Relationship between clinical and laboratory findings of rheumatoid arthritis patients with their oral status and disease activity (original) (raw)
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Oral health status in outpatients with rheumatoid arthritis: the OSARA study
Oral health and dental management, 2014
Observational studies and clinical trials are increasingly highlighting significant associations between periodontitis (chronic, infectious, inflammatory disease affecting tooth supporting tissues) and rheumatoid arthritis (chronic systemic autoimmune disease). The aim of the study was to describe the dental, periodontal and oral prosthetic status of outpatients with Rheumatoid Arthritis (RA). The study was conducted from June 2010 to March 2011 in the Rheumatology Day Care Department of the University Teaching Hospital, Toulouse. Activity of the RA was defined according to disease activity score 28 (DAS28). 74 subjects with RA were included. Periodontal status was determined using measurements of pocket depth, bleeding on probing and attachment loss. Periodontal Epithelial Surface Area (PESA) and Periodontal Inflamed Surface Area (PISA) were calculated. The study population was 60.3 ± 11.9 years old with 75.7% women. 48.6% of the subjects had moderate RA (3.2 < DAS28 ≤ 5.1) and ...
Evaluation of Periodontal health in rheumatoid arthritis patients
Background and aims There is a hypothesis that people with rheumatoid arthritis (RA) can also be at risk of periodontal disease. This study aimed to assess the periodontal health in patients with and without rheumatoid arthritis. Materials and methods Thirty RA patients with RA and 30 healthy individuals without RA were included. Information regarding demographic characteristics and periodontal parameters (probing pocket depth, attachment loss, plaque index, simplified oral hygiene index and modified gingival index) were recorded. Results There was no significant difference in periodontal parameters between participants with and without RA. Conclusion According to the cross-sectional pattern of the present study, further evaluation is needed to determine the possible role of RA in the periodontal status of patients.
Prevalence of Periodontitis in Patients with Rheumatoid Arthritis
International journal of health sciences
Background and Aim: Rheumatoid arthritis (RA) patients are more susceptible to the initiation of severe periodontitis which can ultimately intensify their systemic inflammation associated with RA. The present study aimed to determine the incidence of periodontitis in rheumatoid arthritis patients. Materials and Methodology: A cross-sectional analytical study was carried out on 168 rheumatoid arthritis patients in the Department of Dentistry and Internal Medicine of a Tertiary Care Hospital of Lahore, Pakistan from January 2022 to December 2022. All the patients were inquired about their demographic details, medical history and smoking habits. A detailed periodontal examination of full mouth was done and plaque index, clinical attachment level (CAL) and probing pocket depth (PPD) was measured. Rheumatoid factor (RF)’s presence, number of tender and swollen joints, erythrocyte sedimentation rate (ESR); Disease Activity Index (DAS) and hand radiographs were the different RA parameters ...
Periodontitis And Rheumatoid Arthritis: A Case-Control Study
SBR 2021 Congresso Brasileiro de Reumatologia, 2021
BACKGROUND Periodontitis and rheumatoid arthritis (RA) may be linked to each other. In both diseases, hard and soft tissue destruction is seen with pro inflammatory cytokines such as IL (interleukin)-6, TNF-alpha and IL-1 playing a role. Several studies have detected increased periodontal disease in RA patients and periodontitis is considered to influence in the RA appearance and in the disease activity. The aim of this work was to study the oral health of RA patients comparing it with controls in a Brazilian sample from a public health rheumatologic center. METHODS One hundred and sixteen RA patients and 68 controls (patients' companions) were compared for epidemiological data and presence of periodontal disease evaluated by number of remaining teeth, presence of bacterial plaque, bleeding on probing, probing depth and clinical level of gingival insertion. Periodontitis was classified in severe, moderate and mild. Data on comorbidities was also collected RESULTS Patients and controls were paired for gender, age, tobacco use, years of formal education and presence of diabetes mellitus, hypothyroidism, hypertension and dyslipidemia. Rheumatoid arthritis patients and controls have the same amount of teeth loss/ person (11 vs. 9; p = 0.84); RA patients had more calculus (p = 0.02); dental plaques (p = 0.04); gingival retraction (p = 0.02) and bleeding (p = 0.01). Although the number of individuals with periodontitis was higher in RA patients (56.1% vs. 32.8%), the severity of periodontitis was similar in both groups (p = ns). Diabetes and hypothyroidism also associated with periodontitis (p = 0.01 and 0.02, respectively). In a model of logistic regression built to assess the independence of association of RA and its comorbidities with periodontitis, only diabetes (p = 0.006; OR = 5.2; 95%CI = 1.5-17.1) and RA (p = 0.01; OR = 2.45; 95%CI = 1.1-5.2) remained independent. CONCLUSION This case control study shows that oral health in RA patients is poorer than controls. Diabetes mellitus also associated with periodontitis.
Comparative Evaluation of Periodontal Status in Rheumatoid Arthritis
Aim: Periodontitis, a chronic infectious disease, affects most of the population at one time or the other and its expression is a combination of hosts, microbial agents, and environmental factors. Extensive literature exists for the relationship between periodontal disease and diabetes mellitus, cardiovascular diseases, and adverse pregnancy outcomes. Only a few studies performed in a limited number of patients have reported periodontal health status in chronic renal failure patients. Hence, the aim of the present study is to assess and compare the periodontal status of patients with chronic renal failure undergoing dialysis, predialysis with systemically healthy individuals. Materials and methods: A total of 90 patients were divided into three groups. Group I: 30 renal dialysis patients. Group II: 30 predialysis patients. Control group comprised 30 systemically healthy patients who formed group III. Periodontal examination was carried out using oral hygiene index-simplified (OHI-S), plaque index (PI), gingival index (GI), probing depth, and clinical attachment loss. Results: The results of the study showed that the periodontal status of patients with chronic renal failure undergoing dialysis (dialysis group) and patients with chronic renal failure not undergoing renal dialysis (predialysis) when compared with systemically healthy subjects showed significantly higher mean scores of OHI-S, PI, and clinical attachment loss. Conclusion: Thus, patients with chronic renal failure showed poor oral hygiene and higher prevalence of periodontal disease. Clinical significance: The dental community's awareness of implications of poor health within chronic renal failure patients should be elevated.
Activity of rheumatoid arthritis correlates with oral inflammatory burden
Rheumatology international, 2018
To study oral health in patients with rheumatoid arthritis (RA) with emphasis on disease activity and treatment of RA. In this prospective cohort study 81 RA patients [53 early untreated RA (EURA) and 28 chronic RA (CRA) patients with inadequate response to synthetic disease modifying antirheumatic drugs (DMARDs)], underwent rheumatological [Disease Activity Score (28-joint) DAS28] and dental examinations [Total Dental Index (TDI), Decayed Missing Filled Teeth (DMFT) and Decayed Missing Filled Surfaces (DMFS)]. For controls, 43 volunteers were examined. After the examinations, EURA patients started treatment with synthetic DMARDs, oral and intra-articular glucocorticoids. CRA patients were candidates for biological DMARDs. The patients were re-examined mean 16 months later. Results were analyzed with descriptive statistics and logistic regression. TDI was higher in both RA groups at baseline compared to controls [EURA: 2 (2-3); CRA: 2 (1-3); controls 1 (1-3), p = 0.045]. DMFT [r 0.5...
Effect of rheumatoid arthritis on periodontitis: a historical cohort study
Journal of Periodontal & Implant Science, 2012
Purpose: Rheumatoid arthritis (RA) is a chronic multi-systemic disease that causes damage to the bone and connective tissues. This study was conducted in order to accurately measure the correlation between RA and periodontitis, and to obtain an unbiased estimate of the effect of RA on periodontal indices. Methods: In this historical cohort study, which was conducted from February to May 2011 in Hamadan city, Iran, 53 exposed people (with RA) were compared with 53 unexposed people (without RA) in terms of clinical periodontal indices (the outcomes of interest) including 1) plaque index (PI), 2) bleeding on probing (BOP), and 3) clinical attachment loss (CAL). Results: A sample of 106 volunteers were evaluated, 53 rheumatoid versus 53 non-rheumatoid subjects. There was a statistically significant correlation between RA and BOP (P < 0.001) and between RA and CAL (P < 0.001). However, there was no statistically significant correlation between RA and any of the periodontal indices. No correlation was seen between gender and any of the indices either. There was a strong positive correlation between age and all three periodontal indices (P < 0.001). Conclusions: The present study indicated a potential effect of RA on periodontal indices. However, much more evidence based on a prospective cohort study is needed to support the cause and effect relationship between RA and periodontal indices.
Oral hygiene and periodontal status in a group of patients with rheumatoid arthritis
Indian Journal of Rheumatology, 2011
Background: Periodontitis (PD) and rheumatoid arthritis (RA) having similar clinico-pathological characteristics frequently affect the middle-aged population. Objectives: To study the oral hygiene (OH) and periodontal disease (PD) status in patients with RA and without RA (control) and to investigate the association between PD and RA. Methods: OH and PD were assessed in RA patients (n = 35) and controls (n = 35) using plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD) and connective tissue attachment loss (AL). RA severity was determined with a standardized disease activity score (DAS). Results: Mean age of RA and control groups were 54.7 ± 9.9 and 51.1 ± 7.1 years. Either group female participation was 91.4%. PI and AL in the RA group positively correlated with DAS (Spearman's rho 0.48, 0.67; P ≤ 0.01). PI, BOP, PPD and AL were higher in RA patients (P ≤ 0.01) than the control. RA group had higher mean number of missing teeth (16.1 ± 7.8) than control (6.5 ± 3.6) (P ≤ 0.01). Conclusions: RA is common in middle-aged females. RA patients' PI and DAS showed positive correlation which could be attributed to compromised OH practice resulted by increasing severity of RA. AL in RA group had positive correlation with DAS implying that severe PD leads to severe arthritis and vice versa. PI, BOP, PPD and AL are high in RA patients showing that they are prone to PD. RA patients may also lose teeth early.
Arthritis Research & Therapy, 2019
Abstract Background: A high prevalence of periodontitis has been reported in rheumatoid arthritis (RA) patients, although the strength of this association, its temporal link and the possible relationship between the severity of periodontitis and RA disease activity remain unclear. The objective of this work was to investigate whether periodontitis is associated with RA and whether periodontitis severity is linked to RA disease activity. Methods: This case–control study included 187 patients diagnosed with RA and 157 control patients without inflammatory joint disease. RA disease activity and severity were evaluated by the Disease Activity Score 28, the Simplified Disease Activity Index, the Clinical Disease Activity Index, rheumatoid factor, anti-citrullinated protein antibody titers, the erythrocyte sedimentation rate, C-reactive protein, presence of extra-articular manifestations and type of RA therapy. Exposure severity was assessed by the following periodontal parameters: plaque index, bleeding on probing, probing pocket depth and clinical attachment levels. Sociodemographic variables and comorbidities were evaluated as confounding variables. Outcome and exposure variables were compared by both parametric and nonparametric tests, and possible associations were assessed through regression analysis with a calculation for the adjusted odds ratio (OR). Results: A significant association was demonstrated between periodontitis and RA with an adjusted OR of 20.57 (95% CI 6.02–70.27, p < 0.001). Compared with controls, all parameters related to periodontal status (plaque index, bleeding on probing, probing pocket depth and clinical attachment levels) were significantly worse in RA patients (p < 0.001). Periodontitis severity was significantly associated with RA disease activity (p < 0.001), showing in an ordinal logistic regression model an association between periodontal severity and disease activity with an adjusted OR of 2.66 (95% CI 1.24–5.74, p = 0.012). Conclusion: A significant association was demonstrated between periodontitis and RA, independent of other confounders. This association was more evident in patients with pronounced periodontal disease and higher RA disease activity.
The interrelationship of periodontitis and rheumatoid arthritis
Den norske tannlegeforenings Tidende, 2020
Rheumatoid arthritis (RA) and periodontitis are both common chronic inflammatory diseases and may associate bidirectionally. The diseases show several similarities in their pathogenesis i.e. inflammatory mediators, cytokines and proteolytic enzymes are largely similar, with a tissue degrading profile in the two conditions. Soft as well as hard tissues are affected. Both are multifactorial disorders, influenced by a combination of host, lifestyle (smoking), environmental and genetic components, and both have a cyclic nature, fluctuating between chronic and acute periods. The clinical course of periodontitis in RA patients has been reported as more severe independent of age, gender, ethnicity, or smoking history, and RA patients suffer from increased tooth loss and attachment loss compared with controls.