Periodontal Disease in Patients with Ankylosing Spondylitis: myth or reality?

Iordache, Cristina; Chirieac, Rodica; Ancuta, E.; Pomirleanu, Cristina; Ancuţa, Codrina

doi:10.37358/rc.17.7.5740

Cited by 5 publications

(6 citation statements)

References 12 publications

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“…In the non‐randomized clinical studies there is a general concordance that the anti‐TNF‐α therapy reduces alveolar bone loss and improves periodontal indices in patients who are not under periodontal treatment . However, two studies did not support these findings.…”

Section: Resultsmentioning

confidence: 99%

“…Quality of information in non‐randomized clinical studies was considered high level in seven articles and moderate in the remaining studies . Quality of information in the In vivo animal studies was considered moderate in five articles and high in seven studies .…”

Section: Resultsmentioning

confidence: 99%

“…The overall results of our research tend to support this hypothesis. The majority of clinical studies, and two animal studies, show that BMs lead to the clinical improvement in the systemic disease as well as in P and AP. This finding suggests that cytokine‐targeted therapies might exert a positive effect on the periodontal conditions in patients with autoimmune inflammatory diseases and altered levels of inflammatory cytokines .…”

Section: Discussionmentioning

confidence: 99%

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Interaction of biologic therapy with apical periodontitis and periodontitis: a systematic review

Peddis

Musu

Ideo

et al. 2019

Australian Dental Journal

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Biologic medications (BMs) are increasingly used for the management of systemic chronic inflammatory diseases. These diseases are often associated with a higher prevalence of apical periodontitis (AP) and periodontitis (P). The purpose of this systematic review was to ascertain the interactions between AP and/or P and BMs. The review was registered in the PROSPERO database (CRD42017054756). Electronic searches were performed on Pubmed Medline, Scopus and The Web of Science from their inception through to 20 March 2018. The references of the articles selected were checked. The keywords were chosen based on a pilot search, which aimed to find the most frequently prescribed BMs. The included studies were appraised qualitatively using appropriate tools. Thirty-five articles met the inclusion criteria, comprising 16 non-randomized clinical studies, 12 in vivo animal studies and 7 case reports. Quality of information was assessed as high in 18 articles, moderate in 16 articles and low in 1 article. BMs in patients suffering from chronic inflammatory diseases seems to inhibit the progression of AP and P, and to enhance the healing response to periodontal and endodontic treatment. A healthier condition of the periodontal tissues seems to be associated with a better response of the patient to BMs therapy.Abbreviations and acronyms: AP = apical periodontitis; BM = biologic medications; P = periodontitis; RANKL = receptor activator of nuclear factor kappa-Β ligand (RANKL).

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Interaction of biologic therapy with apical periodontitis and periodontitis: a systematic review

Peddis

Musu

Ideo

et al. 2019

Australian Dental Journal

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“…Pivotal studies have already explored the role of different synthetic and biological therapies in active RA and comorbid periodontal disease, showing controversial results [ 5 , 9 , 12 , 16 , 17 , 25 , 28 , 35 , 36 , 37 , 38 , 39 ]. Overall, there is a trend to consider that TNF inhibitors, IL-6 receptor antagonist, B-cells depletive agents and, even, JAK inhibitors improve periodontal health in both RA and other arthritis (e.g., ankylosing spondylitis, psoriatic arthritis); it seems that all these drugs are ultimately effective in decreasing gingival and periodontal inflammation and, to a lesser extent, associated tissue damage [ 16 , 27 , 28 , 35 , 36 , 37 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 ]. Researchers even proposed a multistep approach of the sequential tissue repairing following TNF inhibitors, comprising reduced leukocytes traffic in the inflamed tissue, decreased proteolytic activity, and the normalization of osteoclast activity [ 1 , 5 , 9 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

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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“…Ancuta et al examined RA patients (n = 96) and Iordach et al examined AS patients (n = 86). Both studies showed a statistical significant decrease after 6 months of anti-TNF therapy in GI, BOP, PPD, and CAL (34,35). Since the literature has reported most frequently on the 6 months after treatment, the quantitative effects of before and after treatment on the 5 periodontal parameters is summarized in Figure 2.…”

Section: Days Anti-tnf May Improve Pi and Gimentioning

confidence: 94%

Use of TNF Inhibitors in Rheumatoid Arthritis and Implications for the Periodontal Status: For the Benefit of Both?

Zamri

Vries

2020

Front. Immunol.

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The inflammatory diseases rheumatoid arthritis (RA) and periodontitis show similarities in misbalances of cytokine levels, such as tumor necrosis factor-a (TNF-a). RA has been treated for two decades with TNF inhibitors which are effective by blocking TNF's destructive action. Since RA and periodontitis show similarities in high levels of TNF, the periodontal status of RA patients may improve with the use of anti-TNF therapy. To assess this, a systematic review with special emphasis on duration of therapy was performed to evaluate the effect of anti-TNF-a treatment on the periodontal status of RA patients. Overall, studies showed an improvement in periodontal health with anti-TNF therapy. When analyzed over time (6 weeks to 9 months), it became apparent that initial improvements concerned bleeding on probing (BOP) and gingival index (GI) after therapy duration of 6 weeks. Periodontitis parameters that improved after prolonged treatment were: probing pocket depth (PPD) after 3 months and clinical attachment level (CAL) after 6 months. In conclusion, this systematic review reveals that anti-TNF treatment is therefore not only beneficial for rheumatic joints but also for the gums of rheumatoid arthritis patients. We propose that the sequential tissue recovery due to anti-TNF therapy progresses as follows: 1. block of diapedesis by lowering vessel permeability, 2 fewer leukocytes in the inflamed tissue, and 3. reduced proteolytic activity and subsequent repair of collagen fiber functionality and normalization of osteoclast activity. Clinically, this could lead to a decrease in bleeding on probing and ultimately in an improved clinical attachment level.

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Periodontal Disease in Patients with Ankylosing Spondylitis: myth or reality?

Cited by 5 publications

References 12 publications

Interaction of biologic therapy with apical periodontitis and periodontitis: a systematic review

Interaction of biologic therapy with apical periodontitis and periodontitis: a systematic review

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

Use of TNF Inhibitors in Rheumatoid Arthritis and Implications for the Periodontal Status: For the Benefit of Both?

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