Korean J Intern Med.  2016 Sep;31(5):977-986. 10.3904/kjim.2015.202.

Periodontitis is associated with rheumatoid arthritis: a study with longstanding rheumatoid arthritis patients in Korea

Affiliations
  • 1Department of Internal Medicine, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea. ysong@snu.ac.kr
  • 2Department of Periodontology, Seoul National University School of Dentistry, Seoul, Korea.
  • 3Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University, Seoul, Korea.
  • 4Dental Research Institute, Seoul National University School of Dentistry, Seoul, Korea.

Abstract

BACKGROUND/AIMS
A cross-sectional study was undertaken to investigate the association between severity of periodontitis and clinical manifestation of rheumatoid arthritis (RA).
METHODS
Two hundred sixty-four RA patients and 88 age- and sex-matched controls underwent dental exam. Additionally, clinical manifestations including disease activity and anti-citrullinated protein antibodies were evaluated in RA patients.
RESULTS
The prevalence of moderate or severe periodontitis was higher in RA patients compared to controls (63.6% vs 34.1%, p < 0.001). In markers of periodontal inflammation, bleeding on probing was correlated with disease activity score 28 (r = 0.128, p = 0.041), RA disease duration (r = 0.211, p = 0.001), erythrocyte sedimentation rate (ESR; r = 0.141, p = 0.023), anti-cyclic citrullinated peptide antibody (r = 0.183, p = 0.009), and anti-citrullinated α-enolase peptide-1 antibody (r = 0.143, p = 0.025). Gingival index was correlated with RA duration (r = 0.262, p < 0.001), ESR (r = 0.162, p = 0.009), anti-cyclic citrullinated peptide antibody (r = 0.203, p = 0.004) and anti-citrullinated α-enolase peptide-1 antibody (r = 0.225, p < 0.001). Periodontal structural damage represented by probing pocket depth and clinical attachment level were less in RA patients with human leukocyte antigen (HLA)-DRB1 shared epitope compared than those without shared epitope (p = 0.005 and p =0.006, respectively).
CONCLUSIONS
The prevalence of moderate or severe periodontitis was increased in RA patients compared to controls. Periodontal inflammation was correlated with RA disease duration, ESR, and anti-citrullinated protein antibodies. Periodontal structural damage was less in RA patients with HLA-DRB1 shared epitope.

Keyword

Periodontitis; Arthritis, rheumatoid

MeSH Terms

Antibodies
Arthritis, Rheumatoid*
Blood Sedimentation
Cross-Sectional Studies
Hemorrhage
HLA-DRB1 Chains
Humans
Inflammation
Korea*
Leukocytes
Periodontal Index
Periodontitis*
Prevalence
Antibodies
HLA-DRB1 Chains
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