Nguyen Van Bich, Nguyen Thuy Thu, Huynh Nam Cong-Nhat, Nguyen Khoa Dinh, Le Thu Anh, Hoang Hung Tu
Department of Periodontology, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.
Department of Dental Basic Sciences, Faculty of Odonto-Stomatology, University of Medicine and Pharmacy at Ho Chi Minh City, Vietnam.
Dent Med Probl. 2021 Jan-Mar;58(1):97-105. doi: 10.17219/dmp/131266.
The periodontal condition has a reciprocal relationship with rheumatoid arthritis (RA). Rheumatoid arthritis patients are reported to present with more serious periodontal disease (PD) as compared to non-RA patients.
This study aimed to evaluate the effects of non-surgical periodontal treatment on Vietnamese patients with active RA and PD, where the clinical characteristics and serum indices of the patients were of interest.
We conducted a randomized clinical trial (RCT) on 82 RA patients with PD. The patients were randomly divided into 2 groups: the intervention group, consisting of patients who received oral hygiene instructions, scaling and root planing; and the control group, consisting of patients who received oral hygiene instructions only. Both groups received the same treatment plan for RA. The Disease Activity Score 28 based on C-reactive protein (DAS28-CRP), disease activity classification, rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), anti-citrullinated protein autoantibodies (ACPAs), and C-reactive protein (CRP) were monitored, with the measurements taken at 3 months and 6 months following the treatment.
The 2 groups exhibited similar parameters at baseline. In the intervention group, DAS28-CRP and disease activity classification were significantly reduced at 3 months after treatment as compared to the baseline data. At 6 months following the treatment there was a significant decrease in ESR, ACPAs and DAS28-CRP in the intervention group, while the control group showed a decrease only in ACPAs. Further, when comparing the intervention and control groups at 6 months following the treatment, there were no differences between the groups in the ACPAs, RF and CRP serum levels.
Non-surgical periodontal treatment can significantly reduce DAS28-CRP, disease activity classification, ESR, and the ACPAs level in serum, and can be applied to reduce RA severity in RA patients with PD.
牙周状况与类风湿关节炎（RA）存在相互关系。据报道，与非类风湿关节炎患者相比，类风湿关节炎患者的牙周病（PD）更为严重。
本研究旨在评估非手术牙周治疗对患有活动性类风湿关节炎和牙周病的越南患者的影响，同时关注患者的临床特征和血清指标。
我们对82例患有牙周病的类风湿关节炎患者进行了一项随机临床试验（RCT）。患者被随机分为两组：干预组，由接受口腔卫生指导、龈上洁治和根面平整的患者组成；对照组，由仅接受口腔卫生指导的患者组成。两组患者接受相同的类风湿关节炎治疗方案。监测基于C反应蛋白的28关节疾病活动评分（DAS28-CRP）、疾病活动分类、类风湿因子（RF）、红细胞沉降率（ESR）、抗瓜氨酸化蛋白自身抗体（ACPAs）和C反应蛋白（CRP），并在治疗后3个月和6个月进行测量。
两组在基线时表现出相似的参数。干预组在治疗后3个月时，DAS28-CRP和疾病活动分类较基线数据显著降低。治疗后6个月，干预组的ESR、ACPAs和DAS28-CRP显著下降，而对照组仅ACPAs有所下降。此外，在治疗后6个月比较干预组和对照组时，两组在ACPAs、RF和CRP血清水平上没有差异。
非手术牙周治疗可显著降低DAS28-CRP、疾病活动分类、ESR和血清中ACPAs水平，并可用于降低患有牙周病的类风湿关节炎患者的类风湿关节炎严重程度。
