Kaushal Shalini, Singh Anita Kumari, Lal Nand, Das Siddharth K, Mahdi Abbas Ali
Department of Periodontology, Faculty of Dental Sciences, King George, Medical University, Lucknow, 226003, Uttar Pradesh, India.
Department of Rheumatology, King George, Medical University, Lucknow, Uttar Pradesh, India.
J Oral Biol Craniofac Res. 2019 Apr-Jun;9(2):128-132. doi: 10.1016/j.jobcr.2019.02.002. Epub 2019 Feb 2.
Evidence have been proposed a positive association between severity of Periodontitis and Rheumatoid arthritis (RA) activity, individuals with advanced RA are more likely to develop periodontal problems compared to their non-RA counterparts, and vice versa. Studies have been suggested that RA manifest as a result of an inflammatory imbalance and autoimmunity. In this perspective, treatment modalities that lead to inhibition of proinflammatory mediators, may prove beneficial for reducing the severity of RA. This study examined the effects of non surgical periodontal therapy (NSPT) on disease activity of RA.
Diagnosed patients of active rheumatoid arthritis with chronic periodontitis were recruited in this study and divided in to treatment and controls groups, both groups were similar in all demographics assessed. Treatment group (n = 20) and controls group (n = 20) underwent assessment for periodontal clinical parameters (plaque index, gingival index, probing pocket depth, clinical attachment level), Rheumatologic clinical (simplified disease activity index) and biochemical parameters(C-reactive protein, Rheumatoid factor, Anti-cyclic citrullinated protein) at baseline and 8 weeks. Serum levels of biochemical parameters were measured by enzyme-linked immunosorbent assay (ELISA).
The statistically significant (p < 0.001) reduction observed in mean values of PI, GI, PPD, CAL, SDAI in treatment group at 8weeks after NSPT as compare to control group. However serum level of ACCPA, CRP and RF did not show statistically significant (p > 0.05) changes from baseline to reassessment (8 weeks) in both groups.
The improvement in RA disease activity may occurs after non surgical periodontal therapy.
有证据表明牙周炎的严重程度与类风湿性关节炎（RA）的活动之间存在正相关，与非RA患者相比，晚期RA患者更有可能出现牙周问题，反之亦然。研究表明，RA是由炎症失衡和自身免疫引起的。从这个角度来看，能够抑制促炎介质的治疗方式可能对减轻RA的严重程度有益。本研究探讨了非手术牙周治疗（NSPT）对RA疾病活动的影响。
本研究招募了被诊断为患有慢性牙周炎的活动性类风湿性关节炎患者，并将其分为治疗组和对照组，两组在所有评估的人口统计学特征方面均相似。治疗组（n = 20）和对照组（n = 20）在基线和8周时接受牙周临床参数（菌斑指数、牙龈指数、探诊袋深度、临床附着水平）、风湿病临床（简化疾病活动指数）和生化参数（C反应蛋白、类风湿因子、抗环瓜氨酸化蛋白）的评估。通过酶联免疫吸附测定（ELISA）测量生化参数的血清水平。
与对照组相比，治疗组在NSPT后8周时PI、GI、PPD、CAL、SDAI的平均值出现了具有统计学意义（p < 0.001）的降低。然而，两组从基线到重新评估（8周）时ACCPA、CRP和RF的血清水平均未显示出具有统计学意义（p > 0.05）的变化。
非手术牙周治疗后RA疾病活动可能会有所改善。
