Abstract
BackgroundsTo date, there is still no consensus about the clinical efficacy of non-surgical periodontal therapy in rheumatoid arthritis (RA) patients with periodontitis. Therefore, the aim of this study was to summarize clinical data regarding the efficacy of scaling and root planing (SRP) in patients with RA and periodontitis compared to non-RA periodontitis patients.MethodsWe selected randomized controlled trials (RCTs) that compared periodontal clinical data in RA as compared to non-RA periodontitis patients by searching Embase, PubMed and Cochrane Central Register of Controlled Trials and by manually retrieving from the earliest records to March 8, 2021. The overall effect size of plaque index (PI), gingival index (GI), attachment loss (AL), probing depth (PD) and bleeding on probing (BOP) were calculated by either a fixed or random-effect model, and subgroup analyses were conducted according to the different time points of follow-up. Two investigators extracted the data and assess the accuracy of the obtained results with 95% of Confidence Intervals (CI). Cochrane Collaboration's tool was responsible for the evaluation of the literature quality and the inter-study heterogeneity was evaluated by Q test and I2 statistic. Sensitivity analyses were applied for results with heterogeneity. Publication bias was determined by Begg's test, Egger's test and the trim-and-fill method.ResultsSeven RCTs including 212 patients eventually met the inclusion criteria for the study. As the primary results, the change of PD was not statistically significant and in the secondary results changes of PI, GI, AL and BOP were also not statistically significant in RA patients with periodontitis compared to non-RA periodontitis patients. In subgroup analysis, a larger BOP reduction at 3 months, PI and AL reduction at 6 months were observed in patients with RA and periodontitis group. The results of sensitivity analyses had no significant effect. No evidence of potential publication bias was tested. There were some limitations due to the small number of eligible RCTs.ConclusionsSRP is equally effective in RA as compared to non-RA periodontitis patients. It suggests RA does not affect the clinical efficacy of non-surgical periodontal therapy. These results could serve evidence-based practice.
Highlights
Periodontitis is a chronic inflammation of the periodontal tissues, with negative impact on both local and systemic health
Literature selection At the beginning, a total of 914 records were identified through database searching, and eight additional records identified through other sources
After removal of the duplicates, 798 publications were identified for independent screening, of which 769 were deemed irrelevant on the basis of their title and abstract and 29 publications were eligible for full-text evaluation
Summary
Periodontitis is a chronic inflammation of the periodontal tissues, with negative impact on both local and systemic health. In a comprehensive epidemiological report in 1990 and 2010 of severe periodontitis (SP), a global age-standardized rate of severe periodontitis was reported to be high around 11.2% [3]. It suggested a growing global health threat from severe periodontitis. There is strong evidence that people with RA have elevated risk for inflammation of periodontal ligament, respiratory mucosa and intestinal mucosa to some extent [15]. The mechanisms accounting for the aggravation of periodontitis by RA are not completely clarified
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