Periodontitis in early and chronic rheumatoid arthritis: a prospective follow-up study in Finnish population
Identifieur interne : 000119 ( Main/Exploration ); précédent : 000118; suivant : 000120Periodontitis in early and chronic rheumatoid arthritis: a prospective follow-up study in Finnish population
Auteurs : Leena Yr V Inen [Finlande] ; Marjatta Leirisalo-Repo [Finlande] ; Antti Kuuliala [Finlande] ; Kirsi Ahola [Finlande] ; Riitta Koivuniemi [Finlande] ; Jukka H. Meurman [Finlande] ; Anna Maria Heikkinen [Finlande]Source :
- BMJ Open [ 2044-6055 ] ; 2017.
Abstract
To investigate the association between rheumatoid arthritis (RA) and periodontitis with special emphasis on the role of antirheumatic drugs in periodontal health.
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.
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.
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.
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
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.
Url:
DOI: 10.1136/bmjopen-2016-011916
PubMed: 28143836
PubMed Central: 5293865
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Periodontitis in early and chronic rheumatoid arthritis: a prospective follow-up study in Finnish population</title><author><name sortKey=" Yr V Inen, Leena" sort=" Yr V Inen, Leena" uniqKey=" Yr V Inen L" first="Leena" last=" Yr V Inen">Leena Yr V Inen</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Department of Oral and Maxillofacial Diseases</addr-line>,<institution>University of Helsinki</institution>,<addr-line>Helsinki</addr-line>,<country>Finland</country></nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Leirisalo Repo, Marjatta" sort="Leirisalo Repo, Marjatta" uniqKey="Leirisalo Repo M" first="Marjatta" last="Leirisalo-Repo">Marjatta Leirisalo-Repo</name><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>Department of Rheumatology</addr-line>,<institution>University of Helsinki and Helsinki University Hospital</institution>,<addr-line>Helsinki</addr-line>,<country>Finland</country></nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kuuliala, Antti" sort="Kuuliala, Antti" uniqKey="Kuuliala A" first="Antti" last="Kuuliala">Antti Kuuliala</name><affiliation wicri:level="1"><nlm:aff id="af3"><addr-line>Department of Bacteriology and Immunology</addr-line>,<institution>University of Helsinki and Helsinki University Hospital</institution>,<addr-line>Helsinki</addr-line>,<country>Finland</country></nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ahola, Kirsi" sort="Ahola, Kirsi" uniqKey="Ahola K" first="Kirsi" last="Ahola">Kirsi Ahola</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Department of Oral and Maxillofacial Diseases</addr-line>,<institution>University of Helsinki</institution>,<addr-line>Helsinki</addr-line>,<country>Finland</country></nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Koivuniemi, Riitta" sort="Koivuniemi, Riitta" uniqKey="Koivuniemi R" first="Riitta" last="Koivuniemi">Riitta Koivuniemi</name><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>Department of Rheumatology</addr-line>,<institution>University of Helsinki and Helsinki University Hospital</institution>,<addr-line>Helsinki</addr-line>,<country>Finland</country></nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Meurman, Jukka H" sort="Meurman, Jukka H" uniqKey="Meurman J" first="Jukka H" last="Meurman">Jukka H. Meurman</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Department of Oral and Maxillofacial Diseases</addr-line>,<institution>University of Helsinki</institution>,<addr-line>Helsinki</addr-line>,<country>Finland</country></nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Heikkinen, Anna Maria" sort="Heikkinen, Anna Maria" uniqKey="Heikkinen A" first="Anna Maria" last="Heikkinen">Anna Maria Heikkinen</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Department of Oral and Maxillofacial Diseases</addr-line>,<institution>University of Helsinki</institution>,<addr-line>Helsinki</addr-line>,<country>Finland</country></nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">28143836</idno><idno type="pmc">5293865</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5293865</idno><idno type="RBID">PMC:5293865</idno><idno type="doi">10.1136/bmjopen-2016-011916</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">002866</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002866</idno><idno type="wicri:Area/Pmc/Curation">002866</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">002866</idno><idno type="wicri:Area/Pmc/Checkpoint">000109</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000109</idno><idno type="wicri:Area/Ncbi/Merge">006D87</idno><idno type="wicri:Area/Ncbi/Curation">006D87</idno><idno type="wicri:Area/Ncbi/Checkpoint">006D87</idno><idno type="wicri:Area/Main/Merge">000119</idno><idno type="wicri:Area/Main/Curation">000119</idno><idno type="wicri:Area/Main/Exploration">000119</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Periodontitis in early and chronic rheumatoid arthritis: a prospective follow-up study in Finnish population</title><author><name sortKey=" Yr V Inen, Leena" sort=" Yr V Inen, Leena" uniqKey=" Yr V Inen L" first="Leena" last=" Yr V Inen">Leena Yr V Inen</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Department of Oral and Maxillofacial Diseases</addr-line>,<institution>University of Helsinki</institution>,<addr-line>Helsinki</addr-line>,<country>Finland</country></nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Leirisalo Repo, Marjatta" sort="Leirisalo Repo, Marjatta" uniqKey="Leirisalo Repo M" first="Marjatta" last="Leirisalo-Repo">Marjatta Leirisalo-Repo</name><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>Department of Rheumatology</addr-line>,<institution>University of Helsinki and Helsinki University Hospital</institution>,<addr-line>Helsinki</addr-line>,<country>Finland</country></nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Kuuliala, Antti" sort="Kuuliala, Antti" uniqKey="Kuuliala A" first="Antti" last="Kuuliala">Antti Kuuliala</name><affiliation wicri:level="1"><nlm:aff id="af3"><addr-line>Department of Bacteriology and Immunology</addr-line>,<institution>University of Helsinki and Helsinki University Hospital</institution>,<addr-line>Helsinki</addr-line>,<country>Finland</country></nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Ahola, Kirsi" sort="Ahola, Kirsi" uniqKey="Ahola K" first="Kirsi" last="Ahola">Kirsi Ahola</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Department of Oral and Maxillofacial Diseases</addr-line>,<institution>University of Helsinki</institution>,<addr-line>Helsinki</addr-line>,<country>Finland</country></nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Koivuniemi, Riitta" sort="Koivuniemi, Riitta" uniqKey="Koivuniemi R" first="Riitta" last="Koivuniemi">Riitta Koivuniemi</name><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>Department of Rheumatology</addr-line>,<institution>University of Helsinki and Helsinki University Hospital</institution>,<addr-line>Helsinki</addr-line>,<country>Finland</country></nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Meurman, Jukka H" sort="Meurman, Jukka H" uniqKey="Meurman J" first="Jukka H" last="Meurman">Jukka H. Meurman</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Department of Oral and Maxillofacial Diseases</addr-line>,<institution>University of Helsinki</institution>,<addr-line>Helsinki</addr-line>,<country>Finland</country></nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Heikkinen, Anna Maria" sort="Heikkinen, Anna Maria" uniqKey="Heikkinen A" first="Anna Maria" last="Heikkinen">Anna Maria Heikkinen</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Department of Oral and Maxillofacial Diseases</addr-line>,<institution>University of Helsinki</institution>,<addr-line>Helsinki</addr-line>,<country>Finland</country></nlm:aff><country xml:lang="fr">Finlande</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">BMJ Open</title><idno type="eISSN">2044-6055</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Objectives</title><p>To investigate the association between rheumatoid arthritis (RA) and periodontitis with special emphasis on the role of antirheumatic drugs in periodontal health.</p></sec><sec><title>Design</title><p>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.</p></sec><sec><title>Settings and participants</title><p>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.</p></sec><sec><title>Outcome measures</title><p>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.</p></sec><sec><title>Results</title><p>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 <italic>Porphyromonas gingivalis</italic> 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.</p></sec><sec><title>Conclusions</title><p>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. 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Inen</name></noRegion><name sortKey="Ahola, Kirsi" sort="Ahola, Kirsi" uniqKey="Ahola K" first="Kirsi" last="Ahola">Kirsi Ahola</name><name sortKey="Heikkinen, Anna Maria" sort="Heikkinen, Anna Maria" uniqKey="Heikkinen A" first="Anna Maria" last="Heikkinen">Anna Maria Heikkinen</name><name sortKey="Koivuniemi, Riitta" sort="Koivuniemi, Riitta" uniqKey="Koivuniemi R" first="Riitta" last="Koivuniemi">Riitta Koivuniemi</name><name sortKey="Kuuliala, Antti" sort="Kuuliala, Antti" uniqKey="Kuuliala A" first="Antti" last="Kuuliala">Antti Kuuliala</name><name sortKey="Leirisalo Repo, Marjatta" sort="Leirisalo Repo, Marjatta" uniqKey="Leirisalo Repo M" first="Marjatta" last="Leirisalo-Repo">Marjatta Leirisalo-Repo</name><name sortKey="Meurman, Jukka H" sort="Meurman, Jukka H" uniqKey="Meurman J" first="Jukka H" last="Meurman">Jukka H. 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