de Pablo Paola, Chapple Iain L C, Buckley Christopher D, Dietrich Thomas
Rheumatology Research Group, School of Immunity and Infection, College of Medical and Dental Sciences, University of Birmingham, Edgbaston Birmingham, UK.
Nat Rev Rheumatol. 2009 Apr;5(4):218-24. doi: 10.1038/nrrheum.2009.28.
Periodontitis is a chronic inflammatory disease that is characterized by loss of the periodontal ligament and alveolar bone, and is a major cause of tooth loss. Results from clinical and epidemiologic studies have suggested that periodontitis and tooth loss are more prevalent in individuals with rheumatoid arthritis (RA). However, the strength and temporality of the association are uncertain. Several biologically plausible causal and noncausal mechanisms might account for this association between periodontitis and RA. There is evidence to suggest that periodontitis could indeed be a causal factor in the initiation and maintenance of the autoimmune inflammatory response that occurs in RA. If proven, chronic periodontitis might represent an important modifiable risk factor for RA. In addition, patients with RA might show an increased risk of developing periodontitis and tooth loss through various mechanisms. Moreover, exposure to common genetic, environmental or behavioral factors might contribute to a noncausal association between both conditions.
牙周炎是一种慢性炎症性疾病，其特征是牙周韧带和牙槽骨丧失，是牙齿脱落的主要原因。临床和流行病学研究结果表明，类风湿性关节炎（RA）患者中牙周炎和牙齿脱落更为普遍。然而，这种关联的强度和时间顺序尚不确定。几种生物学上合理的因果和非因果机制可能解释牙周炎与RA之间的这种关联。有证据表明，牙周炎确实可能是RA中发生的自身免疫炎症反应启动和维持的一个因果因素。如果得到证实，慢性牙周炎可能是RA的一个重要可改变风险因素。此外，RA患者可能通过各种机制出现患牙周炎和牙齿脱落的风险增加。此外，暴露于常见的遗传、环境或行为因素可能导致这两种疾病之间的非因果关联。
