Association between rheumatoid arthritis and periodontal disease: A meta-analysis

Abstract

Rheumatoid arthritis (RA) is related to periodontal disease (PD) because both diseases share similar inflammatory pathogenic mechanisms that produce bone resorption. To assess the possible bidirectional link between RA and PD. A search for articles on RA and PD was conducted in the following electronic databases: PubMed (MEDLINE, Cochrane Library), Web of Science (WoS), and Google Scholar. Twenty-two studies with a low-moderate risk of bias according to the Newcastle-Ottawa Methodological Quality Scale were considered in this meta-analysis. The data were analyzed using the Statistical Software RevMan 5.4 (The Cochrane Collaboration, Oxford, UK). For continuous outcomes, the estimates of effects of the intervention were expressed as mean differences (MDs) using the inverse variance method, and for dichotomous outcomes, the estimates of effects of the intervention were expressed as odds ratios (OR) using the Mantel-Haenszel method, both with 95% confidence intervals. Patients with RA showed higher levels of: Plaque index (MD: 0.10; P < 0.001), gingival index (MD: 0.31; P < 0.001), probing depth (MD: 0.45; P < 0.001), clinical attachment loss (MD: 0.59; P < 0.001), and bleeding on probing (MD: 8.06; P < 0.001). They also had a lower number of remaining teeth (MD:-0.80; P = 0.27) and a greater number of missing teeth (MD: 2.70; P < 0.001). These same patients had a higher risk of both moderate (OR: 2.90; P = 0.008) and severe periodontitis (OR: 2.78; P = 0.01). Patients with RA have a higher risk of moderate-severe PD and a worsening of all periodontal parameters.