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G. MUMCU, et alOral health in patients with Behcet's diseaseS.mutans colonisation might be related to low serummannose-binding lectin levels that recognisemicroorganisms as a part of the first-line innatedefences 27 . In a germ-free mouse model, S.sanguisis shown to adhere to buccal epithelial cells andcause local inflammatory cytokine responses 9 .Increases in patern-recognition receptors such astoll-like receptor-6 (TLR-6) expressed ongranulocytes, was also observed after S.sanguisstimulation in patients with BD 28 . In addition, TLRscan recognize lipoteichoic-acid localized in grampositivebacteria cell walls and stimulate immuneresponses in BD 29 . The other molecular mechanismof oral ulcer formation may be “molecular-mimicry”as in the cross-reactivity between heat shockprotein-65 (HSP-65) of S.sanguis and human HSP-60 in BD 30 . As a result, the presence of infectiousfocus and poor oral health may activate immuneresponses with different pathways in BD. If theseconnections could be eliminated by theimprovement of oral health, recurrence of oral ulcerswould be limited. In this perspective, improvement oforal health by the preventive oral health care shouldbe a part of the treatment protocols for patients withBD. Moreover, a decrease in oral ulcer activity maybe related with the nature of disease sinceremission and exacerbations of symptoms could bedifferent time periods in BD 31 .As a conclusion, data from this studyindicate that dental and periodontal health remainedstable by motivation and education for oral hygienein a 10-year follow-up in BD patients. However,whether better oral hygine improves the diseasecourse and prevents oral ulcer activity requiresfurther studies.REFERENCES1. Direskeneli H. Behcet’s Disease: Infectiousetiology, new auto-antigens and HLA-B51. AnnRheum Dis 2001; 60:996-1002.doi:10.1136/ard.60.11.9962. Direskeneli H. Autoimmunity vsautoinflammation in Behcet’s disease: do weoversimplify a complex disorder? Rheumatology2006; 45:1461-465. doi:10.1093/rheumatology/kel3293. Sakane T, Takeno M, Suzuki N, Inaba G.Behçet's disease. N Engl J Med 1999;341:1284-1291.4. Mumcu G, Inanc N, Yavuz S, Direskeneli H. Therole of infectious agents in the pathogenesis,clinical manifestations and treatment strategiesin Behçet’s Disease-Review. Clin ExpRheumatol 2007; 25(4 Suppl 45):S27-33.5. Mumcu G. Behçet’s disease: a dentist’soverview . Clin Exp Rheumatol 2008;26(4 Suppl50):S121-124.6. Kaneko F, Oyama N, Yanagihori H, Isogai E,Yokota K, Oguma K. The role of streptococcalhypersensitivity in the pathogenesis of Behçet’sdisease. Eur J Dermatol 2008; 18: 489-498.7. Yoshikawa K, Kotake S, Sasamoto Y, Ohno S,Matsuda H. Close association of Streptococcussanguis and Behcet’s Disease. Nippon GankaGakkai Zasshi 1991; 95: 1261-1267.8. Mizushima Y. Behçet’s Disease ResearchCommitte of Japan, Skin hypersensitivity ofstreptococal antigens and the induction ofsystemic symptoms by the antigens in Behçetdisease. J Rheumatol 1989;16:506-511.9. Isogai E, Isogai H, Kotake S, Ohno S, Kimura K,Oguma K. Role of Streptococcus Sanguis andtraumatic factors in Behcet’s disease. J ApplRes 2003;3:64-75.10. Kaneko F, Oyama N, Nishibu A. Streptococcalinfection in the pathogenesis of Behçet’sDisease and clinical effects of minocycline onthe disease symptoms. Yonsei Med J 1997; 38;444-454.11. Mumcu G, Ergun T, Elbir Y, Eksioglu-DemiralpE. Clinical and immunological effects ofazithromycin in Behcet's disease. J Oral PatholMed 2005;34:13-16. Article first publishedonline: 16 DEC 2004 doi: 10.1111/j.1600-0714.2004.00265.x12. Calguneri M, Ertenli I, Kiraz S, Erman M, Celik I.Effect of prophylactic benzathine penicilline onmucocutaneous symptoms of Behçet’s Disease.Dermatology 1996; 192: 125-128.doi:10.1159/00024633613. Mumcu G, Ergun T, Inanç N, et al. Oral health isimpaired in Behçet’s disease and associate withdisease severity. Rheumatol 2004; 43: 1028-1033. doi: 10.1093/rheumatology/keh23614. Karacayli U, Mumcu G, Simsek I, et al. Theclose association between dental andperiodontal treatments and oral ulcer course inBehcet's disease: a prospective clinical study. JOral Pathol Med 2009;38:410-415.doi:10.1111/j.1600-0714.2009.00765.x15. Mumcu G, Niazi S, Stewart J, Hagi-Pavli E,Gokani B, Seoudi N, Ergun T, Yavuz S, StanfordM, Fortune F, Direskeneli H: Oral health andrelated quality of life status in patients from UKand Turkey: A comparative study in Behcet'sdisease. J Oral Pathol Med. 2009;38:406-9. doi:10.1111/j.1600-0714.2009.00752.x16. Mumcu G, Ergun T. Behçet Hastalığında OralSağlık ve Hastalığın Gelişimindeki Yeri.TURKDERM 2009;43 (Ek: 2): 39-41.17. Akman A, Ekinci NC, Kacaroglu H, Yavuzer U,Alpsoy E, Yegin O: Relationship betweenperiodontal findings and specific polymorphisimsof interleukin-1 alpha and -1 beta in Turkishpatients with Behçet’s disease. Arch DermatolRes 2008;300:19-26. doi:10.1007/s00403-007-0794-118. Akman A, Sallakci N, Kacaroglu H, et al.Relationship between periodontal findings andthe TNF-alpha Gene 1031T/C polymorphism inTurkish patients with Behçet's disease. J EurAcad Dermatol Venereol 2008;22:950-957.Article first published online: 19 MAR 2008 doi:10.1111/j.1468-3083.2008.02678.x19. Celenligil-Nazliel H, Kansu E, Ebersole J.Periodontal findings and systemic antibodyresponses to oral microorganisms in Behçet’sdisease. J Periodontol 1999;70: 1449-1456.doi:10.1902/jop.1999.70.12.144924Marmara Medical Journal 2011; 24 (1):21-25