Background Periodontitis and rheumatoid arthritis (RA) are two chronic destructive inflammatory diseases with significant worldwide prevalence. Periodontal disease and RA are characterized by the destruction of articular and periodontal tissue, and they share several biological and pathological features.
Objectives Evaluate the effects of conventional drug treatment and anti-TNF therapy in patients with RA on periodontal condition and subgingival microbiota, establishing the association of markers of periodontal infection with indexes of rheumatic activity.
Methods A cross-sectional study was conducted in two groups of RA patients with more than two years of diagnosis. The first group used conventional therapy, and the second group used anti-TNF treatment. An association analysis was performed to observe the relationship between clinical and microbiological markers of periodontal infection, and RA activity. A comparative analysis was performed to assess clinical and microbiological periodontal markers and RA activity.
The data were released to STATA v11. Frequencies of nominal variables and means and standard deviations for continuous variables were calculated for sociodemographic, periodontal and rheumatological data. Associations between periodontal status and rheumatological variables by Chi square/Fisher's exact test and Mann-Whitney U tests. The results were considered statistically significant at p≤0.05. The ethics committee of institution approved the study.
Results An overall high frequency of periodontal disease 91%, in most cases from moderate to severe, was observed in all subjects. The frequency of periodontal disease was 93.22% in the anti-TNF-alpha group and 88.7% in the conventional treatment group. The percentage of sites with clinical attachment loss ≥4 mm was significantly associated with the group receiving methotrexate and leflunomide p=0.05. Steroid therapy was associated with the presence of teeth p=0.027. Significant associations were observed with the use of more than one DMARD and the presence of P. gingivalis p=0.004. T. denticola was found in the anti-TNF-α therapy group compared to the conventional therapy group p=0.001.
Conclusions Different pharmacological treatments for RA affect the clinical condition and sub-gingival microbiota. Patients treated with more than one DMARD promote the increase subgingival microbiota. Therefore, a more strict periodontal monitoring is necessary in these RA patients
Lafaurie Gi, Contreras a, barόn a, et al. demographic, clinical, and microbial aspects of chronic and aggressive periodontitis in Colombia: a multicenter study. J Periodontol. 2007; 78: 629–639.
Bingham Co, Moni M. periodontal disease and rheumatoid arthritis: the evidence accumulates for complex pathobiologic interactions. Curr Opin Rheumatol. 2013 25:345–53.
Disclosure of Interest None declared