Periodontitis in patients with rheumatoid arthritis

Abstract

INTRODUCTION: Periodontal disease (PD) may contribute to the pathogenesis of rheumatoid arthritis
(RA). Both conditions are chronic inflammatory disorders that share a common pathogenesis characterized
by the destruction of joint tissues and extra-articular manifestations in RA, and periodontal tissues—both
the protective and supporting periodontium—in PD.
OBJECTIVES: To evaluate the presence and severity of periodontitis and its relationship with anti-CCP
concentration, treatment, disease progression, and clinical activity in patients with rheumatoid arthritis and
periodontitis.
MATERIAL AND METHOD: A total of 87 adult patients with RA (12 males and 75 females), either in
remission or active disease, were included. The Disease Activity Score in Rheumatoid Arthritis (DAS-28)
was recorded and compared with periodontal disease parameters. Periodontal assessments included probing
depth (PD), attachment loss (AL), and bleeding on probing (BOP) in a sample of 44 patients.
RESULTS: In this preliminary study, 43.2% of patients with moderate to high RA activity (mean DAS-28
scores between 4.01 and 6.03) had periodontitis, whereas only 20% of patients with low or mild RA activity
(mean DAS-28 scores between 2.32 and 2.94) presented with periodontitis.
CONCLUSION: Periodontitis is common in RA patients, particularly in those with moderate to high
disease activity. This highlights the importance of periodontal control in RA patients, as they remain at risk
for disseminated infections originating from periodontal sites despite receiving anti-inflammatory
treatment.