Periodontitis in early and chronic rheumatoid arthritis: a prospective follow-up study in Finnish population
Leena Äyräväinen,Marjatta Leirisalo-Repo,Antti Kuuliala,Kirsi Ahola,Riitta Koivuniemi,Jukka H. Meurman,Anna Maria Heikkinen +6 more
TLDR
Moderate periodontitis was more frequent in patients with RA than in controls, and patients with ERA and CRA exhibited poorer periodontal health parameters when compared with controls.Abstract:
Objectives To investigate the association between rheumatoid arthritis (RA) and periodontitis with special emphasis on the role of antirheumatic drugs in periodontal health. Design Prospective follow-up study. Patients with early untreated RA and chronic active RA were examined at baseline and 16 months later. Controls were examined once. Settings and participants The study was conducted in Finland from September 2005 to May 2014 at the Helsinki University Hospital. Overall, 124 participants were recruited for dental and medical examinations: 53 were patients with early disease-modifying antirheumatic drug (DMARD) naїve RA (ERA), 28 were patients with chronic RA (CRA) with insufficient response to conventional DMARDs. After baseline examination, patients with ERA started treatment with synthetic DMARDs and patients with CRA with biological DMARDs. Controls were 43 age-matched, gender-matched and community-matched participants. Outcome measures Degree of periodontitis (defined according to the Center for Disease Control and Prevention and the American Academy of Periodontology). Prevalence of periodontal bacteria (analysed from plaque samples), clinical rheumatological status by Disease Activity Score, 28-joint count (DAS28), function by Health Assessment Questionnaire (HAQ) and treatment response by European League Against Rheumatism (EULAR) criteria. Results Moderate periodontitis was present in 67.3% of patients with ERA, 64.3% of patients with CRA and 39.5% of control participants (p=0.001). Further, patients with RA had significantly more periodontal findings compared with controls, recorded with common periodontal indexes. In the re-examination, patients with RA still showed poor periodontal health in spite of treatment with DMARDs after baseline examination. The prevalence of Porphyromonas gingivalis was higher in patients with ERA with periodontal probing depth ≥4 mm compared with patients with CRA and controls. Antirheumatic medication did not seem to affect the results. Conclusions Moderate periodontitis was more frequent in patients with RA than in controls. Patients with ERA and CRA exhibited poorer periodontal health parameters when compared with controls. There was no association between antirheumatic treatment and periodontal parameters.read more
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The case for periodontitis in the pathogenesis of rheumatoid arthritis
TL;DR: The clinical and experimental evidence supporting the new paradigm of citrullinated epitopes recognized by anti-citrullination protein antibodies is discussed and the potential mechanisms involved in linking periodontitis to RA are presented.
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Linkage of Periodontitis and Rheumatoid Arthritis: Current Evidence and Potential Biological Interactions.
Rafael Scaf de Molon,Carlos Rossa,Rogier M Thurlings,Joni Augusto Cirelli,Marije I. Koenders +4 more
TL;DR: An overview of the relationship between rheumatoid arthritis and periodontal disease is provided, exploring the similarities in the immune-pathological aspects and the possible mechanisms linking the development and progression of both diseases.
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Association between severity of periodontitis and clinical activity in rheumatoid arthritis patients: a case–control study
B Rodríguez-Lozano,Jerián González-Febles,Jorge Luis Garnier-Rodríguez,Shashi Dadlani,Sagrario Bustabad-Reyes,Mariano Sanz,Fernando Sánchez-Alonso,Carlos Sánchez-Piedra,Enrique González-Dávila,Federico Díaz-González +9 more
TL;DR: A significant association was demonstrated between periodontitis and RA, independent of other confounders, and was more evident in patients with pronounced periodontal disease and higher RA disease activity.
Journal ArticleDOI
Prevalence of Periodontal Disease and Periodontopathic Bacteria in Anti-Cyclic Citrullinated Protein Antibody-Positive At-Risk Adults Without Arthritis.
Kulveer Mankia,Kulveer Mankia,Zijian Cheng,Thuy Do,L. Hunt,L. Hunt,Josephine Meade,Jing Kang,Val Clerehugh,A. Speirs,Aradhna Tugnait,Elizabeth M A Hensor,Jackie L Nam,Jackie L Nam,Deirdre A. Devine,Paul Emery,Paul Emery +16 more
TL;DR: Results showed that CCP+ at-risk individuals had increased abundance of Porphyromonas gingivalis at healthy periodontal sites compared with the control group and patients with early rheumatoid arthritis.
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M.L.L. Prevoo,M.A. van 't Hof,H.H. Kuper,M.A. van Leeuwen,L. B. A. Van De Putte,P.L.C.M. van Riel +5 more
TL;DR: The Modified DAS that included 28-joint counts were able to discriminate between high and low disease activity (as indicated by clinical decisions of rheumatologists) and are as valid as disease activity scores that include more comprehensive joint counts.
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The shared epitope hypothesis. An approach to understanding the molecular genetics of susceptibility to rheumatoid arthritis.
TL;DR: Relation entre risque de pemphigus et DW1eme et DRW6eme, et relation entre susceptibilite a la polyarthrite rhumatoide and un groupe d'epitopes trouves dans les sous-types non DW10 de DR4.
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A new model for an etiology of rheumatoid arthritis: smoking may trigger HLA-DR (shared epitope)-restricted immune reactions to autoantigens modified by citrullination.
Lars Klareskog,Patrik Stolt,Karin Lundberg,Henrik Källberg,Camilla Bengtsson,Johan Grunewald,Johan Rönnelid,Helena Erlandsson Harris,Ann-Kristin Ulfgren,Solbritt Rantapää-Dahlqvist,Anders Eklund,Leonid Padyukov,Lars Alfredsson +12 more
TL;DR: An etiology involving a specific genotype, an environmental provocation, and the induction of specific autoimmunity are suggested, all restricted to a distinct subset of RA.
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Case Definitions for Use in Population-Based Surveillance of Periodontitis
Roy C. Page,Paul I. Eke +1 more
TL;DR: This classification defines severeperiodontitis and moderate periodontitis in terms of PD and CAL to enhance case definitions and further demonstrates the importance of thresholds ofPD and CAL and the number of affected sites when determining prevalence.
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