Klinische Querschnittstudie zur möglichen Assoziation rheumatoider Arthritis und parodontaler Gesundheit - Ein Vergleich zwischen Patienten mit rheumatoider Arthritis und allgemein Gesunden

Abstract

The objective of this clinical cross-sectional study was to analyse rheumatoid arthritis patients (RA) in regard to their periodontal healthiness and compare it with healthy, non rheumatoid arthritis patients. Diagnosed and treated RA-patients were considered for the study. A control group (C) of healthy individuals was created matched to their age, gender and smoking behavior. Questionaires on general health and medication were applied from all participants . In addition, in all RA-patients the disease duration, disease activity by Disease Activity Score using 28 joints (DAS-28), the rheumatoid factor and anti citrullinated protein antibodies were noted. All participants had an oral examination included dental finding (Decayed, Missing, Filled Teeth-Index, DMF-T), gingival inflamation (Papilla Bleeding Index, PBI) and periodontal status on six sites per tooth assessing probing pocket depth (PD), bleeding on probing (BOP), missing teeth and clinical attachment loss (CAL) were measured. The classification of the periodontal disease was established based on PD and/or CAL in healthy/mild, moderate or pronounced periodontitis. Statistical analysis made by Cochran-Armitage-Test for Trend, Wilcoxon Two Sample Test and Fisher`s Exact Test. The significance level was α=5%. In total, 103 RA-patients (55,5±11,0 Years, female=58, average duration of disease: 11,1±15,9 Years) and 104 healthy controls (56,7±11,9 Years, female=68) were considered. DMF-T (RA: 17,6±6,1 / C: 16,0 ± 6,5) and PBI (RA: 0,10±0,18 / C 0,08±0,18) didn`t show any significant differences (p>0,05); however, RA-patients had on average one tooth less (missing-teeth: RA: 5,3±5,4 / C: 4,2±4,5). The average PD (RA: 3,2±1,1 / C: 3,4±1,3) and CAL (RA: 3,4±1,3 / C: 3,5±1,5) was minor, but significantly increased (p 0,05). Under bidirectional consideration, the results of this study do not show a clear relationship between rheumatoid arthritis and periodontal disease. However, it has to be considered that a majority of the RA-patients had a periodontal disease.