Effects of non-surgical periodontal treatment in rheumatoid arthritis patients: A randomized clinical trial

Nguyen, Van Bich; Nguyễn, Thủy Thu; Huynh, Nam Cong-Nhat; Nguyen, Khoa D.; Le, Thu Anh; Hoang, Hung Tu

doi:10.17219/dmp/131266

Cited by 23 publications

(30 citation statements)

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“…Also, RA patients can have periods of disease remission/relapse and this way, the systemic inflammation will be altered increasing CRP levels 36 . The results agree with other studies 22,27,[37][38][39] , but systematic reviews have shown no effect of NSPT on ACPAs and RF, consequently, producing contrasting conclusions 23,40 . It has been suggested that NSPT has systemic effects by reducing periodontal inflammatory sources 21 .…”

Section: Discussionsupporting

confidence: 91%

Effects of nonsurgical periodontal therapy in patients with rheumatoid arthritis: a prospective before and after study

et al. 2021

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Background: periodontal therapy has been suggested to have systemic effects. However, studies of periodontal therapy in rheumatoid arthritis patients have produced controversial results. Aim: To compare the effects of nonsurgical periodontal therapy on biochemical markers of rheumatoid arthritis and periodontal parameters in patients with and without rheumatoid arthritis. Methods: a prospective before-and-after study was conducted that included 21 participants without and 29 participants with rheumatoid arthritis. Periodontal parameters, Porphyromonas gingivalis detection, C-reactive protein, rheumatoid factor and anti-citrullinated protein antibodies were measured at baseline and three months after nonsurgical periodontal therapy and the changes were statistically assessed. Results: In general, both groups presented statistically significant improvement in periodontal parameters (p<0.05). There was an increase in the counts of P. gingivalis in both groups at three months. In addition, there was a reduction in levels of anti-citrullinated protein antibodies and rheumatoid factor in participants with rheumatoid arthritis. In contrast, C-reactive protein levels increased in both groups but were higher in the rheumatoid arthritis group. Periodontal parameters in rheumatoid arthritis participants under disease-modifying antirheumatic drugs presented a slightly higher improvement (p <0.05). Conclusions: Nonsurgical periodontal therapy has similar improvements in periodontal parameters in patients with and without rheumatoid arthritis. In addition, nonsurgical periodontal therapy may benefit serum levels of anti-citrullinated protein antibodies and rheumatoid factors in patients with rheumatoid arthritis. NCT04658615.

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Section: Discussionsupporting

confidence: 91%

Effects of nonsurgical periodontal therapy in patients with rheumatoid arthritis: a prospective before and after study

et al. 2021

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“…The former trends show how accessing periodontal treatment and periodic and professional check-up appointments impact people's oral health, reflecting their impact on the dimensions and functions of HRQoL and OHRQoL. This is in line with the results of the blood and periodontal parameters and consistent with the results of other clinical trials [58,59]. A similar study conducted by Okada et al found a statistically significant reduction (p < 0.001) observed in PD and PAL values in the treatment group in 26 patients 8 weeks after NSPT, compared with the control group [60].…”

Section: Discussionsupporting

confidence: 87%

“…Nguyen et al conducted a randomized clinical trial (RCT) in 82 RA patients with periodontitis and found that DAS-28 disease activity (CRP) was significantly reduced 3 months after the procedure, both in the group treated with NSPT and in the control group (dental hygiene only). In addition, this study showed a significant decrease in ESR, ACPAs, and DAS-28-PCR in the group treated with NSPT 6 months later, while the control group showed a decrease only in ACPAs [59]. This suggests that prolonged follow-up of patients could show significant changes in study variables.…”

Section: Discussionmentioning

confidence: 56%

“…This suggests that prolonged follow-up of patients could show significant changes in study variables. Non-surgical periodontal treatment can significantly reduce DAS-28-CRP, classification of disease activity, ESR, and serum ACPA level, and it can also be applied to reduce RA severity in RA patients with periodontitis [59]. By observation, a meta-analysis analyzed the effect of non-surgical periodontal treatment in RA and non-RA patients with periodontitis, concluding that treatment is equally effective in both groups and thus suggesting that RA does not affect the clinical efficacy of non-surgical periodontal therapy [61].…”

Section: Discussionmentioning

confidence: 99%

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The Effect of Periodontal Treatment on Clinical and Biological Indicators, Quality of Life, and Oral Health in Rheumatoid Arthritis Patients: A Quasi-Experimental Study

Posada-López

Botero

Pineda-Tamayo³

et al. 2022

IJERPH

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Non-surgical periodontal therapy (NSPT) has been shown to have systemic effects. It has been suggested that, similar to rheumatoid arthritis (RA), periodontitis (PD) has an impact on general health, in terms of psychological, physical, and social aspects. This study determines the effect of periodontal treatment in RA activity, health-related quality of life, and oral health self-perception before and after periodontal treatment in RA patients. A quasi-experimental, prospective, non-randomized study was conducted, and 52 patients were included in the study. Periodontal parameters and the instruments disease activity score-28 (DAS-28), SF-36, and OHIP-14 were measured at baseline and at 3 months after NSPT. All differences were statistically assessed. The study protocol was registered in Clinical Trials (NCT04658615). No statistically significant differences were found in the scores of DAS-28 before and after the intervention in the group with PD and reduced periodontium. When the effect of periodontal treatment was analyzed in the group of 29 patients who were followed up, it was found that there were statistically significant differences before and after in variables such as psychological distress, emotional role, and mental health, which indicates an improvement in the scores of these variables. NSPT influenced the health-related quality of life measured with SF-36 and OHIP-14 in patients with RA. In conclusion, NSPT has an effect on self-reported quality of life and health indicators more than the RA activity as measured with DAS-28. However, the clinical effect of periodontal treatment in RA patients provides important data to support periodontal care in patients.

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“…Following an update of the systematic search, five new studies were identified (Buwembo et al, 2020; Montero et al, 2020; Nguyen et al, 2021; Qureshi et al, 2021; Rapone et al, 2021) with data from four of them included in meta‐analyses (Montero et al, 2020; Nguyen et al, 2021; Qureshi et al, 2021; Rapone et al, 2021). The updated meta‐analyses did not change the interpretation of the available evidence apart from the increase in diastolic blood pressure previously observed for PICOS #2, which became non‐statistically significant (0.15 mmHg 95% CI (−0.14; 0.44]; p = .311].…”

Section: Impact Of Periodontal Treatment On Systemic Health and Quali...mentioning

confidence: 99%

Treatment of stage IV periodontitis: The EFP S3 level clinical practice guideline

Herrera

Sanz

Kebschull

et al. 2022

J Clinic Periodontology

184

132

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Background: The recently published clinical practice guideline (CPG) for the treatment of periodontitis in stages I-III provided evidence-based recommendations for the treatment of periodontitis patients, defined according to the 2018 classification. Stage IV periodontitis shares the severity and complexity characteristics of stage III periodontitis, but includes the anatomical and functional sequelae of tooth and periodontal attachment loss (tooth flaring and drifting, bite collapse, etc.), which require additional interventions following completion of active periodontal therapy. Aim: To develop an S3 Level CPG for the treatment of stage IV periodontitis, focusing on the implementation of inter-disciplinary treatment approaches required to treat/rehabilitate patients following associated sequelae and tooth loss. Materials and Methods: This S3 Level CPG was developed by the European Federation of Periodontology (EFP), following methodological guidance from the Association of Scientific Medical Societies in Germany and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) process. A rigorous and transparent process included synthesis of relevant research in 13 specifically commissioned systematic reviews, evaluation of the quality and strength of evidence, the formulation of specific recommendations and a structured consensus process with leading experts and a broad base of stakeholders. Results: The S3 Level CPG for the treatment of stage IV periodontitis culminated in recommendations for different interventions, including orthodontic tooth movement, EFP workshop participants and methodological consultant are listed in Appendix.

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Effects of non-surgical periodontal treatment in rheumatoid arthritis patients: A randomized clinical trial

Cited by 23 publications

References 0 publications

Effects of nonsurgical periodontal therapy in patients with rheumatoid arthritis: a prospective before and after study

Effects of nonsurgical periodontal therapy in patients with rheumatoid arthritis: a prospective before and after study

The Effect of Periodontal Treatment on Clinical and Biological Indicators, Quality of Life, and Oral Health in Rheumatoid Arthritis Patients: A Quasi-Experimental Study

Treatment of stage IV periodontitis: The EFP S3 level clinical practice guideline

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