Effects of periodontal therapy on disease activity and systemic inflammation in rheumatoid arthritis patients

Ercıyas, Kamile; Sezer, Ufuk; Üstün, Kemal; Pehlıvan, Yavuz; Kısacık, Bünyamin; Şenyurt, SZ; Tarakçıoğlu, Mehmet; Onat, A.M.

doi:10.1111/odi.12017

Cited by 101 publications

(114 citation statements)

References 44 publications

(89 reference statements)

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“…Other studies [29–32] have suggested that nonsurgical periodontal therapy improves rheumatoid arthritis parameters, including a recent study showing reductions in erythrocyte sedimentation rate/C-reactive protein, tumor necrosis factor (TNF) levels, and Disease Activity Score. Though not designed to address a periodontal hypothesis, a rheumatoid arthritis treatment study [33] with doxycycline with methotrexate (MTX) showed that 20 mg/day doxycycline (the dose typically used to treat periodontal disease) had similar ACR50 responses as a 100-mg dose; both doses were superior to placebo–MTX.…”

Section: Association Studies Between Periodontal Disease and Rheumatomentioning

confidence: 99%

Periodontal disease and rheumatoid arthritis

Bingham

Moni

2013

Current Opinion in Rheumatology

141

106

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Purpose of review This review was conducted to focus on the recent clinical and translational research related to the associations between periodontal disease and rheumatoid arthritis. Recent findings There is a growing interest in the associations between oral health and autoimmune and inflammatory diseases. A number of epidemiologic studies have described associations between rheumatoid arthritis and periodontal disease. Recent clinical studies continue to support these reports, and are increasingly linked with biological assessments to better understand the nature of these relationships. A number of recent studies have evaluated the periopathogenic roles of Porphyromonas gingivalis, the oral microbiome, and mechanisms of site-specific and substrate-specific citrullination. These are helping to further elucidate the interactions between these two inflammatory disease processes. Summary Studies of clinical oral health parameters, the gingival microenvironment, autoantibodies and biomarkers, and rheumatoid arthritis disease activity measures are providing a better understanding of the potential mechanisms responsible for rheumatoid arthritis and periodontal disease associations. The cumulative results and ongoing studies have the promise to identify novel mechanisms and interventional strategies to improve patient outcomes for both conditions.

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Section: Association Studies Between Periodontal Disease and Rheumatomentioning

confidence: 99%

Periodontal disease and rheumatoid arthritis

Bingham

Moni

2013

Current Opinion in Rheumatology

141

106

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“…110 More recent treatment studies confirm these findings, with a significant decrease in TNF-a levels. [119][120][121] Improvement in signs and symptoms of RA occurred, regardless of whether the RA patients were under anti-TNF-a treatment. 117 Anti-TNF-a RA treatment had no effect on the periodontal health without periodontal therapy.…”

Section: Rheumatoid Arthritismentioning

confidence: 95%

Does Treatment of Periodontal Disease Influence Systemic Disease?

Borgnakke

2015

Dental Clinics of North America

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“…Additional longitudinal studies are therefore needed to establish a role for PD in RA pathogenesis. Intriguingly, however, treating PD appears to improve RA severity and concomitantly decrease pro-inflammatory biomarkers of disease activity such as CRP, ESR, TNF, and IL-1beta [37–38]. RA patients with active PD are also less responsive to anti-TNF-α inhibition, indicating a potential role for the co-treatment of PD in TNF refractory patients [39].…”

Section: Evidence For the Ra-periodontal Disease Associationmentioning

confidence: 99%

Microbiome and mucosal inflammation as extra-articular triggers for rheumatoid arthritis and autoimmunity

Brusca

Abramson

Scher

2014

Current Opinion in Rheumatology

200

169

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Purpose of Review Despite progress towards understanding the molecular pathogenesis of Rheumatoid Arthritis (RA), its etiology remains elusive. Genes are important but rather insufficient to explain the majority of RA cases. This review describes novel data supporting the microbiome and its interactions with the human host as potential en(‘in’)vironmental factors in RA pathogenesis. Recent Findings Animal models of inflammatory arthritis have shown that the presence of bacteria in mucosal surfaces is sufficient to alter local and systemic host immune responses and elicit joint inflammation. Human RA studies have focused on three mucosal sites: the gut, the gingival, and the respiratory tree. The oral microbiome, and specifically Porphyromonas gingivalis (P. gingivalis), has long been implicated. Novel sequencing technologies have allowed investigations into the role of the gut microbiome in the development of autoimmune arthritis. Most recently, the pulmonary parenchyma has also been described as yet another possible mucosal site of initiation of autoimmunity in RA. Summary Emerging data implicates the microbiome in RA pathogenesis. Mucosal sites exposed to a high load of bacterial antigens - such as the periodontium, lung, and gut - may represent the initial site of autoimmune generation. If validated, these findings could lead to the discovery of potential biomarkers and therapeutic approaches in the pre-clinical and clinical phases of RA.

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Effects of periodontal therapy on disease activity and systemic inflammation in rheumatoid arthritis patients

Abstract: Non-surgical periodontal treatment may prove beneficial in reducing RA severity as measured by ESR, CRP, TNF-α levels in serum and DAS28 in low or moderate to highly active RA patients with chronic periodontitis.

Cited by 101 publications

References 44 publications

Periodontal disease and rheumatoid arthritis

Periodontal disease and rheumatoid arthritis

Does Treatment of Periodontal Disease Influence Systemic Disease?

Microbiome and mucosal inflammation as extra-articular triggers for rheumatoid arthritis and autoimmunity

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