Association Between Rheumatoid Arthritis and Periodontitis: Recent Progress

Eezammuddeen, Nazurah Nik; Vaithilingam, Rathna Devi; Hassan, Norul Husna Mohamad; Bartold, P. Mark

doi:10.1007/s40496-020-00264-4

Cited by 12 publications

(23 citation statements)

References 87 publications

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“…It is defined by the excessive activation of proinflammatory cytokines mediators, specific autoantibodies and progressive irreversible articular damage [ 1 , 2 ]. Considered the hallmark of RA and, perhaps, the most important step in the pathobiology of the disease, the immune response against citrullinated peptides is driven, at least in part, by antigens derived from the periodontal tissue exposed to a dysbiotic oral microbiome during periodontitis [ 1 , 2 , 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Chronic periodontitis is a complex condition outlined by chronic inflammation and the subsequent damage of soft collagen-rich tissues progressing to periodontal ligament and alveolar bone loss as well as a gradual increase in tooth mobility [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 ]. It is typically initiated by an infection with oral anaerobic bacteria followed by inflammatory and immune response in the gingival and periodontal microenvironment [ 1 , 2 , 3 ]. Autoantigens generated during citrullination induced by peptidylarginine-deaminase enzyme produced by Porphyromonas gingivalis (P. gingivalis), the keystone pathogen in the oral microbial biofilm, break the immune tolerance with induction of anti-citrullinated protein antibodies (ACPA) and promote chronic inflammatory response in both periodontal and synovial/articular tissues [ 1 , 3 , 4 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

“…Periodontal disease (PD) is generally associated with a broad spectrum of chronic systemic disorders including diabetes, cardiovascular, respiratory, kidney, and neurodegenerative diseases as well as immune-mediated rheumatic conditions [ 1 , 2 , 3 , 4 , 5 , 19 ]. Several epidemiological studies have already communicated that PD is more prevalent during RA and vice versa [ 4 , 20 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

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Exploring the Role of Interleukin-6 Receptor Inhibitor Tocilizumab in Patients with Active Rheumatoid Arthritis and Periodontal Disease

Ancuta

Chirieac²,

Ancuta

et al. 2021

JCM

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Background: The aim of our study was to explore the influence of weekly subcutaneous administration of interleukin-6 (IL-6) receptor inhibitor tocilizumab (TCZ) on periodontal status in a local longitudinal study of patients with rheumatoid arthritis (RA) and periodontal disease (PD). Methods: We performed a 6-month prospective study in 51 patients with chronic periodontitis and moderate-to-severe RA starting TCZ in accordance with local recommendations. Extensive rheumatologic (clinical activity, inflammatory, serological biomarkers) and periodontal (visible plaque index, gingival index, bleeding on probing, probing pocket depth, clinical attachment loss) assessments were done. Changes in RA activity and periodontal status were reassessed after 3 and 6 months. Results: We demonstrated significant correlations between periodontal status, disease activity, and serologic biomarkers (p < 0.05). Tocilizumab significantly improved the gingival index scores and decreased the number of sites with bleeding on probing after only 3 months (p < 0.05), while the probing pocket depth significantly decreased after 6 months; overall, clinical attachment loss presented only slight changes without any statistical significance as well as teeth count and plaque levels (p > 0.05). Conclusion: IL-6 inhibition is able to improve periodontal outcomes in patients with RA and concomitant PD, which is essentially related to a dramatic decrease in serum inflammatory mediators.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Exploring the Role of Interleukin-6 Receptor Inhibitor Tocilizumab in Patients with Active Rheumatoid Arthritis and Periodontal Disease

Ancuta

Chirieac²,

Ancuta

et al. 2021

JCM

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“…On the basis of the important biochemical, cellular, genetic, microbiological, and clinical studies, Eezammuddeen et al . [ 39 ] reported that there is a good evidence available now to support a relationship between RA and periodontitis.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and severity of periodontitis in patients with established rheumatoid arthritis and osteoarthritis

Disale

Zope

Suragimath

et al. 2020

J Family Med Prim Care

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Introduction: Periodontitis is associated with many chronic health conditions including diabetes, cardiovascular disease, and rheumatoid arthritis (RA). RA and periodontitis have similarities in inflammatory mechanism, morphology, and histopathology. Osteoarthritis (OA) is a chronic, multifactorial degenerative disease characterized by the deterioration of cartilage in joints. Objective: The aim of this study was to evaluate the prevalence and severity of periodontal disease in patients with established RA and OA. Materials and Methods: A total of 200 patients reporting to the Department of Orthopaedics, KIMSDU, Karad were included in the study. Patients were divided into two groups: Group 1 that included 100 patients with established RA diagnosed according to American College of Rheumatology (ACR) classification 1987 criteria and Group 2 that comprised 100 patients diagnosed with OA. Demographic profile, medical and dental history, oral hygiene practices, and smoking status of study participants were recorded. Periodontal status of the patients were evaluated using the simplified oral hygiene index (OHI-S), Loe and Silness gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL). On the basis of the CAL score periodontitis severity was defined as slight, moderate, and severe. Rheumatoid Factor (RF) and C-reactive protein (CRP) were considered as a serological marker in RA. Serological tests were performed to measure RF and CRP. Periodontal parameters and serological tests were correlated. Results: This study reported 45% severe periodontitis prevalence in RA compared to OA group, which was 33%. Severity of periodontitis is significantly greater in RF positive RA group with mean CAL 5.38 mm compared to RF negative RA group with mean CAL 2.81 mm ( P = 0.001). There was moderate positive correlation found between RF titer and severity of periodontitis (r = 0.311). Conclusion: The severity of periodontitis was significantly higher among the patients with established RA as compared to patients with OA. RF positive patients had higher periodontal disease compared to RF negative patients. There was an increase in the mean clinical attachment loss with increase in RF titer.

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Periodontitis and Systemic Diseases

Vaithilingam

Baharuddin

2023

Immunology for Dentistry

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Association Between Rheumatoid Arthritis and Periodontitis: Recent Progress

Cited by 12 publications

References 87 publications

Exploring the Role of Interleukin-6 Receptor Inhibitor Tocilizumab in Patients with Active Rheumatoid Arthritis and Periodontal Disease

Exploring the Role of Interleukin-6 Receptor Inhibitor Tocilizumab in Patients with Active Rheumatoid Arthritis and Periodontal Disease

Prevalence and severity of periodontitis in patients with established rheumatoid arthritis and osteoarthritis

Periodontitis and Systemic Diseases

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