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Extended report
Periodontal disease in patients with ankylosing spondylitis
  1. N Pischon1,
  2. T Pischon2,
  3. E Gülmez1,
  4. J Kröger1,
  5. P Purucker1,
  6. B-M Kleber1,
  7. H Landau3,
  8. P-G Jost-Brinkmann3,
  9. P Schlattmann4,
  10. J Zernicke5,
  11. G-R Burmester5,
  12. J-P Bernimoulin1,
  13. F Buttgereit5,
  14. J Detert5
  1. 1
    Department of Periodontology, Charité – Universitätsmedizin Berlin, Germany
  2. 2
    Department of Epidemiology, German Institute of Human Nutrition, Potsdam-Rehbrücke, Germany
  3. 3
    Department of Orthodontics, Dentofacial Orthopedics and Pedodontics, Charité – Universitätsmedizin Berlin, Germany
  4. 4
    Institute for Biometry and Clinical Epidemiology, Charité – Universitätsmedizin Berlin, Germany
  5. 5
    Department of Rheumatology and Clinical Immunology, Charité – Universitätsmedizin Berlin, Germany
  1. Correspondence to Dr N Pischon, Department of Periodontology, Charité – Universitätsmedizin Berlin, Campus Virchow, Augustenburger Platz 1, 13353 Berlin, Germany; nicole.pischon{at}


Objective: Ankylosing spondylitis (AS) and periodontal disease (PD) are characterised by dysregulation of the host inflammatory response, resulting in soft and hard connective tissue destruction. AS has been related to other inflammatory diseases, however, there is a paucity of data on whether AS is associated with inflammatory PD.

Methods: The association between AS and PD was examined in 48 patients with AS and 48 healthy controls, matched for age and gender. AS was diagnosed according to the modified New York criteria. Periodontal examination included probing pocket depth (PPD), clinical attachment loss (CAL), plaque index (PI) and bleeding on probing (BOP). Potential risk factors of PD such as smoking, low education, alcohol consumption, body mass index (BMI), as well as chronic diseases associated with PD and AS were assessed through questionnaires.

Results: In stepwise logistic regression, including AS status, age, gender, education, smoking, alcohol consumption and BMI, only AS status, age and education remained significant predictors of PD. Patients with AS had significant 6.81-fold increased odds (95% CI 1.96 to 23.67) of PD (defined as mean attachment loss >3 mm) compared to controls. The strength of the association was attenuated but remained statistically significant after further adjustment for plaque accumulation (odds ratio (OR) 5.48, 95% CI 1.37 to 22.00).

Conclusions: The present study shows that patients with AS have a significantly higher risk of PD, strongly suggesting the need for close collaboration between rheumatologists, periodontists and dental hygienists when treating patients with AS.

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  • Funding This work was financially supported by grants of the German Research Foundation (DFG) GK 325, Bonn, Germany and a Habilitation Fellowship from the Charité – Universitätsmedizin Berlin, Germany to NP.

  • Competing interests None declared.

  • Ethics approval Ethics approval was granted by the Ethics Committee, Charité – Universitätsmedizin, Berlin, Germany.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

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