Abstract
Background: Periodontitis (PD) is well-known chronic disease affecting the periodontal ligament and alveolar bone, Osteoarthritis (OA) is a chronic joint disease with compound reasons characterized by synovial inflammation, subchondral bone remodeling, also the formation of osteophytes, that cause cartilage degradation. Chronic periodontitis and osteoarthritis are considered widely prevalent diseases and related to tissue destruction due to chronic inflammation in general health and oral health. The aim of this study is todetermine the association of chronic periodontitis and osteoarthritits in patients by analysing tumor necrosis factor alpha TNFα and high sensitive c-reactive protein (hsCRP) in the serum. Materials and Method: A total of 80 patients of both sexes aged 35-50 years ,30 patients with osteoarthritis and moderate chronic periodontitis (CP+OA), 30 patients of both sexes aged 35-50 years with moderate chronic periodontitis alone (CP). And control group (C) of 20 healthy patients with healthy periodontium participated in this cross sectional study. we excluded the postmenopausal and pregnant woman from female patient and smoker patient also. All patients are free of medication and have good general health with no history of systemic disease. Participants with OA have documentation or radiographic imaging, consistent with degenerative arthritis in the absence of an inflammatory condition. Venous blood samples were drawn from each subject using pyrogen-free heparinized collection tubes. Tubes were centrifuged according to the manufacturer’s guidelines, then stored at -15°C till analyse. serum TNFα and hs CRP were measured using an enzyme-linked immunosorbent assay (ELISA). Results: A non-significant differences between studied group regarding serum level of hsCRP and TNF-α, as well as, the result revealed that the median of serum levels of hsCRP were little higher in chronic periodontitis with osteoarthritis group than chronic periodontitis group and control groups represent as 0.31, 0.29, and 0.24. Similarly, the medium serum level of TNFα was higher in chronic periodontitis with OAthan in other two groups (10.615, 10.533, and 9.682 respectively). The age and gender showed a non-significant difference between the groups Conclusion: The present study revealed that there’s a strong positive correlation between serum levels of hsCRP and TNFα in patients of all groups but there is no correlation between Osteoarthritis and chronic periodontitis.
Highlights
PD, is considered one of the common oral diseases, it is a destructive inflammatory disorder affecting the tissues that support teeth and it is mostly associated with range of pathogenic bacteria (Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia together with Aggregatibacteractinomycetem-comitans) (1), PD is characterized by both chronic inflammation of connective tissue and alveolar bone destruction which lead to loss of tooth-supporting apparatus (2)
Statistical analysis showed that there were non-significant differences regarding gender and these demographic data is coinciding with a study done in Europe by Lugonja et al (11) they mentioned that no significant difference in terms of gender and age between chronic periodontitis alone (CP)+OA group and CP group and agree with study of Torkzaban et al (12) which found no correlation between gender and any of periodontal indices. this study disagrees with the study done by Pokrajac‐Zirojevic et al (13) which found the association between OA and gender was proven to be highly significant with female more commonly affected with OA than male (P=0.001)
The present study reported non-significant correlation of TNFα among the groups, TNFα was increased in OA+CP group more than CP and C group, TNFα has an important role in inflammatory arthritis and in degenerative joint disease (14) it may be from the fact that human articular chondrocytes from OA cartilage expressed a significantly higher number of the p55 TNFα receptor which could make OA cartilage susceptible to TNFα degradative stimuli(15). associated with the level of OA severity
Summary
PD, is considered one of the common oral diseases, it is a destructive inflammatory disorder affecting the tissues that support teeth and it is mostly associated with range of pathogenic bacteria (Porphyromonas gingivalis, Tannerella forsythia, Prevotella intermedia together with Aggregatibacteractinomycetem-comitans) (1), PD is characterized by both chronic inflammation of connective tissue and alveolar bone destruction which lead to loss of tooth-supporting apparatus (2). Monocytes and macrophages are the most important cell types producing TNF-α(10) These cytokines are normally found in the blood and increase with inflammation so in this study we determine the level of TNFα and hsCRP in the serum of the patient to determine the degree of inflammation in chronic periodontitis and osteoarthritis. The aim of this study is todetermine the association of chronic periodontitis and osteoarthritits in patients by analysing tumor necrosis factor alpha TNFα and high sensitive c-reactive protein (hsCRP) in the serum. The age and gender showed a non-significant difference between the groups Conclusion: The present study revealed that there’s a strong positive correlation between serum levels of hsCRP and TNFα in patients of all groups but there is no correlation between Osteoarthritis and chronic periodontitis.
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