Background Various studies postulate that the prevalence of periodontal disease is greater among patients with rheumatoid arthritis compared to the healthy population.
Objectives To investigate whether the prevalence of periodontal disease is different in our patients with RA compared to healthy population.
Methods Transversal study comparing 2 groups, RA patients and a control group without inflammatory joint pathology. We performed clinical examination of patients in the control appointment with a rheumatologist and within 20 days they were checked by a dentist, who performed the data collection of the control group. Variables included were: age, sex, alcoholism, smoking, oral hygiene measured by the plaque index (PI), bleeding index (PBI), mean periodontal pockets (MPB) and mean attachment loss (MAL) as markers of periodontitis. We consider case of periodontitis if the average of periodontal pockets is > 3 mm. Periodontitis degree was graded as mild (1-2 mm MPI), moderate (MPI 3-4 mm) or severe (MPI ≥ 5), based on the classification of the American Academy of Periodontology. Within the RA group the following variables were also compiled: degree of activity (DAS28), RF and APCC positivity, treatment (corticosteroids, DMARDs and/or biological medications), duration, presence of erosions and association with Sjögren’s Syndrome. We conducted a descriptive study of frequencies for qualitative variables and mean ± standard deviation for quantitative variables. For inferential statistics Chi square (using the continuity correction where necessary) and Mann Whitney u statistics (SPSS v13) were used.
Results There were no statistically significant differences in analyzed variables except in oral hygiene variable (RA patients in our sample had poorer health than controls) and mean average insertion loss. There were no statistically significant differences in the prevalence of periodontitis between RA patients and healthy controls. Severe periodontitis was not detected in either group. There were differences in the degree of periodontitis, with moderate periodontitis being more frequent in patients with RA. In RA group, none of the variables analyzed showed correlation with presence of periodontitis.
Age (median, minimum, maximum): RA (30,69), Controls (42,69) p 0.809 Gender: RA Male18.5% Female81.5%; Controls Male19.4%Female80.6%, p 0.935 Smoking: RA Yes22.2%No77.8%. Controls Yes29%No71%, p 0.555 Alcoholism: RA Yes13.6%No86.4%. Controls: Yes9.7%No90.3%, p 0.993 IP: RA 1.45, Control 0.88, p 0.000 MPP: RA 2.51, Control 2.5, p 0.088 PBI: RA 11.20, Control 10.18, p 0.685 MPI: RA 2.59, Control 2.5, p 0045 Presence of periodontitis: RA Yes 22.2%No77.8%, Controls Yes12.9%No87.1%, p 0.556 Degree of periodontitis: RA Mild44.4%Moderate55.6%Severe0;Controls Mild71%Moderate29% Severe 0, p 0.041
Conclusions We found no differences in prevalence of periodontitis between RA patients and global population. However, differences in the degree of periodontitis were detected, and also in insertion loss, perhaps due to functional deterioration of our patients. Main limitation of our study is the sample size. It is called to extend the study to a larger number of subjects in order to extrapolate to the population.
Disclosure of Interest None Declared
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