Abstract
Objectives: To evaluate frequency of periodontitis (PD) in rheumatoid arthritis (RA) patients and relate it with clinical characteristics, disease activity, functional status, anti-cyclic citrullinated peptide (anti-CCP) and radiographic scores.Methods: The study included 60 RA patients and 30 controls. Clinical Disease activity index (CDAI), Modified Health Assessment Questionnaire (MHAQ), visual analogue scale of pain and Scott's modification to Larsen scoring method were assessed. Rheumatoid factor (RF) positivity and anti-CCP titer were measured. Periodontal examination was performed and relevant indices calculated.Results: The mean age of the patients was 49.1 ± 13 years and they were 52 females and 8 males. PD was present in 71.7% of RA patients versus 46.7% in control (p=0.02). PD was predominantly generalized (p=0.004) with moderate-severe degree (p=0.01). Age (p=0.007), disease duration (p<0.0001), morning stiffness (p=0.01), CDAI (p<0.0001), MHAQ (p=0.02), CRP (p=0.02), anti-CCP titer (p=0.01) and methotrexate treatment (p=0.005) were significantly higher in RA-PD versus RA. However, gender, smoking, oral hygiene, erythrocyte sedimentation rate, RF, anti-CCP positivity and radiographic scoring were insignificantly different. PD positivity was 96.3%, predominant generalized in 92.6%, moderate (40.7%) and severe degree (37%) in early RA versus (51.5%, 24.2%, 24.2%, 12.1% respectively) in late RA patients. All PD indices were higher in early patients (p ≤ 0.05) while teeth loss (p=0.03) was higher in late cases. CDAI, VAS and ACPA titer all significantly correlated with PD indices (p<0.05).Conclusion: Periodontitis is frequent in RA patients’ especially in early cases and is remarkably associated to disease activity and reduced functional status.
Highlights
Rheumatoid Arthritis (RA) is a chronic inflammatory autoimmune disease characterized by persistent synovitis, systemic inflammation, production of autoantibodies, and bone destruction preferentially involving the peripheral joints [1]
Disease activity and functional status in RA especially early cases influenced with periodontal status
The importance of peptide citrullinationas an etio-pathological event in RA with development of Anti-Citrulinatted Peptide antibodies [5], and the discovery of a major bacterial species involved in the development and propagation of periodontal disease having a peptide arginine deaminase (PAD) capability of citrullination [6,7] have spotted the light on the possible relation between RA and PD
Summary
Rheumatoid Arthritis (RA) is a chronic inflammatory autoimmune disease characterized by persistent synovitis, systemic inflammation, production of autoantibodies, and bone destruction preferentially involving the peripheral joints [1]. The importance of peptide citrullinationas an etio-pathological event in RA with development of Anti-Citrulinatted Peptide (antiCCP) antibodies [5], and the discovery of a major bacterial species involved in the development and propagation of periodontal disease having a peptide arginine deaminase (PAD) capability of citrullination [6,7] have spotted the light on the possible relation between RA and PD. Both RA and PD present an imbalance between pro-inflammatory and anti-inflammatory cytokines, which is thought to be responsible for the tissue damage resulting in bone destruction [2]. Both RA and PD share a number of pathobiologic processes as similar cellular participation at the inflammatory focus, microenvironmental, serum cytokines, matrix metallo-proteinase and osteoclast-mediated bone destruction [8], common genetic risk factors including the Human Leukocyte Antigen (HLA)-DR shared epitope, polymorphisms and epigenetic modifications in cytokine genes [9] and common interleukin-6 promoter DNA methylation site [10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
