J Periodontal Implant Sci.  2012 Jun;42(3):67-72. 10.5051/jpis.2012.42.3.67.

Effect of rheumatoid arthritis on periodontitis: a historical cohort study

• Torkzaban
• Hjiabadi T
• Basiri Z
• Poorolajal J

• KMID: 2094729
• DOI: http://doi.org/10.5051/jpis.2012.42.3.67

Abstract

PURPOSE
Rheumatoid arthritis (RA) is a chronic multi-systemic disease that causes damage to the bone and connective tissues. This study was conducted in order to accurately measure the correlation between RA and periodontitis, and to obtain an unbiased estimate of the effect of RA on periodontal indices.
METHODS
In this historical cohort study, which was conducted from February to May 2011 in Hamadan city, Iran, 53 exposed people (with RA) were compared with 53 unexposed people (without RA) in terms of clinical periodontal indices (the outcomes of interest) including 1) plaque index (PI), 2) bleeding on probing (BOP), and 3) clinical attachment loss (CAL).
RESULTS
A sample of 106 volunteers were evaluated, 53 rheumatoid versus 53 non-rheumatoid subjects. There was a statistically significant correlation between RA and BOP (P<0.001) and between RA and CAL (P<0.001). However, there was no statistically significant correlation between RA and any of the periodontal indices. No correlation was seen between gender and any of the indices either. There was a strong positive correlation between age and all three periodontal indices (P<0.001).
CONCLUSIONS
The present study indicated a potential effect of RA on periodontal indices. However, much more evidence based on a prospective cohort study is needed to support the cause and effect relationship between RA and periodontal indices.

Keyword

Rheumatoid arthritis; Periodontitis; Periodontal index; Iran

MeSH Terms

Arthritis, Rheumatoid
Cohort Studies
Connective Tissue
Hemorrhage
Iran
Periodontal Index
Periodontitis

Figure

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  Figure 1 Method of assessment of bleeding on probing.

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  Figure 2 Assessment of clinical attachment loss using a Williams probe.

Reference

1. Novak MJ. Newman MG, Takei H, Klokkevold PR, Carranza FA, editors. Classification of Diseases and Conditions Affecting of Periodontium. Carranza's clinical periodontology. 2006. 10th ed. Philadelphia: Saunders;100–109.

2. Lipsky PE. Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, editors. Rheumatoid Arthritis. Harrison's principles of internal medicine. 2008. 17th ed. New York: McGraw Hill;2083–2092.

3. Mercado FB, Marshall RI, Bartold PM. Inter-relationships between rheumatoid arthritis and periodontal disease. A review. J Clin Periodontol. 2003. 30:761–772.

4. Pischon N, Pischon T, Kroger J, Gulmez E, Kleber BM, Bernimoulin JP, et al. Association among rheumatoid arthritis, oral hygiene, and periodontitis. J Periodontol. 2008. 79:979–986.

5. Mercado F, Marshall RI, Klestov AC, Bartold PM. Is there a relationship between rheumatoid arthritis and periodontal disease? J Clin Periodontol. 2000. 27:267–272.

6. Bakhtiari S, Taheri JB, Abbasi F. Association between rheumatoid arthritis and moderate to severe periodontitis in Iranian adults. J Dent (Teheran). 2009. 6:145–149.

7. Pinho Mde N, Oliveira RD, Novaes AB Jr, Voltarelli JC. Relationship between periodontitis and rheumatoid arthritis and the effect of non-surgical periodontal treatment. Braz Dent J. 2009. 20:355–364.

8. Dissick A, Redman RS, Jones M, Rangan BV, Reimold A, Griffiths GR, et al. Association of periodontitis with rheumatoid arthritis: a pilot study. J Periodontol. 2010. 81:223–230.

9. Perry DA. Newman MG, Takei HH, Klokkevold FR, Carranza FA, editors. Plaque Control for the Periodontal Patient. Carranza's clinical periodontology. 2012. 11th ed. Missouri: WB Saunders;552–560.

10. Ishi Ede P, Bertolo MB, Rossa C Jr, Kirkwood KL, Onofre MA. Periodontal condition in patients with rheumatoid arthritis. Braz Oral Res. 2008. 22:72–77.

11. Kasser UR, Gleissner C, Dehne F, Michel A, Willershausen-Zonnchen B, Bolten WW. Risk for periodontal disease in patients with longstanding rheumatoid arthritis. Arthritis Rheum. 1997. 40:2248–2251.