Pinho Márcia de Noronha, Oliveira Renê Donizeti Ribeiro, Novaes Arthur Belém, Voltarelli Júlio César
Dental School of Campinas, Pontifical Catholic University, Campinas, SP, Brazil.
Braz Dent J. 2009;20(5):355-64. doi: 10.1590/s0103-64402009000500001.
This study analyzed the association of periodontal disease (PD) and rheumatoid arthritis (RA). Seventy-five 35-60-year-old patients were assigned to 5 groups according to the presence (+) or not (-) of PD and RA and the treatment received (TR+) or not (TR-) for PD. Group 3 uses total prosthesis (TP). Clinical and laboratory evaluations were performed at baseline, 3 and 6 months of follow-up by probing pocket depth, bleeding on probing and plaque index for PD, HAQ, DAS28, SF-36 and laboratory: AAG, ESR, CRP for RA. Statistically significant differences for PD after 3 (p=0.0055) and after 6 months (p=0.0066) were obtained in Group 1 (RA+PD+TR+) and 2(RA+PD+TR-); significant reduction in the % of BOP after 6 months (p=0.0128) and significant reduction in the % of Pl after 3 (p=0.0128) and 6 months (p=0.0002) in Group 1. Statistically significant differences between Groups 1 and 3 (RA+TP) for DAS28 at baseline and after 3 months were observed, but not after 6 months. No other parameters for RA were significantly affected. The relationship between RA and PD disease activities is not clear, but the importance of periodontal treatment in the control of inflammation to avoid tooth extraction is evident.
本研究分析了牙周病（PD）与类风湿性关节炎（RA）之间的关联。75名35至60岁的患者根据是否患有PD和RA以及是否接受PD治疗（TR+或TR-）被分为5组。第3组使用全口义齿（TP）。在基线、随访3个月和6个月时进行临床和实验室评估，评估指标包括PD的探诊深度、探诊出血和菌斑指数，RA的健康评估问卷（HAQ）、疾病活动评分28（DAS28）、健康调查简表36（SF-36）以及实验室指标：RA的α1抗胰蛋白酶（AAG）、红细胞沉降率（ESR）、C反应蛋白（CRP）。在第1组（RA+PD+TR+）和第2组（RA+PD+TR-）中，3个月后（p=0.0055）和6个月后（p=0.0066）PD有统计学显著差异；第1组6个月后探诊出血百分比显著降低（p=0.0128），3个月后（p=0.0128）和6个月后（菌斑百分比）显著降低（p=0.0002）。在基线和3个月后，第1组和第3组（RA+TP）之间DAS28有统计学显著差异，但6个月后无差异。RA的其他参数均未受到显著影响。RA与PD疾病活动之间的关系尚不清楚，但牙周治疗在控制炎症以避免拔牙方面的重要性是显而易见的。
