HOME - Clinical cases - Periodontology
19 June 2019

Periodontitis and reumatoid arthritis: a common responsible

Alessandra Abbà

Periodontitis is a chronic inflammatory disease characterized by an irreversible loss of connective tissue attachment and alveolar bone and it is a major cause of tooth loss.
Reumatoid Arthritis (RA) is a chronic destructive multifactorial disease of unknown etiology in which genetic susceptibility, environmental and hormonal factors interact in complex ways. It’s characterized by the accumulation and persistence of an inflammatory infiltrate in the synovial membrane, resulting in synovitis and joint architecture destruction.  

So what do they share?

Porphyromonas gingivalis (Pg) is a key factor in the pathogenesis both of rheumatoid arthritis (RA) and periodontitis. An increasing number of studies have demonstrated this association. Pg can induce anticyclic-citrullinated peptide autoantibodies (anti-CCP antibodies),responsible of the development of RA. Periodontitis and RA also share genetic and environmental risk factors.  
In this prospective cross-sectional study, published in JPIS in 2018, authors aimed to evaluate the relationships and the clinical implications between the two diseases in Korean adults.

The RA group included 260 patients who satisfied the 1987 American College of Rheumatology classification criteria for RA. Serologic analyses were performed for them. An age- and sex-matched control group of 86 volunteers without arthritis was enrolled too.    In order to evaluate periodontal conditions, the following data were registered:  

  • plaque index (PI)
  • gingival index (GI)
  •  probing pocket depth (PPD)
  •  bleeding on probing (BOP)
  • clinical attachment level (CAL) 

Periodontal indices and the prevalence and amount of periodontal pathogens were recorded and compared between the groups. Correlations between periodontal and RA indices were examined.  

Statistacally significant higher values were registered for the RA group (P<0.05) for all periodontal indices except the number of teeth. The severity of periodontitis in all participants was slight or more than slight. The RA group showed also a significantly higher prevalence of moderate-to-severe periodontitis (64.2% vs. 34.9%, P<0.001).
The GI, BOP, and PPD showed positive relationships with several RA indices. The anti-Pg antibody titer had positive relationships with PPD, BOP, CAL, and periodontitis severity (table 1).

  • Table 1

    Table 1

Even if there was no significant difference in the prevalence of periodontal pathogens between the two groups, RA was associated with higher values of periodontal indices and periodontitis severity. In conclusion, alteration of periodontal indices could be used as a warning sign of disease development in RA patients and at the same time an increasing anti-Pg antibody titer could be considered as a risk indicator in RA patients suffering with periodontitis.

For additional informations: 
Periodontal pathogens and the association between periodontitis and rheumatoid arthritis in Korean adults

Related articles

Aesthetics is becoming everyday more and more important for patients. Indeed, one of the main reason for a dental consultation is the alteration of tooth...

The main purpose of dental treatment is to prevent tooth loss and aid in maintaining the functions of the stomatognathic system. However, the maintenance of...

Good hygiene practices are universally recognized essential factors for oral health, and flossing is considered an indispensable part of an effective oral...

Periodontitis is a chronic inflammatory disease resulting from an opportunistic infection of endogenous plaque biofilm. Periodontitis affects more than 50% of...

Periodontal disease is one of the most common oral diseases worldwide.. The major consequence of periodontitis is an increased mobility of teeth followed by...

Read more

From October 1st to 5th the annual meeting of the Academy of Dental Materials (ADM) was held in Jackson Hole (Wyoming, USA), entitled: "Materials to...

From October 1st to 5th the annual meeting of the Academy of Dental Materials was held in Jackson Hole (Wyoming, USA), entitled: "Materials to Enable the Evolution/Revolution of Digital...

Authors: M. Gobbo, G. Ottaviani, K. Rupel, M. Biasotto

A female patient was sent to the Medicine and Oral Pathology clinic of the Dental Clinic of Trieste for the evaluation of an intensely radiopaque foreign body...

Root caries results from the dissolution of minerals in dentine by the acids produced by bacteria, since dentine have a much lower mineral content when compared...

Tooth autotransplantation is the transplantation of one's own tooth from one site of the mouth to another edentulous site. This technique is possible only when a donor tooth is available....




Most popular