Department of Dental Clinics, Oral Pathology, and Oral Surgery, Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627, Pampulha, PO Box 359, Belo Horizonte, Minas Gerais, 31270-901, Brazil.
Faculty of Dentistry, University of Taubaté, São Paulo, Brazil.
Odontology. 2021 Apr;109(2):484-493. doi: 10.1007/s10266-020-00566-0. Epub 2020 Nov 3.
The effect of periodontal treatment on clinical, microbiological and serological parameters of patients with rheumatoid arthritis (RA) are scarce and controversial. The aim of this study was to investigate the influence of non-surgical periodontal treatment on clinical periodontal status, subgingival bacterial levels of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and RA activity through a controlled clinical trial on individuals with RA and periodontitis (PE). From a convenience sample, 107 individuals were considered eligible and consecutively allocated in four groups: (1) individuals without PE and RA (- PE-RA, n = 30); (2) individuals without PE and with RA (- PE + RA, n = 23); (3) individuals with PE and RA (+ PE + RA, n = 24); and (4) individuals with PE and without RA (+ PE-RA, n = 30). Full-mouth periodontal clinical examinations, microbiological analysis and Disease Activity Score (DAS-28) evaluations were performed at baseline (T1) and 45 days after non-surgical periodontal treatment (T2). At T1, individuals + PE + RA showed greater severity of PE than + PE-RA individuals. At T2, significant reductions were observed in all periodontal clinical parameters in both groups (p < 0.001) with a significant reduction in DAS-28 in + PE + RA (p = 0.011). Individuals + PE-RA and + PE-RA showed significant reductions for all bacteria (p < 0.001). Additionally, P. gingivalis demonstrated an expressively significant reduction in + PE + RA (p < 0.001). Non-surgical periodontal treatment was effective on improving the clinical periodontal condition, improving the RA clinical status and reducing the presence of periodontal pathogens. Brazilian Registry of Clinical Trials (ReBEC) protocol #RBR-8g2bc8 ( https://www.ensaiosclinicos.gov.br/rg/RBR-8g2bc8/ ).
牙周治疗对类风湿关节炎(RA)患者的临床、微生物和血清学参数的影响尚不清楚且存在争议。本研究的目的是通过一项针对患有牙周炎(PE)和 RA 的个体的对照临床试验,调查非手术性牙周治疗对临床牙周状况、龈下 Aggregatibacter actinomycetemcomitans、Porphyromonas gingivalis、Tannerella forsythia、Treponema denticola 和 RA 活性的影响。从方便样本中,考虑了 107 名符合条件的个体,并连续分为四组:(1)无 PE 和 RA 的个体(-PE-RA,n=30);(2)无 PE 但有 RA 的个体(-PE+RA,n=23);(3)有 PE 和 RA 的个体(+PE+RA,n=24);(4)有 PE 但无 RA 的个体(+PE-RA,n=30)。在基线(T1)和非手术性牙周治疗后 45 天(T2)时进行全口牙周临床检查、微生物分析和疾病活动评分(DAS-28)评估。在 T1 时,+PE+RA 个体的 PE 严重程度大于+PE-RA 个体。在 T2,两组的所有牙周临床参数均显著降低(p<0.001),+PE+RA 的 DAS-28 也显著降低(p=0.011)。+PE-RA 和+PE-RA 个体的所有细菌均显著减少(p<0.001)。此外,P. gingivalis 在+PE+RA 中表达显著减少(p<0.001)。非手术性牙周治疗可有效改善临床牙周状况,改善 RA 临床状况,并减少牙周病原体的存在。巴西临床试验注册中心(ReBEC)方案 #RBR-8g2bc8(https://www.ensaiosclinicos.gov.br/rg/RBR-8g2bc8/)。