Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi Gakuin University, Aichi, Japan.
Hashimoto Orthopedic Surgery Clinic, Aichi, Japan.
J Periodontol. 2018 Sep;89(9):1033-1042. doi: 10.1002/JPER.17-0575. Epub 2018 Aug 14.
Functional disability of the finger joints in rheumatoid arthritis (RA) patients could affect their oral hygiene and periodontal status because of poor plaque control. We examined the influence of plaque control on the relationship between the severity of RA and periodontal status in RA patients.
This study recruited 89 Japanese RA patients who reported no difficulty in performing oral hygiene. We assessed RA severity using four indices: the Steinbrocker stage and class, the Health Assessment Questionnaire (HAQ) and the Disease Activity Score (DAS). Probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) were taken as parameters of periodontal status. Oral hygiene status was assessed using the plaque index (PlI). We examined the association between the severity of RA and periodontal parameters using multivariable linear regression analyses.
In multivariable linear regression analyses not including PlI, Steinbrocker stage III-IV patients had significantly higher PlI scores and greater PD compared with those of stage I. The class III-IV patients had significantly higher PlI scores and greater PD. Patients with an HAQ score ≥0.5 had a significantly higher PlI score than those with an HAQ score of 0. However, when PlI was added to each multivariable model as an independent variable, no significant relationship between RA severity and periodontal status was observed.
This study suggests that it is important to consider the influence of plaque control when assessing the relationship between RA severity and periodontal health status in RA patients.
类风湿关节炎 (RA) 患者手指关节功能障碍会影响其口腔卫生和牙周状况,因为他们难以控制牙菌斑。我们研究了控制牙菌斑对 RA 严重程度与 RA 患者牙周状况之间关系的影响。
本研究纳入了 89 名自述口腔卫生无困难的日本 RA 患者。我们使用 Steinbrocker 分期和分级、健康评估问卷 (HAQ) 和疾病活动评分 (DAS) 评估 RA 严重程度。牙周状况的参数包括探诊深度 (PD)、临床附着丧失 (CAL) 和探诊出血 (BOP)。采用菌斑指数 (PlI) 评估口腔卫生状况。我们采用多变量线性回归分析,研究 RA 严重程度与牙周参数之间的关系。
在未纳入 PlI 的多变量线性回归分析中,Steinbrocker 分期 III-IV 患者的 PlI 评分和 PD 显著高于分期 I 患者。III-IV 级患者的 PlI 评分和 PD 显著更高。HAQ 评分≥0.5 的患者的 PlI 评分显著高于 HAQ 评分 0 的患者。然而,当将 PlI 作为独立变量纳入每个多变量模型时,RA 严重程度与牙周状况之间没有显著关系。
本研究表明,在评估 RA 患者 RA 严重程度与牙周健康状况之间的关系时,考虑牙菌斑控制的影响很重要。