Proinflammatory and Anti‐Inflammatory Cytokines in Gingival Crevicular Fluid and Serum of Patients With Rheumatoid Arthritis and Patients With Chronic Periodontitis

Abstract

Although clinical periodontal disease parameters indicated more severe periodontal disease in CP compared to RA patients, immunologic evaluation did not reveal consistent results regarding proinflammatory and anti-inflammatory cytokine levels. This might be a result of the use of non-steroidal anti-inflammatory drugs and rheumatoid agents by patients with RA.

Prevalence and Severity of Periodontitis in Indonesian Patients With Rheumatoid Arthritis

“…However, the prevalence of moderate to severe periodontitis in controls was also high (69%) and not significantly different. Likewise, some other studies reported no significant differences in periodontitis prevalence between RA patients and controls [10][11][12][13][14] , which also might be (partly) due to the potent anti-inflammatory medications used by the RA patients 15,16 . The vast majority of studies did find a higher prevalence of periodontitis in RA patients as compared to controls 2,[6][7][8] , It has to be noted that the patients in these studies, like in our study, were taking antiinflammatory drugs.…”

“…Both diseases share risk factors and have pathological pathways in common, resulting in loss of function and disability as a final clinical outcome 35 . As such, drugs used for RA have also been reported to reduce periodontitis severity 11,15,16 . About eighty percent of the RA patients in our study were on corticosteroids (Table 1).…”

“…Exclusion criteria were presence of other systemic diseases or conditions (e.g diabetes) which are known as risk factors for periodontitis and a history of treatment for periodontal disease. With regard to controls, additional exclusion criteria were the use of medication or consuming drugs which are known to be risk factors for periodontitis 15,16 . Since no (pilot) data concerning differences between Indonesian RA patients and controls was available we did not perform a formal power analysis.…”

“…Although Caucasian, African American, Latin American, North-African and Japanese populations have been studied [2][3][4][5][6][7][8]11 , no study has yet been performed in a South East Asian population. Furthermore, the use of non-steroid antiinflammatory drugs (NSAIDs) and rheumatoid agents in RA patients may affect the pro-and anti-inflammatory cytokine levels in RA patients and thus confound the association between RA and periodontitis 15,16 .…”

“…Although various studies have assessed the association between periodontitis and RA [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] , no study has yet investigated the effect of using several definitions for periodontitis prevalence and severity on the association between periodontitis and RA.…”