Abstract
BackgroundPeriodontitis has been regarded as a potential risk factor for rheumatoid arthritis (RA). A systematic review is made to determine whether nonsurgical periodontal treatment in patients with RA offers benefits in terms of the clinical activity and inflammatory markers of the disease.Material and MethodsA search was made of the Medline-PubMed, Cochrane, Embase and Scopus databases to identify studies on the relationship between the two disease processes, and especially on the effects of nonsurgical treatment in patients of this kind. The search was based on the following keywords: rheumatoid arthritis AND periodontitis (MeSH), rheumatoid arthritis AND periodontal treatment.ResultsEight articles on the nonsurgical treatment of patients with periodontitis and RA were finally included in the study. All of them evaluated clinical (DAS28) and laboratory test activity (ESR, CRP, IL-6, TNFα) before and after treatment. A clear decrease in DAS28 score and ESR was recorded, while other parameters such as CRP, IL-6 and TNFα showed a non significant tendency to decrease as a result of treatment.ConclusionsNonsurgical treatment improved the periodontal condition of patients with periodontitis and RA, with beneficial effects upon the clinical and laboratory test parameters (DAS28 and ESR), while other inflammatory markers showed a marked tendency to decrease. However, all the studies included in the review involved small samples sizes and follow-up periods of no more than 6 months. Larger and particularly longitudinal studies are therefore needed to more firmly establish possible significant relations between the two disease processes. Key words:Periodontitis, rheumatoid arthritis, periodontal treatment.
Highlights
Periodontal disease (PD) is one of the most frequent oral disorders, in elderly patients, and is one of the most common causes of tooth loss
Rheumatoid arthritis is an autoimmune disease characterized by chronic inflammation of the joints, the small joints of the hands and feet, with progressive destruction resulting in variable degrees of deformity and functional disability
A number of laboratory test parameters may experience clear alterations during the active phases of rheumatoid arthritis (RA), such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), interleukin 1β (IL-1β), interleukin 6 (IL-6) or tumor necrosis factor-α (TNFα) [5,10]. With regard to this possible bidirectional relationship between PD and RA, changes have been described in the aforementioned biochemical markers after nonsurgical periodontal treatment, implying a decrease in the inflammation generated at periodontal level, and this in turn could exert a positive influence upon RA
Summary
Journal section: Medically compromised patients in Dentistry Publication Types: Review doi:10.4317/medoral.20974 http://dx.doi.org/doi:10.4317/medoral.20974. Francisco-Javier Silvestre 1, Javier Silvestre-Rangil 2, Leticia Bagan 3, Jose V. Silvestre FJ, Silvestre-Rangil J, Bagan L, Bagan JV. Effect of nonsurgical periodontal treatment in patients with periodontitis and rheumatoid arthritis: A systematic review. Med Oral Patol Oral Cir Bucal. 2016 May 1;21 [3]:e349-54
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