Departament of Dental Clinical Specialties, Faculty of Odontology, University Complutense, Madrid, Spain.
Research Group on the Aetiology and Treatment of Periodontal and Periimplant Diseases (ETEP), Faculty of Odontology, University Complutense, Madrid, Spain.
Periodontol 2000. 2021 Oct;87(1):181-203. doi: 10.1111/prd.12385.
Rheumatoid arthritis and periodontitis are chronic inflammatory diseases defined respectively by the destruction of the articular cartilage and tooth-supporting periodontal tissues. Although the epidemiologic evidence for an association between these two diseases is still scarce, there is emerging scientific information linking specific bacterial periodontal pathogens, such as Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, in the citrullination process, leading to autoantibody formation and compromised immunotolerance of the susceptible patient to rheumatoid arthritis. In this review, we update the existing information on the evidence, not only regarding the epidemiologic association, but also the biologic mechanisms linking these two diseases. Finally, we review information emerging from intervention studies evaluating whether periodontal treatment could influence the initiation and progression of rheumatoid arthritis.
类风湿关节炎和牙周炎是两种慢性炎症性疾病，分别由关节软骨破坏和支持牙齿的牙周组织破坏所定义。尽管这两种疾病之间存在关联的流行病学证据仍然有限，但越来越多的科学信息将特定的牙周致病菌，如牙龈卟啉单胞菌和伴放线放线杆菌，与瓜氨酸化过程联系起来，导致自身抗体的形成，并使易患病人对类风湿关节炎的免疫耐受受到损害。在这篇综述中，我们更新了现有的关于这两种疾病之间的证据，不仅包括流行病学关联，还包括将这两种疾病联系起来的生物学机制。最后，我们综述了来自干预研究的信息，这些研究评估了牙周治疗是否可以影响类风湿关节炎的发生和进展。
