Oliveira Sicília Rezende, de Arruda José Alcides Almeida, Schneider Ayda Henriques, Ferreira Gilda Aparecida, Calderaro Débora Cerqueira, Costa Fernando Oliveira, Teixeira Antonio Lucio, de Oliveira Renê Donizeti Ribeiro, Louzada-Júnior Paulo, Cunha Fernando Queiroz, Abreu Lucas Guimarães, Silva Tarcília Aparecida
Department of Oral Surgery, Pathology, and Clinical Dentistry, School of Dentistry, Universidade Federal de Minas Gerais, Av. Pres. Antônio Carlos, 6627, Room 3204, Belo Horizonte, Minas Gerais, Brazil.
Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil.
Odontology. 2025 Jul;113(3):903-917. doi: 10.1007/s10266-024-01033-w. Epub 2024 Nov 29.
The aim of the present study was to provide an overview evaluating the effects of non-surgical periodontal treatment in rheumatoid arthritis, focusing on 28-joint Disease Activity Score (DAS28), C-reactive protein, and erythrocyte sedimentation rate. Systematic reviews, with and without meta-analyses, comparing individuals who had undergone non-surgical periodontal treatment with those who had not, and assessing parameters before and after treatment, were included. Electronic searches were conducted in August 2023 and updated in August 2024 across four databases (PubMed, Scopus, Embase, and Web of Science) and gray literature, with no restriction on language or publication date. The study followed the 2020 PRISMA statement, and a protocol was registered in PROSPERO (CRD42023414714). A total of 10 systematic reviews were included: six with meta-analyses and four without meta-analyses. The number of articles included ranged from three to 31 studies. Non-surgical periodontal treatment resulted in a significant decrease in C-reactive protein, erythrocyte sedimentation rate, and DAS28. The follow-up period after treatment ranged from six to 24 weeks. A meta-analysis was conducted, incorporating data from 18 primary studies identified in the systematic reviews and comparing the difference in DAS28 at baseline (n = 454) and up to three months (n = 449) after the non-surgical periodontal treatment. A significant reduction in DAS28 was observed (MD = - 0.76; 95% CI = - 1.07 to - 0.44). Despite the heterogeneity of data related to rheumatoid arthritis and periodontitis status, non-surgical periodontal treatment can result in a decrease in the concentration of circulating inflammatory mediators and, consequently, in a reduction in DAS28 in rheumatoid arthritis.
本研究的目的是提供一项综述，评估非手术牙周治疗对类风湿性关节炎的影响，重点关注28个关节疾病活动评分（DAS28）、C反应蛋白和红细胞沉降率。纳入了系统评价，包括或不包括荟萃分析，比较接受非手术牙周治疗的个体与未接受治疗的个体，并评估治疗前后的参数。2023年8月进行了电子检索，并于2024年8月在四个数据库（PubMed、Scopus、Embase和Web of Science）以及灰色文献中进行了更新，对语言或出版日期没有限制。该研究遵循2020年PRISMA声明，并在PROSPERO（CRD42023414714）中注册了方案。共纳入10项系统评价：6项有荟萃分析，4项无荟萃分析。纳入的文章数量从3项到31项研究不等。非手术牙周治疗导致C反应蛋白、红细胞沉降率和DAS28显著降低。治疗后的随访期为6至24周。进行了一项荟萃分析，纳入了系统评价中确定的18项主要研究的数据，比较了非手术牙周治疗后基线时（n = 454）和长达三个月时（n = 449）DAS28的差异。观察到DAS28显著降低（MD = -0.76；95%CI = -1.07至-0.44）。尽管与类风湿性关节炎和牙周炎状态相关的数据存在异质性，但非手术牙周治疗可导致循环炎症介质浓度降低，从而使类风湿性关节炎患者的DAS28降低。
