Periodontal pathogens and the association between periodontitis and rheumatoid arthritis in Korean adults.

PURPOSE

Periodontitis and rheumatoid arthritis (RA) share a similar inflammatory pathogenesis. () can induce anticyclic-citrullinated peptide autoantibodies (anti-CCP antibodies), a key factor in the development of RA. This study aimed at evaluating the relationships between the 2 diseases and identifying the clinical implications thereof, with a focus on periodontal pathogens in Korean adults.

METHODS

A total of 260 RA patients and 86 age- and sex-matched control patients without arthritis were enrolled in this prospective cross-sectional study. Periodontal indices and the prevalence and amount of periodontal pathogens were compared between the groups. Correlations between periodontal and RA indices were examined, as were correlations between 9 periodontal pathogens and RA indices.

RESULTS

The RA group had significantly higher values than the control group for all investigated periodontal indices (<0.05) except the number of teeth. The gingival index (GI) was correlated with the disease activity score 28 (DAS28) (=0.125, =0.049), RA disease duration (=0.253, <0.001), erythrocyte sedimentation rate (ESR) (=0.162, =0.010), and anti-CCP antibody titer (=0.205, =0.004). Probing pocket depth (PPD) was correlated with ESR (=0.139, =0.027) and anti- antibody titer (=0.203, =0.001). Bleeding on probing (BOP) was correlated with DAS28 (=0.137, =0.030), RA disease duration (=0.202, =0.001), ESR (=0.136, =0.030), anti- antibody titer (=0.177, =0.005), and anti-CCP antibody titer (=0.188, =0.007). Clinical attachment level (CAL) and periodontitis severity were correlated with anti- antibody titer (the former =0.201, =0.002; the latter =0.175, =0.006). The quantity of was positively correlated with the serum anti- antibody titer (=0.148, =0.020).

CONCLUSIONS

The GI, BOP, and PPD showed positive relationships with several RA indices. The anti- antibody titer had positive relationships with PPD, BOP, CAL, and periodontitis severity. Thus, increasing values of periodontal indices could be used as a risk indicator of disease development in RA patients, and an increasing anti- antibody titer could be considered as a warning sign in RA patients suffering with periodontitis.