RESUMO
BACKGROUND AND OBJECTIVE: Periodontitis and rheumatoid arthritis (RA) have been associated in a bidirectional way. The objective of this study was to determine the association between clinical parameters of periodontitis and RA. MATERIALS AND METHODS: Seventy-five (75) participants distributed in 3 groups (21 patients with periodontitis without RA, 33 patients with periodontitis with RA and 21 patients with reduced periodontium with RA) were included in this cross-sectional study. A full periodontal and medical examination was performed in each patient. Additionally, subgingival plaque samples for the detection of Porphyromonas gingivalis (P. gingivalis) and blood samples for biochemical markers of RA were also taken. Logistic regression analysis adjusted for confounding variables, Spearman's rank correlation coefficient and a linear multivariate regression were used to analyze the data. RESULTS: Patients with RA presented less severity of periodontal parameters. The highest levels of anti-citrullinated protein antibodies were detected in non-periodontitis patients with RA. Covariates such as age, P. gingivalis, diabetes, smoking, osteoporosis and use of medication were not associated with RA. All periodontal variables and P. gingivalis expressed a negative correlation with biochemical markers of RA (P<0.05). CONCLUSIONS: Periodontitis was not associated with RA. Furthermore, there was no correlation between periodontal clinical parameters and biochemical markers of RA.
Assuntos
Artrite Reumatoide , Periodontite , Humanos , Estudos Transversais , Artrite Reumatoide/complicações , Porphyromonas gingivalis , BiomarcadoresRESUMO
Non-surgical periodontal therapy (NSPT) has been shown to have systemic effects. It has been suggested that, similar to rheumatoid arthritis (RA), periodontitis (PD) has an impact on general health, in terms of psychological, physical, and social aspects. This study determines the effect of periodontal treatment in RA activity, health-related quality of life, and oral health self-perception before and after periodontal treatment in RA patients. A quasi-experimental, prospective, non-randomized study was conducted, and 52 patients were included in the study. Periodontal parameters and the instruments disease activity score-28 (DAS-28), SF-36, and OHIP-14 were measured at baseline and at 3 months after NSPT. All differences were statistically assessed. The study protocol was registered in Clinical Trials (NCT04658615). No statistically significant differences were found in the scores of DAS-28 before and after the intervention in the group with PD and reduced periodontium. When the effect of periodontal treatment was analyzed in the group of 29 patients who were followed up, it was found that there were statistically significant differences before and after in variables such as psychological distress, emotional role, and mental health, which indicates an improvement in the scores of these variables. NSPT influenced the health-related quality of life measured with SF-36 and OHIP-14 in patients with RA. In conclusion, NSPT has an effect on self-reported quality of life and health indicators more than the RA activity as measured with DAS-28. However, the clinical effect of periodontal treatment in RA patients provides important data to support periodontal care in patients.
Assuntos
Artrite Reumatoide , Qualidade de Vida , Artrite Reumatoide/terapia , Biomarcadores Ambientais , Humanos , Saúde Bucal , Estudos ProspectivosRESUMO
Abstract Background: periodontal therapy has been suggested to have systemic effects. However, studies of periodontal therapy in rheumatoid arthritis patients have produced controversial results. Aim: To compare the effects of nonsurgical periodontal therapy on biochemical markers of rheumatoid arthritis and periodontal parameters in patients with and without rheumatoid arthritis. Methods: a prospective before-and-after study was conducted that included 21 participants without and 29 participants with rheumatoid arthritis. Periodontal parameters, Porphyromonas gingivalis detection, C-reactive protein, rheumatoid factor and anti-citrullinated protein antibodies were measured at baseline and three months after nonsurgical periodontal therapy and the changes were statistically assessed. Results: In general, both groups presented statistically significant improvement in periodontal parameters (p<0.05). There was an increase in the counts of P. gingivalis in both groups at three months. In addition, there was a reduction in levels of anti-citrullinated protein antibodies and rheumatoid factor in participants with rheumatoid arthritis. In contrast, C-reactive protein levels increased in both groups but were higher in the rheumatoid arthritis group. Periodontal parameters in rheumatoid arthritis participants under disease-modifying antirheumatic drugs presented a slightly higher improvement (p <0.05). Conclusions: Nonsurgical periodontal therapy has similar improvements in periodontal parameters in patients with and without rheumatoid arthritis. In addition, nonsurgical periodontal therapy may benefit serum levels of anti-citrullinated protein antibodies and rheumatoid factors in patients with rheumatoid arthritis. NCT04658615.
Resumen Antecedentes: se ha sugerido que la terapia periodontal tiene efectos sistémicos. Sin embargo, los estudios de la terapia periodontal en pacientes con artritis reumatoide han producido resultados controvertidos. Objetivo: comparar los efectos de la terapia periodontal no quirúrgica sobre los marcadores bioquímicos de la artritis reumatoide y los parámetros periodontales en pacientes con y sin artritis reumatoide. Métodos: se realizó un estudio prospectivo de antes y después que incluyó a 21 participantes sin artritis reumatoide y 29 participantes con artritis reumatoide. Se midieron los parámetros periodontales, detección de Porphyromonas gingivalis, proteína C reactiva, factor reumatoide y anticuerpos anti-proteína citrulinada al inicio del estudio y tres meses después de la terapia periodontal no quirúrgica y los cambios se evaluaron estadísticamente. Resultados: En general, ambos grupos presentaron mejoría estadísticamente significativa en los parámetros periodontales (p <0.05). Hubo un aumento en los recuentos de P. gingivalis en ambos grupos a los tres meses. Además, hubo una reducción en los niveles de anticuerpos anti-proteína citrulinada y factor reumatoide en participantes con artritis reumatoide. Por el contrario, los niveles de proteína C reactiva aumentaron en ambos grupos, pero fueron más altos en el grupo de artritis reumatoide. Los parámetros periodontales en los participantes con artritis reumatoide bajo fármacos antirreumáticos modificadores de la enfermedad presentaron una mejoría ligeramente mayor (p <0.05). Conclusiones: La terapia periodontal no quirúrgica tiene mejoras similares en los parámetros periodontales en pacientes con y sin artritis reumatoide. Además, la terapia periodontal no quirúrgica puede beneficiar los niveles séricos de anticuerpos anti-proteína citrulinada y factor reumatoide en pacientes con artritis reumatoide. NCT04658615.
RESUMO
Background: periodontal therapy has been suggested to have systemic effects. However, studies of periodontal therapy in rheumatoid arthritis patients have produced controversial results. Aim: To compare the effects of nonsurgical periodontal therapy on biochemical markers of rheumatoid arthritis and periodontal parameters in patients with and without rheumatoid arthritis. Methods: a prospective before-and-after study was conducted that included 21 participants without and 29 participants with rheumatoid arthritis. Periodontal parameters, Porphyromonas gingivalis detection, C-reactive protein, rheumatoid factor and anti-citrullinated protein antibodies were measured at baseline and three months after nonsurgical periodontal therapy and the changes were statistically assessed. Results: In general, both groups presented statistically significant improvement in periodontal parameters (p<0.05). There was an increase in the counts of P. gingivalis in both groups at three months. In addition, there was a reduction in levels of anti-citrullinated protein antibodies and rheumatoid factor in participants with rheumatoid arthritis. In contrast, C-reactive protein levels increased in both groups but were higher in the rheumatoid arthritis group. Periodontal parameters in rheumatoid arthritis participants under disease-modifying antirheumatic drugs presented a slightly higher improvement (p <0.05). Conclusions: Nonsurgical periodontal therapy has similar improvements in periodontal parameters in patients with and without rheumatoid arthritis. In addition, nonsurgical periodontal therapy may benefit serum levels of anti-citrullinated protein antibodies and rheumatoid factors in patients with rheumatoid arthritis. NCT04658615.
Antecedentes: se ha sugerido que la terapia periodontal tiene efectos sistémicos. Sin embargo, los estudios de la terapia periodontal en pacientes con artritis reumatoide han producido resultados controvertidos. Objetivo: comparar los efectos de la terapia periodontal no quirúrgica sobre los marcadores bioquímicos de la artritis reumatoide y los parámetros periodontales en pacientes con y sin artritis reumatoide. Métodos: se realizó un estudio prospectivo de antes y después que incluyó a 21 participantes sin artritis reumatoide y 29 participantes con artritis reumatoide. Se midieron los parámetros periodontales, detección de Porphyromonas gingivalis, proteína C reactiva, factor reumatoide y anticuerpos anti-proteína citrulinada al inicio del estudio y tres meses después de la terapia periodontal no quirúrgica y los cambios se evaluaron estadísticamente. Resultados: En general, ambos grupos presentaron mejoría estadísticamente significativa en los parámetros periodontales (p <0.05). Hubo un aumento en los recuentos de P. gingivalis en ambos grupos a los tres meses. Además, hubo una reducción en los niveles de anticuerpos anti-proteína citrulinada y factor reumatoide en participantes con artritis reumatoide. Por el contrario, los niveles de proteína C reactiva aumentaron en ambos grupos, pero fueron más altos en el grupo de artritis reumatoide. Los parámetros periodontales en los participantes con artritis reumatoide bajo fármacos antirreumáticos modificadores de la enfermedad presentaron una mejoría ligeramente mayor (p <0.05). Conclusiones: La terapia periodontal no quirúrgica tiene mejoras similares en los parámetros periodontales en pacientes con y sin artritis reumatoide. Además, la terapia periodontal no quirúrgica puede beneficiar los niveles séricos de anticuerpos anti-proteína citrulinada y factor reumatoide en pacientes con artritis reumatoide. NCT04658615.