented in bold letters.

*Multivariate GLM; independent variables are sex, age, smoking, and either Montreal class, and dependent variables are the number of teeth, D + F %, and mean pocket depth.

Table 4. Correlation between degree severity? of Crohn’s disease and the number of missing teeth.

Average number of teeth in each disease behavior group
	B1 (N)	B2 (N)	B3 (N)	B2 + B3 (N)	N
No perianal involvement	27.4 (17)	27.6(13)	31 (1)	27.3 (7)	38
Perianal involvement	24.5 (2)	24 (1)	25 (2)	12.8 (4)	9
n	19	14	3	11	47 p = .074^a

Univariate GLM: Montreal class B, p = .034; Montreal class p, p = .008. Interaction effect, p = .55.

Montreal classification in relation to Crohn’s disease behaviour: B1, non-stricturing; non-penetrating; B2, stricturing; B3, penetrating; p, perianal.

Shown are the average numbers of teeth for each group, with a maximum of 32 teeth.

^aFisher’s exact test.