Non-surgical periodontal treatment improves rheumatoid arthritis disease activity: a meta-analysis

Sun, Jia; Zheng, Youli; Bian, Xiaowei; Ge, Huijian; Wang, Jun; Zhang, Zheng

doi:10.1007/s00784-021-03807-w

Cited by 20 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 - 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%

“…Además, los pacientes con AR pueden tener períodos de remisión / recaída de la enfermedad y de esta manera, la inflamación sistémica se verá alterada aumentando los niveles de PCR 36 . Los resultados concuerdan con otros estudios 22 , 27 , 37 - 39 , pero revisiones sistemáticas no han mostrado ningún efecto de TPNQ sobre ACPA y RF 40 , por lo tanto, produciendo conclusiones contrastantes. Se ha sugerido que la TPNQ tiene efectos sistémicos al reducir las fuentes inflamatorias periodontales 21 .…”

Section: Discussionunclassified

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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%

Section: Discussionunclassified

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

et al. 2021

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“…A study by Baser et al found significant positive correlation between CRP levels and the severity of periodontitis in patients with type-2 diabetes mellitus [33]. A review paper by Sun et al concluded that NSPT significantly reduced CRP serum levels in periodontitis patients with rheumatoid arthritis [34]. Our study reached comparable results, showing that in HCV+P patients, NSPT significantly reduced the GCF CRP levels (p = 0.0191) at a 3-month recall.…”

Section: Discussionsupporting

confidence: 79%

Non-Surgical Periodontal Therapy Could Improve the Periodontal Inflammatory Status in Patients with Periodontitis and Chronic Hepatitis C

Gheorghe

Popescu

Sălan

et al. 2021

JCM

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Non-surgical periodontal therapy (NSPT) is the first essential step for the management of any periodontitis patient. This study aims to evaluate the impact of NSPT on pro-inflammatory mediators’ regulation and on clinical parameters in periodontitis patients who suffer from chronic hepatitis C. At baseline, selected patients were clinically evaluated for their periodontal status. A subsequent quantitative assessment of C-reactive protein and pentraxin-3 in samples of gingival fluid was performed by Enzyme-Linked Immunosorbent Assay (ELISA). Afterwards, NSPT was performed. Three months after NSPT, the clinical and ELISA assessments were repeated. The results show an improvement of the clinical parameters in periodontitis patients at the three-month recall. In chronic hepatitis C patients with periodontitis, the gingival fluid levels of pro-inflammatory markers reduced significantly. The targeted markers also expressed significant correlations with the clinical parameters used for the assessment of periodontitis’ severity. The results suggest that, while chronic hepatitis C patients exhibited a more negative periodontal status at baseline as compared to non-hepatitis ones, NSPT is effective in decreasing the local periodontal inflammatory reaction and in proving the periodontal status of this type of patients. Given the limitation of the study, periodontal screening and NSPT should be included in the integrated therapeutical approach of chronic hepatitis C patients, for its impact on the local inflammatory response.

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“…Although the presence of periodontitis has been associated to a worse rheumatoid arthritis outcome and clinical activity, not all RA patients have a more severe periodontal evolution [5]. A recent meta-analysis that included nine studies sought to assess whether non-surgical periodontal therapy could improve rheumatoid arthritis activity and concluded that RA activity was improved as assessed by disease activity score (DAS28), tender joint counts (TJC), swollen joint counts (SJC), visual analogical scale (VAS), and C-reactive protein (CRP) by non-surgical periodontal therapy [6].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Acknowledged and Novel Anti-Rheumatic Therapies on Periodontal Tissues—A Narrative Review

et al. 2021

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Rheumatoid arthritis (RA) and periodontal disease (PD) are chronic complex inflammatory diseases with several common susceptibility factors, especially genetic and environmental risk factors. Although both disorders involve a perturbation of the immune–inflammatory response at multiple levels, one major difference between the two is the different locations in which they develop. RA is triggered by an exaggerated autoimmune response that targets joints, while periodontal disease occurs as a consequence of the subgingival periodontopathogenic microbiota. Current treatment models in both pathologies involve the stratification of patients to allow therapeutic individualization according to disease stage, complexity, progression, lifestyle, risk factors, and additional systemic diseases. Therapeutic guidelines for RA comprise of five main classes of drugs: non-steroidal anti-inflammatory drugs (NSAIDs), analgesics, glucocorticoids, and disease-modifying anti-rheumatic drugs (DMARDs): biologic and non-biologic. Although various treatment options are available, a definitive treatment remains elusive, therefore research is ongoing in this area. Several alternatives are currently being tested, such as matrix metalloproteinases (MMP) inhibitors, toll-like receptors (TLR) blockers, pro-resolution mediators, anti-hypoxia inducing factors, stem cell therapy, NLRP3 inhibitors and even natural derived compounds. Although the link between PD and rheumatoid arthritis has been investigated by multiple microbiology and immunology studies, the precise influence and causality is still debated in the literature. Furthermore, the immunomodulatory effect of anti-rheumatic drugs on the periodontium is still largely unknown. In this narrative review, we explore the mechanisms of interaction and the potential influence that anti-rheumatoid medication, including novel treatment options, has on periodontal tissues and whether periodontal health status and treatment can improve the prognosis of an RA patient.

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Non-surgical periodontal treatment improves rheumatoid arthritis disease activity: a meta-analysis

Cited by 20 publications

References 48 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

Non-Surgical Periodontal Therapy Could Improve the Periodontal Inflammatory Status in Patients with Periodontitis and Chronic Hepatitis C

The Effect of Acknowledged and Novel Anti-Rheumatic Therapies on Periodontal Tissues—A Narrative Review

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