Article Text

PDF
SAT0100 Association between Chronic Periodontitis and Clinical Profile of Rheumatoid Arthritis
  1. B. Rodríguez-Lozano1,
  2. J.L. Garnier Rodríguez2,
  3. J. González Febles3,
  4. S. Dadlani4,
  5. B. Tejera Segura1,
  6. I. Ferraz Amaro1,
  7. J.F. Díaz González1,
  8. S. Bustabad Reyes1
  1. 1Rheumatology, Hospital Universitario de Canarias., Prov. Santa Cruz Tenerife
  2. 2Odontology, Dental Clinic Dr Garnier, Santa Cruz de Tenerife
  3. 3Periodontology, UCM, Madrid
  4. 4Periodontology, Dental Clinic Dr Garnier, Santa Cruz de Tenerife, Spain

Abstract

Background Recent clinical data show a clear association between periodontitis (P) and rheumatoid arthritis (RA). However, the literature is inconsistent whether severity of P is associated with RA activity; some studies haven't shown any or negative association.Nevertheless, there is one study1 that has found a positive association between severity of P and activity of RA.

Objectives 1) To describe if the severity of P affects the clinical expression and activity of RA.2) To define the characteristics of P in RA patients with high clinical activity.

Methods Observational, cross-sectional, case-control study of adult RA patients (ACR/EULAR 2010) in a hospital Rheumatology Service,with at least 4 teeth, no dental prophylaxis or antibiotic intake 6 months before. Socio-demographic/anthropometric variables including smoking status, Graffar scale and stress level. RA variables: DAS28 (ESR & CRP), SDAI, titles RF/ACPA, extraarticular manifestations and comorbidities:o steoporosis (OP), diabetes mellitus (DM), dyslipidemia (DS), ischemic cardiovascular disease (ICD); glucocorticoid (GC),synthetic and biological therapy (DMARDs/BT). Periodontal Variables: plaque index (PI), bleeding on probing (BoP), probing pocket depth (PPD), recession (REC), clinical attachment level (CAL). Dental team: 2 periodontists/2 general dentists. Full mouth CAL, PPD and periapical x-rays were taken. CAL was classified according to the European Workshop in 2005 (Tonetti), into level 0 (absence), N 1T (mild), N2 T (severe). Statistical Analysis: t-student, Kruskal Wallis, Chi-square. Statistical program: Stata 13.1.

Results 187 RA patients, F/M 78,6%/21,4%, mean age 54,4 yo, follow-up: 8,8 y. Early RA 18,72%. Positive F/ACPA: 74,19%/67,86%. Mean clinical activity: DAS28(ESR) 3,81/DAS28(CRP) 3,18/SDAI 14,49. Disease activity: remission 20, 86%, low 24,06%, moderate 45,45%, high 9,63%; RA treatment: GC therapy 47,06% (pred 2,85 mg/d)l; DMARDs monotherapy/combined: 53%/11,76%, BT 30%. Smoking: Current smoker (19,25%)/former smoker (24,6%); low socioeconomic status (36,36%), relative poverty (33,69%); annual dental prophylaxis: 43%; dyslipidemia: 53,47%, OP/osteopenia: 55,86%. P N2T in 69, 05% of patients with moderate/high activity vs 30,95% remission/low activity; 55,34% patients with P N1T showed RA remission/low activity (p<0,001). It has been found a strong association between severe P and moderate/high RA activity, with OR 57,649±37,403 (CI 95% 16,163–205,620). Patients with moderate/high RA activity presented increased values of all periodontal parameters compared to those with low activity (p<0,005). It has been observed an association between rheumatoid nodes, pleuritis and OP with severe P (p=0,028).

Conclusions 1. High-activity RA is associated with severe P. 2. Patients with moderate and high activity RA have higher prevalence of both number and percentage of probing pocket depth ≥ de 5mm. 3. Presence of rheumatoid nodes and osteoporosis are related to severe P. 4. These results prompt an independent relationship between severe P and RA patients with high clinical disease activity.

  1. Mikuls,et al. Arthritis Rheum 2014

Disclosure of Interest None declared

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.