Relationship between periodontitis and rheumatoid arthritis and the effect of non-surgical periodontal treatment

Abstract

This study analyzed the association of periodontal disease (PD) and rheumatoid arthritis (RA). seventy-five 35-60-year-old patients were assigned to 5 groups according to the presence (+) or not (-) of PD and RA and the treatment received (TR+) or not (TR-) for PD. Group 3 uses total prosthesis (TP). Clinical and laboratory evaluations were performed at baseline, 3 and 6 months of follow-up by probing pocket depth, bleeding on probing and plaque index for PD, hAQ, DAs28, sF-36 and laboratory: AAG, esR, CRP for RA. statistically significant differences for PD after 3 (p=0.0055) and after 6 months (p=0.0066) were obtained in Group 1 (RA+PD+TR+) and 2(RA+PD+TR-); significant reduction in the % of BoP after 6 months (p=0.0128) and significant reduction in the % of Pl after 3 (p=0.0128) and 6 months (p=0.0002) in Group 1. statistically significant differences between Groups 1 and 3 (RA+TP) for DAs28 at baseline and after 3 months were observed, but not after 6 months. No other parameters for RA were significantly affected. The relationship between RA and PD disease activities is not clear, but the importance of periodontal treatment in the control of inflammation to avoid tooth extraction is evident.

Prevalence and Severity of Periodontitis in Indonesian Patients With Rheumatoid Arthritis

“…Since more severe RA is also accompanied by higher CRP levels 48,49 , higher CRP levels may be a reflection of active RA, which may contribute to an increased inflammatory state in periodontitis. Interestingly, CRP level reduces in RA patients after periodontal therapy 20 , lending support to the hypothesis that periodontitis may contribute to an increased systemic inflammation in RA.…”

“…Recently, a few pilot-intervention studies have pointed towards periodontitis as a risk factor for RA [17][18][19][20] . After treating periodontitis, a reduction in RA disease activity was shown, possibly related to a reduction in periodontitis associated inflammatory burden.…”

The Emerging Concepts on the Impact of Periodontitis on Systemic Health

“…Conversely, in another study, it was reported that, in patients with RA and periodontitis, although non-surgical periodontal therapy resulted in reduction of ESR, CRP, and -1 acid glycoprotein, the reductions were not statistically significant. However, in another group in the same study comprising of periodontitis patients who did not have RA, non-surgical periodontal therapy resulted in improvement of periodontal parameters with associated significant improvements in ESR, CRP, and -1 acid glycoprotein levels suggesting that RA is a multifactorial disease (Pinho Mde et al, 2009). …”

Efeito Da Terapia Periodontal Não Cirúrgica Na Redução Da Severidade Da Artrite Reumatoide

“…Este resultado promissor também pôde ser encontrado no estudo de PINHO et al, 2009 39 , que utilizou parâmetros clínicos, como profundidade de sondagem, placa microbiana e sangramento à sondagem para avaliação da atividade da PC, e os parâmetros DAS28 e Medical Outcomes Study 36 -Item Short -Form Health Survey (SF36) para avaliação da atividade da AR. A saber, o SF36 é um questionário com 36 itens que avalia a qualidade de vida de acordo com capacidade funcional, aspectos físicos, dor, estado geral da saúde, vitalidade, aspectos sociais, aspectos emocionais e saúde mental 37 .…”