Skip to main content Skip to main navigation menu Skip to site footer
Page Header Logo
  • ABOUT THE JOURNAL
    • Focus and scope
    • Editorial Management Process
  • EDITORIAL POLICY
    • Ethical Publication Standards
    • Open Access Policy
    • Anti-plagiarism Policy
    • Copyright
    • Policy for Journal Archiving
    • Claim Policy
  • AUTHORS
    • Guidelines to Authors
    • Sending and Receiving Papers
    • Structure and Content of Articles
    • Article Evaluation Process
    • ORCID
    • coi_disclosure Colombia Médica ICMJE
    • Copyright Transfer Statement Colombia Médica
  • PEER REVIEW
    • Peer Review Process
    • Evaluation Forms
  • EDITORIAL TEAM
    • Editorial team
    • Contact
  • ARTICLES
    • Current
    • Archives
  • COLLECTIONS
Search
  • Register
  • Login
  1. Home /
  2. Archives /
  3. Vol 52 No 3 (2021) /
  4. Original Articles

Effects of nonsurgical periodontal therapy in patients with rheumatoid arthritis: a prospective before and after study

  • Abstract
  • Keywords
  • Author Biographies
  • References

Abstract

Background: periodontal therapy has been suggested to have systemic effects. However, studies of periodontal therapy in rheumatoid arthritis patients have produced controversial results.

Aim: To compare the effects of nonsurgical periodontal therapy on biochemical markers of rheumatoid arthritis and periodontal parameters in patients with and without rheumatoid arthritis.

Methods: a prospective before-and-after study was conducted that included 21 participants without and 29 participants with rheumatoid arthritis. Periodontal parameters, Porphyromonas gingivalis detection, C-reactive protein, rheumatoid factor and anti-citrullinated protein antibodies were measured at baseline and three months after nonsurgical periodontal therapy and the changes were statistically assessed.

Results: In general, both groups presented statistically significant improvement in periodontal parameters (p<0.05). There was an increase in the counts of P. gingivalis in both groups at three months. In addition, there was a reduction in levels of anti-citrullinated protein antibodies and rheumatoid factor in participants with rheumatoid arthritis. In contrast, C-reactive protein levels increased in both groups but were higher in the rheumatoid arthritis group. Periodontal parameters in rheumatoid arthritis participants under disease-modifying antirheumatic drugs presented a slightly higher improvement (p <0.05).

Conclusions: Nonsurgical periodontal therapy has similar improvements in periodontal parameters in patients with and without rheumatoid arthritis. In addition, nonsurgical periodontal therapy may benefit serum levels of anti-citrullinated protein antibodies and rheumatoid factors in patients with rheumatoid arthritis. NCT04658615.

Authors

  • Javier Enrique Botero Facultad de Odontología, Universidad de Antioquia, Medellín-Colombia https://orcid.org/0000-0001-7572-7384
  • Adriana Posada-López Facultad de Odontología, Universidad de Antioquia, Medellín-Colombia https://orcid.org/0000-0002-9467-8095
  • Jimi Mejía-Vallejo Grupo de información clínica, Artmédica, IPS, Medellín-Colombia https://orcid.org/0000-0002-6633-0518
  • Ricardo Antonio Pineda-Tamayo Grupo de información clínica, Artmédica, IPS, Medellín-Colombia https://orcid.org/0000-0003-2627-079X
  • Emilio Bedoya-Giraldo Facultad de Odontología, Universidad de Antioquia, Medellín-Colombia https://orcid.org/0000-0002-1434-9700

Downloads

Download data is not yet available.

Keywords

  • rheumatoid arthritis
  • periodontitis
  • C-reactive protein
  • rheumatoid factor
  • anti-citrullinated protein antibodies
  • non-surgical periodontal therapy

Author Biographies


, Facultad de Odontología, Universidad de Antioquia, Medellín-Colombia

orcid_id14.png https://orcid.org/0000-0001-7572-7384


, Facultad de Odontología, Universidad de Antioquia, Medellín-Colombia

orcid_id14.png https://orcid.org/0000-0002-9467-8095


, Grupo de información clínica, Artmédica, IPS, Medellín-Colombia

orcid_id14.png https://orcid.org/0000-0002-6633-0518


, Grupo de información clínica, Artmédica, IPS, Medellín-Colombia

orcid_id14.png  https://orcid.org/0000-0003-2627-079X


, Facultad de Odontología, Universidad de Antioquia, Medellín-Colombia

orcid_id14.png https://orcid.org/0000-0002-1434-9700

References

Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of severe periodontitis in 1990-2010: a systematic review and meta-regression. J Dent Res. 2014; 93 (11): 1045-1053. https://doi.org/10.1177/0022034514552491

Eke PI, Borgnakke WS, Genco RJ. Recent epidemiologic trends in periodontitis in the USA. Periodontol. 2000. 2020; 82 (1): 257-267 https://doi.org/10.1111/prd.12323

Ministerio de Salud y Protección Social. IV Estudio Nacional de Salud Bucal ENSAB IV. Situación en Salud Bucal. Ministerio de Salud y Protección Social; 2015.

Almutairi K, Nossent J, Preen D, Keen H, Inderjeeth C. The global prevalence of rheumatoid arthritis: a meta-analysis based on a systematic review. Rheumatol Int. 2021; 41 (5): 863-877. https://doi.org/10.1007/s00296-020-04731-0

Fernández-Ávila DG, Rincón-Riaño DN, Bernal-Macías S, Gutiérrez Dávila JM, Rosselli D. Prevalencia de la artritis reumatoide en Colombia según información del Sistema Integral de Información de la Protección Social. Rev Colomb Reumatol. 2019; 26: 83-87. https://doi.org/10.1016/j.rcreue.2019.01.009

Goh V, Hassan FW, Baharin B, Rosli TI. Impact of psychological states on periodontitis severity and oral health-related quality of life. J Oral Sci. 2021. https://doi.org/10.2334/josnusd.21-0267

Akram A, Georgiou P, Shi W, Proute MC, Serhiyenia T, Pradeep R, Kerolos ME, Kothur N, Khan S. Impact of Change in Lifestyle and Exercise on Cognitive Function in Patients With Rheumatoid Arthritis: A Systematic Review. Cureus. 2021; 13 (9): e18268. https://doi.org/10.7759/cureus.18268

Berthelot JM, Le Goff B. Rheumatoid arthritis and periodontal disease. Joint Bone Spine. 2010;77(6):537-41. https://doi.org/10.1016/j.jbspin.2010.04.015

Mikuls TR, Payne JB, Yu F, Thiele GM, Reynolds RJ, Cannon GW et al. Periodontitis and Porphyromonas gingivalis in patients with rheumatoid arthritis. Arthritis Rheumatol. 2014; 66 (5): 1090-100 https://doi.org/10.1002/art.38348

Disale PR, Zope SA, Suragimath G, Varma AS, Pisal A. Prevalence and severity of periodontitis in patients with established rheumatoid arthritis and osteoarthritis. J Family Med Prim Care. 2020; 9 (6): 2919-2925. https://doi.org/10.4103/jfmpc.jfmpc_398_20

Brandl C, Bucci L, Schett G, Zaiss MM. Crossing the barriers: Revisiting the gut feeling in rheumatoid arthritis. Eur J Immunol. 2021; 51 (4): 798-810. https://doi.org/10.1002/eji.202048876

McInnes IB, Schett G. The pathogenesis of rheumatoid arthritis. N Engl J Med. 2011 8; 365 (23): 2205-2219 https://doi.org/10.1056/NEJMra1004965

Potempa J, Mydel P, Koziel J. The case for periodontitis in the pathogenesis of rheumatoid arthritis. Nat Rev Rheumatol. 2017; 13 (10): 606-620. https://doi.org/10.1038/nrrheum.2017.132

Kondo N, Kuroda T, Kobayashi D. Cytokine Networks in the Pathogenesis of Rheumatoid Arthritis. Int J Mol Sci. 2021; 22 (20): 10922. https://doi.org/10.3390/ijms222010922

Keirns BH, Lucas EA, Smith BJ. Phytochemicals affect T helper 17 and T regulatory cells and gut integrity: implications on the gut-bone axis. Nutr Res. 2020; 83: 30-48. https://doi.org/10.1016/j.nutres.2020.08.006

Yu HC, Lu MC. The roles of anti-citrullinated protein antibodies in the immunopathogenesis of rheumatoid arthritis. Ci Ji Yi Xue Za Zhi. 2019; 31 (1): 5-10. https://doi.org/10.4103/tcmj.tcmj_116_18

Jenning M, Marklein B, Ytterberg J, Zubarev RA, Joshua V, van Schaardenburg D et al. Bacterial citrullinated epitopes generated by Porphyromonas gingivalis infection-a missing link for ACPA production. Ann Rheum Dis. 2020; 79 (9): 1194-1202. https://doi.org/10.1136/annrheumdis-2019-216919

Hitchon CA, Chandad F, Ferucci ED, Willemze A, Ioan-Facsinay A, van der Woude D et al. Antibodies to porphyromonas gingivalis are associated with anticitrullinated protein antibodies in patients with rheumatoid arthritis and their relatives. J Rheumatol. 2010; 37 (6): 1105-1112. https://doi.org/10.3899/jrheum.091323

Oluwagbemigun K, Yucel-Lindberg T, Dietrich T, Tour G, Sherina N, Hansson M et al. A cross-sectional investigation into the association between Porphyromonas gingivalis and autoantibodies to citrullinated proteins in a German population. Ther Adv Musculoskelet Dis. 2019; 11: 1759720X19883152. https://doi.org/10.1177/1759720X19883152

Perricone C, Ceccarelli F, Saccucci M, Di Carlo G, Bogdanos DP, Lucchetti R, Pilloni A, Valesini G, Polimeni A, Conti F. Porphyromonas gingivalis and rheumatoid arthritis. Curr Opin Rheumatol. 2019; 31 (5): 517-524. https://doi.org/10.1097/BOR.0000000000000638

Gaudilliere DK, Culos A, Djebali K, Tsai AS, Ganio EA, Choi WM et al. Systemic Immunologic Consequences of Chronic Periodontitis. J Dent Res. 2019; 98 (9): 985-993. https://doi.org/10.1177/0022034519857714

Cosgarea R, Tristiu R, Dumitru RB, Arweiler NB, Rednic S, Sirbu CI et al. Effects of nonsurgical periodontal therapy on periodontal laboratory and clinical data as well as on disease activity in patients with rheumatoid arthritis. Clin Oral Investig. 2019; 23 (1): 141-151. https://doi.org/10.1007/s00784-018-2420-3

Kaur S, Bright R, Proudman SM, Bartold PM. Does periodontal treatment influence clinical and biochemical measures for rheumatoid arthritis? A systematic review and meta-analysis. Semin Arthritis Rheum. 2014; 44 (2): 113-122. https://doi.org/10.1016/j.semarthrit.2014.04.009

Monsarrat P, Fernandez de Grado G, Constantin A, Willmann C, Nabet C, Sixou M et al. The effect of periodontal treatment on patients with rheumatoid arthritis: The ESPERA randomised controlled trial. Joint Bone Spine. 2019; 86 (5): 600-609. https://doi.org/10.1016/j.jbspin.2019.02.006

Papapanou PN, Sanz M, Buduneli N, Dietrich T, Feres M, Fine DH et al. Periodontitis: Consensus report of Workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions. J Clin Periodontol. 2018; 45 (Suppl 20): S162- S170. https://doi.org/10.1111/jcpe.12946

Botero JE, Contreras A, Lafaurie G, Jaramillo A, Betancourt M, Arce RM. Occurrence of periodontopathic and superinfecting bacteria in chronic and aggressive periodontitis subjects in a Colombian population. J Periodontol. 2007; 78 (4): 696-704. https://doi.org/10.1902/jop.2007.060129

Kaushal S, Singh AK, Lal N, Das SK, Mahdi AA. Effect of periodontal therapy on disease activity in patients of rheumatoid arthritis with chronic periodontitis. J Oral Biol Craniofac Res. 2019; 9 (2): 128-132 https://doi.org/10.1016/j.jobcr.2019.02.002

Buwembo W, Munabi IG, Kaddumukasa M, Kiryowa H, Mbabali M, Nankya E et al. Nonsurgical oral hygiene interventions on disease activity of Rheumatoid arthritis patients with periodontitis: A randomized controlled trial. J Dent Res Dent Clin Dent Prospects. 2020; 14 (1): 26-36. https://doi.org/10.34172/joddd.2020.004

Tang Q, Fu H, Qin B, Hu Z, Liu Y, Liang Y et al. A Possible Link Between Rheumatoid Arthritis and Periodontitis: A Systematic Review and Meta-analysis. Int J Periodontics Restorative Dent. 2017; 37 (1): 79-86. https://doi.org/10.11607/prd.2656

He S, Zhou Q, Luo B, Chen B, Li L, Yan F. Chloroquine and 3-Methyladenine Attenuates Periodontal Inflammation and Bone Loss in Experimental Periodontitis. Inflammation. 2020; 43 (1): 220-230. https://doi.org/10.1007/s10753-019-01111-0

Heredia-P AM, Lafaurie GI, Bautista-Molano W, Trujillo TG, Chalem-Choueka P, Bello-Gualtero JM et al. Predictive factors related to the progression of periodontal disease in patients with early rheumatoid arthritis: a cohort study. BMC Oral Health. 2019; 19 (1): 240. https://doi.org/10.1186/s12903-019-0939-6

Punceviciene E, Rovas A, Puriene A, Stuopelyte K, Vitkus D, Jarmalaite S, Butrimiene I. Investigating the relationship between the severity of periodontitis and rheumatoid arthritis: a cross-sectional study. Clin Rheumatol. 2021 . https://doi.org/10.1007/s10067-021-05661-3

Pisano González MM, González Pisano A. Modifying habits and treatment adherence, essential for controlling the chronic disease. Enfermeria Clinica. 2014; 24 (1): 59-66. https://doi.org/10.1016/j.enfcli.2013.10.006

Tachibana M, Yonemoto Y, Okamura K, Suto T, Sakane H, Kaneko T et al. Does periodontitis affect the treatment response of biologics in the treatment of rheumatoid arthritis? Arthritis Res Ther. 2020; 22 (1): 178. https://doi.org/10.1186/s13075-020-02269-x

Sproston NR, Ashworth JJ. Role of C-Reactive Protein at Sites of Inflammation and Infection. Front Immunol. 2018; 139:754. https://doi.org/10.3389/fimmu.2018.00754

Ajeganova S, Huizinga T. Sustained remission in rheumatoid arthritis: latest evidence and clinical considerations. Ther Adv Musculoskelet Dis. 2017; 9 (10): 249-262. https://doi.org/10.1177/1759720X17720366

Yang NY, Wang CY, Chyuan IT, Wu KJ, Tu YK, Chang CW et al. Significant association of rheumatoid arthritis-related inflammatory markers with nonsurgical periodontal therapy. J Formos Med Assoc. 2018; 117 (11): 1003-1010. https://doi.org/10.1016/j.jfma.2017.11.006

Nguyen VB, Nguyen TT, Huynh NC, Nguyen KD, Le TA, Hoang HT. Effects of nonsurgical periodontal treatment in rheumatoid arthritis patients: A randomized clinical trial. Dent Med Probl. 2021; 58 (1): 97-105. https://doi.org/10.17219/dmp/131266

de Smit MJ, Westra J, Posthumus MD, Springer G, van Winkelhoff AJ, Vissink A et al. Effect of Anti-Rheumatic Treatment on the Periodontal Condition of Rheumatoid Arthritis Patients. Int J Environ Res Public Health. 2021; 18 (5): 2529. https://doi.org/10.3390/ijerph18052529

Sun J, Zheng Y, Bian X, Ge H, Wang J, Zhang Z. Nonsurgical periodontal treatment improves rheumatoid arthritis disease activity: a meta-analysis. Clin Oral Investig. 2021. https://doi.org/10.1007/s00784-021-03807-w

Sakkas LI, Bogdanos DP, Katsiari C, Platsoucas CD. Anti-citrullinated peptides as autoantigens in rheumatoid arthritis-relevance to treatment. Autoimmun Rev. 2014; 13 (11): 1114-1120 https://doi.org/10.1016/j.autrev.2014.08.012

Moura MF, Cota LOM, Silva TA, Cortelli SC, Ferreira GA, López MM et al. Clinical and microbiological effects of nonsurgical periodontal treatment in individuals with rheumatoid arthritis: a controlled clinical trial. Odontology. 2021; 109 (2): 484-493 https://doi.org/10.1007/s10266-020-00566-0

Socransky SS, Haffajee AD. Dental biofilms: difficult therapeutic targets. Periodontol 2000. 2002; 28: 12-55. https://doi.org/10.1034/j.1600-0757.2002.280102.x

Lee JY, Choi IA, Kim JH, Kim KH, Lee EY, Lee EB, Lee YM, Song YW. Association between anti-Porphyromonas gingivalis or anti-α-enolase antibody and severity of periodontitis or rheumatoid arthritis (RA) disease activity in RA. BMC Musculoskelet Disord. 2015; 12; 16: 190 https://doi.org/10.1186/s12891-015-0647-6

Reichert S, Schlumberger W, Dähnrich C, Hornig N, Altermann W, Schaller HG, et al. Association of levels of antibodies against citrullinated cyclic peptides and citrullinated aα-enolase in chronic and aggressive periodontitis as a risk factor of Rheumatoid arthritis: A case control study. J Transl Med. 2015; 13 (1): 1-10. https://doi.org/10.1186/s12967-015-0625-7

Smiley CJ, Tracy SL, Abt E, Michalowicz BS, John MT, Gunsolley J et al. Evidence-based clinical practice guideline on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. J Am Dent Assoc. 2015; 146 (7): 525-35. https://doi.org/10.1016/j.adaj.2015.01.026

Claffey N. Decision making in periodontal therapy. The re-evaluation. J Clin Periodontol. 1991; 18 (6): 384-389. https://doi.org/10.1111/j.1600-051X.1991.tb02305.x

  • PDF
  • PDF (Español (España))
  • Full text
  • Texto (Español (España))
Published
2021-12-31
Submitted
2021-10-01
| 377 |
How to Cite
Botero, J., Posada-López, A., Mejía-Vallejo, J., Pineda-Tamayo, R., & Bedoya-Giraldo, E. (2021). Effects of nonsurgical periodontal therapy in patients with rheumatoid arthritis: a prospective before and after study. Colombia Médica, 52(3), e2095051. https://doi.org/10.25100/cm.v52i3.5051
  • ACM
  • ACS
  • APA
  • ABNT
  • Chicago
  • Harvard
  • IEEE
  • MLA
  • Turabian
  • Vancouver
Download Citation
  • Endnote/Zotero/Mendeley (RIS)
  • BibTeX
Issue
Vol 52 No 3 (2021)
Section
Original Articles

Copyright (c) 2021 Universidad del Valle

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

The copy rights of the articles published in Colombia Médica belong to the Universidad del Valle. The contents of the articles that appear in the Journal are exclusively the responsibility of the authors and do not necessarily reflect the opinions of the Editorial Committee of the Journal. It is allowed to reproduce the material published in Colombia Médica without prior authorization for non-commercial use

Online ISSN: 1657-9534
Make a Submission

Bibliographics database

Full-text database

Citation Index

Bibliographical information system

Memberships

Licencia Creative Commons
This work is under License Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) .

Indexed

.
0.82
2018CiteScore
 
 
68th percentile
Powered by  Scopus
.
Information
  • For Authors
Open Journal Systems
Universidad del Valle
Universidad del Valle
  • Cali - Colombia
  • © 1994 - 2020
Dirección:
  • Ciudad Universitaria Meléndez
  • Calle 13 # 100-00
  •  
  • Sede San Fernando
  • Calle 4B N° 36-00
PBX:
  • +57 2 3212100
  • Línea gratuita: 018000 22 00 21
  • A.A.25360
Redes Sociales:

2020 Universidad del Valle - Vigilada MinEducación

//Go to www.addthis.com/dashboard to customize your tools