Background Periodontal disease (PD) shares several clinical and pathogenic characteristics with Rheumatoid Arthritis (RA). Some intervention studies have suggested that periodontal treatment can reduce serum inflammatory biomarkers such as C-reactive protein, or erythrocyte sedimentation rate. Periodontal diseases are not only a threat to dentition, but may also be an aggravating factor in patients with RA, its treatment may improve the RA outcomes.In this study we assessed the effect of periodontal basic therapy in relieving the PD symptoms and the clinical signs of RA in order to evaluate the importance of periodontal treatment in the control of inflammation.

Objectives To evaluate the effects of periodontal basic treatment on periodontal condition, clinical response and serum inflammatory parameters in RA patients with moderate to severe periodontitis.

Methods A total of 46 subjects with confirmed diagnosis of RA and moderate to severe periodontitis were included in the study. 18 subjects completing the study received periodontal basic treatment consisting of scaling/root planing and oral hygiene instruction at baseline and at 6 weeks; 28 subjects completing the study received no treatment as control group. Participants continued their usual disease-modifying medications for RA without any changes in DMARD therapy during the study period. Periodontal indices and RA measurements, such as probing depth (Pd), clinical attachment level (CAL), bleeding on probing (BOP), high-sensitivity C-reactive protein (hsCRP), erythrocyte sedimentation rate (ESR), disease activity score in 28 joints (DAS28) and subjective symptom were recorded at baseline, 6 and 12 weeks for each participant.

Results After periodontal basic treatment,significantly lower Pd, CAL and BOP were observed in the treatment group (P<0.01),hsCRP,ESR,DAS28 and patients' subjective symptom improved significantly (p<0.05).Besides,the Pd and BOP were statistically significant between treatment subjects after therapy and controls (P<0.001).Although hsCRP was significantly lower in the treatment group after therapy than controls (P<0.01),there was no significant difference in the DAS 28 level between the two groups after periodontal basic therapy (P>0.05). Visual analog scale (VAS)was used to evalue patients' subjective symptom,the results show that the improvement was much better in patients received periodontal therapy than controls (P<0.001).

Conclusions Periodontal basic treatment can effectively improve periodontal status, patients' subjective symptom and circulating inflammatory status.

References

1. Al-Katma MK, Bissada NF, Bordeaux JM, Sue J, Askari AD.Control of periodontal infection reduces the severity of active rheumatoid arthritis.J Clin Rheumatol. 2007 Jun;13(3):134–7.

2. Ortiz P, Bissada NF, Palomo L, Han YW, Al-Zahrani MS, Panneerselvam A, Askari A.Periodontal therapy reduces the severity of active rheumatoid arthritis in patients treated with or withouttumor necrosis factor inhibitors.J Periodontol. 2009 Apr;80(4):535–40.

3. Calderaro DC, Corrêa JD, Ferreira GA, Barbosa IG, Martins CC, Silva TA, Teixeira AL.Influence of periodontal treatment on rheumatoid arthritis: a systematic review and meta-analysis.Rev Bras Reumatol. 2016 Nov 26. pii: S0482–5004(16)30144–9.

References

Disclosure of Interest None declared