Periodontitis and Porphyromonas gingivalis in Preclinical Stage of Arthritis Patients

Abstract

PurposeTo determine whether the presence of periodontitis (PD) and Porphyromonas gingivalis (Pg) in the subgingival biofilm associates with the development of rheumatoid arthritis (RA) in treatment naïve preclinical stage of arthritis patients.MethodsWe conducted a prospective cohort study of 72 consecutive patients with arthralgia who had never been treated with any anti-rheumatic drugs or glucocorticoids. Periodontal status at baseline was assessed by dentists. PD was defined stringently by the maximal probing depth≧4 mm, or by the classification by the 5th European Workshop in Periodontology (EWP) in 2005 using attachment loss. Up to eight plaque samples were obtained from each patient and the presence of Pg was determined by Taqman PCR. The patients were followed up for 2 years and introduction rate of methotrexate (MTX) treatment on the diagnosis of RA was compared in patients with or without PD or Pg.ResultsPatients with PD (probing depth≧4mm) had higher arthritis activity (p = 0.02) and higher risk for future introduction of MTX treatment on the diagnosis of RA during the follow up than patients without PD (Hazard ratio 2.68, p = 0.03). Arthritis activity and risk for MTX introduction increased with the severity of PD assessed by EWP, although not statistically significant. On the other hand, presence of Pg was not associated with arthritis activity (p = 0.72) or the risk for MTX introduction (p = 0.45).ConclusionIn treatment naïve arthralgia patients, PD, but not the presence of Pg, associates with arthritis activity and future requirement of MTX treatment on the diagnosis of RA.

Cross‐Sectional Evaluation of Periodontal Status and Microbiologic and Rheumatoid Parameters in a Large Cohort of Patients With Rheumatoid Arthritis

“…Microbiologic aspects are increasingly discussed in the literature as a potential connecting factor between periodontitis and RA. In this context, high prevalence of typical periodontopathogens could be shown; 18 however, differences in composition of subgingival biofilm were only partially detected in comparing RA and HC groups 21 , 34 . The current study found higher concentrations and prevalence rates of F. nucleatum and P. micra in patients with RA as well as positive findings of T. denticola in multivariate analysis within the RA group.…”

Dental treatments, tooth extractions, and osteonecrosis of the jaw in Japanese patients with rheumatoid arthritis: results from the IORRA cohort study

“…More advanced forms of periodontitis were found in patients with early RA compared with controls [2]. A recent Japanese study showed that periodontitis in treatment-naïve arthralgia patients was significantly associated with arthritis activity and the later need for methotrexate treatment upon diagnosis of RA [4]. RA has also been associated with tooth loss and periodontitis [3], and oral health-related quality of life is reported to be poor in patients with RA [5].…”

“…A recent Japanese study showed that periodontitis in treatment-naïve arthralgia patients was significantly associated with arthritis activity and the later need for methotrexate treatment upon diagnosis of RA [4]. Oral health-related quality of life is reportedly poor in patients with RA [5].…”

Periodontito Ir Reumatoidinio Artrito Ryšys. Literatūros Apžvalga

“…Tyrimai parodė, kad lėtinis PD yra susijęs su didesniu RA aktyvumu ir greičiau besivystančiais bei labiau išreikštais radiologiniais sąnarių pažeidimo požymiais [49,52].…”