Prevalence and severity of periodontitis in patients with established rheumatoid arthritis and osteoarthritis

Abstract

Introduction: Periodontitis is associated with many chronic health conditions including diabetes, cardiovascular disease, and rheumatoid arthritis (RA). RA and periodontitis have similarities in inflammatory mechanism, morphology, and histopathology. Osteoarthritis (OA) is a chronic, multifactorial degenerative disease characterized by the deterioration of cartilage in joints. Objective: The aim of this study was to evaluate the prevalence and severity of periodontal disease in patients with established RA and OA. Materials and Methods: A total of 200 patients reporting to the Department of Orthopaedics, KIMSDU, Karad were included in the study. Patients were divided into two groups: Group 1 that included 100 patients with established RA diagnosed according to American College of Rheumatology (ACR) classification 1987 criteria and Group 2 that comprised 100 patients diagnosed with OA. Demographic profile, medical and dental history, oral hygiene practices, and smoking status of study participants were recorded. Periodontal status of the patients were evaluated using the simplified oral hygiene index (OHI-S), Loe and Silness gingival index (GI), probing pocket depth (PPD), and clinical attachment level (CAL). On the basis of the CAL score periodontitis severity was defined as slight, moderate, and severe. Rheumatoid Factor (RF) and C-reactive protein (CRP) were considered as a serological marker in RA. Serological tests were performed to measure RF and CRP. Periodontal parameters and serological tests were correlated. Results: This study reported 45% severe periodontitis prevalence in RA compared to OA group, which was 33%. Severity of periodontitis is significantly greater in RF positive RA group with mean CAL 5.38 mm compared to RF negative RA group with mean CAL 2.81 mm ( P = 0.001). There was moderate positive correlation found between RF titer and severity of periodontitis (r = 0.311). Conclusion: The severity of periodontitis was significantly higher among the patients with established RA as compared to patients with OA. RF positive patients had higher periodontal disease compared to RF negative patients. There was an increase in the mean clinical attachment loss with increase in RF titer.

Investigation of periodontitis, halitosis, xerostomia, and serological characteristics of patients with osteoarthritis and rheumatoid arthritis and identification of new biomarkers

“…The predictive performance of anti-CCP Ab and RF was outstanding when diagnosing spRA compared to snRA; however, oral health-related factors did not distinguish between these two RA subsets. According to Disale et al, severe periodontitis occurred more frequently in patients with spRA (69.0%) than in those with snRA (16.6%) 60 . However, in the present study, there was no significant difference in the distribution of periodontal diseases between the snRA and spRA groups.…”

Comparative assessment of conventional periodontal probes and CEJ handpiece of electronic probes in the diagnosis and primary care of periodontal disease

“…Periodontal diseases are widely distributed globally and act as an independent risk factor for many systemic diseases or exacerbate the existing conditions like diabetes mellitus, preterm low birth weight babies, cardiovascular diseases, respiratory diseases, metabolic syndrome, obesity, Alzheimer's disease and rheumatoid arthritis. [ 15 16 17 ] Microorganisms or their products from the oral cavity may reach into the systemic circulation and exert their effects directly or indirectly by releasing the inflammatory mediators on the pathogenesis of these systemic diseases. Herpes virus from the oral cavity may also access the systemic circulation and is associated with systemic diseases.…”

The systemic oral health connection: Biofilms

“…One study reported a prevalence of 45% of severe periodontitis in Rheumatoid arthritis compared to those patients with Osteoarthritis (33%). [69] They further reported that severity of periodontitis was significantly higher among the patients with established Rheumatoid arthritis compared to those patients with Osteoarthritis.…”