非手术牙周治疗可降低类风湿性关节炎的严重程度以及RANKL和Survivin的血浆和唾液水平：一项短期临床研究。
Nonsurgical periodontal therapy decreases the severity of rheumatoid arthritis and the plasmatic and salivary levels of RANKL and Survivin: a short-term clinical study.
作者信息
Moura Marcela Faria, Silva Tarcília Aparecida, Cota Luís Otávio Miranda, Oliveira Sicilia Rezende, Cunha Fernando Queiroz, Ferreira Gilda Aparecida, Cortelli José Roberto, Cortelli Sheila Cavalca, Costa Fernando Oliveira
机构信息
Department of Dental Clinics, Oral Pathology, and Oral Surgery, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil.
School of Dentistry, University of Ribeirão Preto, São Paulo, Brazil.
出版信息
Clin Oral Investig. 2021 Dec;25(12):6643-6652. doi: 10.1007/s00784-021-03950-4. Epub 2021 May 5.
AIM
To investigate the influence of nonsurgical periodontal treatment (NSPT) on clinical periodontal status, rheumatoid arthritis (RA) activity, and plasmatic and salivary levels of biomarkers through a controlled clinical trial on individuals with RA and periodontitis (PE).
METHODS
Sixty-six individuals from a convenience sample were considered eligible and consecutively allocated in 3 groups: (1) individuals without PE and RA (-PE-RA, n = 19); (2) individuals without PE and with RA (-PE+RA, n = 23), and (3) individuals with PE and RA (+PE+RA, n = 24). Full-mouth periodontal clinical examinations, Disease Activity Score (DAS-28) evaluations, and analysis in plasma and saliva of RANKL, OPG, RANKL/OPG, and Survivin were performed at baseline (T1) and 45 days after NSPT (T2).
RESULTS
NSPT in the +PE+RA group was very effective to improve periodontal condition. At T2, significant reductions in DAS-28 were observed in +PE+RA (p = 0.011). Significantly higher levels of Survivin and RANKL were observed in saliva and plasma from RA individuals (with and without PE) compared to controls. Additionally, Survivin e RANKL demonstrated positive correlations with DAS-28 and an expressively significant reduction in +PE+RA at T2 (p < 0.001).
CONCLUSIONS
NSPT was effective on improving both the periodontal and the RA clinical status and reducing the concentration of Survivin and RANKL in saliva and plasma.
PRACTICAL IMPLICATIONS
Nonsurgical periodontal treatment was effective on reducing the concentration of Survivin and RANKL and on improving both the periodontal and the RA clinical status of affected individuals.
TRIAL REGISTRATION
Brazilian Registry of Clinical Trials (ReBEC) protocol #RBR-8g2bc8 ( http://www.ensaiosclinicos.gov.br/rg/RBR-8g2bc8/ ).
目的
通过一项针对类风湿关节炎（RA）和牙周炎（PE）患者的对照临床试验，研究非手术牙周治疗（NSPT）对临床牙周状况、类风湿关节炎活动度以及生物标志物的血浆和唾液水平的影响。
方法
从便利样本中选取66名符合条件的个体，并将其连续分为3组：（1）无PE和RA的个体（-PE-RA，n = 19）；（2）无PE但患有RA的个体（-PE+RA，n = 23），以及（3）患有PE和RA的个体（+PE+RA，n = 24）。在基线（T1）和NSPT后45天（T2）进行全口牙周临床检查、疾病活动评分（DAS-28）评估，并对血浆和唾液中的核因子κB受体活化因子配体（RANKL）、骨保护素（OPG）、RANKL/OPG和生存素进行分析。
结果
+PE+RA组的NSPT对改善牙周状况非常有效。在T2时，+PE+RA组的DAS-28显著降低（p = 0.011）。与对照组相比，RA患者（有和无PE）的唾液和血浆中生存素和RANKL水平显著更高。此外，生存素和RANKL与DAS-28呈正相关，且+PE+RA组在T2时显著降低（p < 0.001）。
结论
NSPT对改善牙周和RA临床状况以及降低唾液和血浆中生存素和RANKL的浓度有效。
实际意义
非手术牙周治疗对降低生存素和RANKL的浓度以及改善受影响个体的牙周和RA临床状况有效。
试验注册
巴西临床试验注册中心（ReBEC）协议#RBR-8g2bc8（http://www.ensaiosclinicos.gov.br/rg/RBR-8g2bc8/）。
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