Background Periodontal disease (PD) and rheumatoid arthritis (RA) are two common chronic inflammatory diseases globally destructive. Recently, there has been increasing evidence that periodontal disease and rheumatoid arthritis share many biological and pathological features like the significant increase in acute phase reactants. It is important to demonstrate that periodontal inflammation can affect clinical index and variability of the patients with RA.
Objectives To evaluate the association between clinical indices of PD and markers of activity in Colombian RA patients and individuals with first-degree relatives of patients with RA.
Methods The rheumatologic condition and periodontal status of 73 individuals with rheumatoid early arthritis and 164 individuals first degree relative with RA patient were evaluated. Porphyromona gingivalis (Pg), IgG1, and IgG2 to Pg were determined. The C-reactive protein, erythrocyte sedimentation rate, rheumatoid factor-RF, anti-citrullinated protein antibodies, RA 33 antibodies and scales of RA activity were measured. The rheumatologic Scores and periodontal condition were evaluated by two experienced and calibrated periodontists and rheumatologist. The chi-square test was used to evaluate association between periodontal variables and RA activity indices. The study was approved by the Ethics Committee of the Universidad El Bosque and the Hospital Militar Central, Bogotá, Colombia.
Results RA group showed 67.1% of periodontitis, of which 43.8% were classified as moderate and 15.1% as severe, positive RF in 49 patients (67.2%) and ACPAs (52%), RA patients had association between dental Plaque >30% with activity clinical index DAS28ESR (p=0.05), SDAI (p=0.008), Bleeding of probing with DAS28ESR (p=0.05), ESR (p=0.03) and CRP (p=0.03) and association between clinical attachment level with ACPAs (p=0.05), Furthermore first-degree relatives of patients with RA showed periodontal disease in a 70.1% classified as moderate 43.9% and 12.8% as severe, positive RF 18 (18%), and ACPAs (7.1%), was finding association between gingival index with activity clinical index DAS28ESR (p=0.05), CRP (p=0.03), ESR (p=0.005) and RAPID3 (p=0.05), association periodontal pocket deep with HAQ-DI score (p=0.05) and bleeding of probing with SDAI (p=0.05).
Conclusions RA and PD share pathophysiological mechanisms that explain how greater commitment periodontal dental plaque index and periodontal pocket deep are directly related to indices of clinical activity of the joint disease. This would explain the persistence of elevated acute phase reactants with minimal or absent joint clinical manifestations.
Bello-Gualtero JM, et al. Periodontal Disease in Individuals With a Genetic Risk of Developing Arthritis or With Early Rheumatoid Arthritis: A Cross-Sectional Study.J Periodontol. 2015;26:1–18
Disclosure of Interest None declared