Department of Preventive Dentistry and Dental Public Health, School of Dentistry, Aichi Gakuin University, Nagoya, Japan.
Hashimoto Orthopaedic Surgery Clinic, Nagoya, Japan.
Int Dent J. 2021 Oct;71(5):429-437. doi: 10.1016/j.identj.2020.12.015. Epub 2021 Mar 17.
Periodontal inflammation can affect the progression of rheumatoid arthritis (RA), and RA drugs may influence the periodontal condition of patients with RA. We examined whether the association between periodontal inflammation and the severity of RA is influenced by RA medication.
This cross-sectional study recruited 98 Japanese patients with RA from an orthopaedic clinic. We assessed the severity of RA using the Steinbrocker class and stage. The periodontal inflamed surface area (PISA) was used as an indicator of periodontal status. We obtained data on RA medications from medical records. We examined the associations among periodontal tissue inflammation, RA medications, and RA severity using multinomial logistic regression analyses.
In univariate multinomial logistic regression analyses, no significant association between PISA score and RA severity was observed. There was no significant association between PISA score and RA severity in multivariate analyses not including variables about RA drugs as independent variables. However, in multivariate analyses adjusted for RA drugs and other confounding variables, patients with a PISA >550 mm had significantly higher odds ratios (ORs) for Steinbrocker class III-IV and stage III-IV (OR, 20.24; 95% confidence interval [CI], 1.78-229.85 and OR, 12.42; 95% CI, 1.79-86.49, respectively) compared to patients with PISA score ≤550 mm.
The extent of periodontal inflammation is associated with the severity of RA independent of RA medications.
牙周炎炎症可能会影响类风湿关节炎(RA)的进展,而 RA 药物可能会影响 RA 患者的牙周状况。我们研究了牙周炎炎症与 RA 严重程度之间的关联是否受到 RA 药物的影响。
本横断面研究从骨科诊所招募了 98 名日本 RA 患者。我们使用 Steinbrocker 分类和分期来评估 RA 的严重程度。牙周炎炎症表面积(PISA)被用作牙周状况的指标。我们从病历中获取 RA 药物的数据。我们使用多项逻辑回归分析检查了牙周组织炎症、RA 药物和 RA 严重程度之间的关联。
在单变量多项逻辑回归分析中,PISA 评分与 RA 严重程度之间没有显著关联。在不将 RA 药物相关变量作为自变量的多变量分析中,PISA 评分与 RA 严重程度之间也没有显著关联。然而,在调整了 RA 药物和其他混杂变量的多变量分析中,PISA >550mm 的患者患有 Steinbrocker 分类 III-IV 和 III-IV 期 RA 的优势比(OR)明显更高(OR,20.24;95%置信区间[CI],1.78-229.85 和 OR,12.42;95%CI,1.79-86.49,分别)与 PISA 评分≤550mm 的患者相比。
牙周炎炎症的严重程度与 RA 药物无关,与 RA 的严重程度相关。