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Effects of non-surgical periodontal therapy on periodontal laboratory and clinical data as well as on disease activity in patients with rheumatoid arthritis

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Abstract

Objectives

To compare the effect of non-surgical periodontal therapy on clinical and inflammatory parameters in patients with moderate to severe chronic periodontitis (CP) and rheumatoid arthritis (RA) (RA-CP) with that in CP patients without RA.

Material and methods

Eighteen patients with RA-CP and 18 systemically healthy patients with CP were treated with scaling and root planing (SRP) within 24 h. At baseline, and at 3 and 6 months after SRP, clinical periodontal parameters, inflammatory markers, and microorganisms in subgingival biofilm were assessed. In addition, disease activity markers of RA (DAS28, CRP, ESR) and specific antibodies (RF) were monitored in the RA-CP group.

Results

In both groups, non-surgical therapy yielded to statistically significant improvements in all investigated clinical periodontal variables; in RA patients, a statistically significant decrease in serum-CRP was seen at 3 months. At all time-points, levels of inflammatory markers in GCF were higher in RA-CP than in CP patients. Counts of Porphyromonas gingivalis, Tannerella forsythia, and Treponema denticola decreased statistically significantly in CP but not in the RA-CP group. Changes of DAS28 correlated positively with those of P. gingivalis and negatively with the plaque index.

Conclusions

Within their limits, the present data suggest that (a) non-surgical periodontal therapy improves periodontal conditions in CP patients with and without RA and (b) in patients with RA, eradication of P. gingivalis in conjunction with a high level oral hygiene may transiently decrease disease activity of RA.

Clinical relevance

In patients with RA and CP, non-surgical periodontal therapy is a relevant modality not only to improve the periodontal condition but also to decrease RA activity.

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Acknowledgements

The authors are grateful to Martin Eckert, Stéphanie Larti, and Anna Magdoń (University of Bern, Department of Periodontology, Laboratory of Oral Microbiology) for technical assistance. The statistical support of Walter B. Bürgin, Dipl. Biomed. Eng. (University Bern, School of Dental Medicine, Ressort Research), is highly appreciated.

Funding

The study was funded by the participating departments, along with grants from Sciex (project number 12.188), from the European Commission (FP7-HEALTH-F3-2012-306029 “TRIGGER”) and POSDRU grant no. 159/1.5/S/138776 (title “Model colaborativ instituţional pentru translarea cercetării ştiinţifice biomedicale în practica clinică- TRANSCENT”).

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Authors and Affiliations

  1. Clinic of Periodontology, Philipps University Marburg, Georg-Voigt Str. 3, 35039, Marburg, Germany

    Raluca Cosgarea & Nicole Birgit Arweiler

  2. Clinic of Prosthodontics, University of Medicine and Pharmacy Iuliu Hatieganu, Str. Clinicilor nr 32, 400006, Cluj-Napoca, Romania

    Raluca Cosgarea, Roxana Tristiu & Liana Lascu

  3. Clinic of Rheumatology, University of Medicine and Pharmacy Iuliu Hatieganu, Str. Clinicilor nr. 2-4, 400006, Cluj-Napoca, Romania

    Raluca Bianca Dumitru & Simona Rednic

  4. Faculty of Economical Sciences, University Babes-Bolyai, str. Universitatii 7-9, 400084, Cluj-Napoca, Romania

    Cristina Ioana Sirbu

  5. Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland

    Anton Sculean & Sigrun Eick

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  1. Raluca Cosgarea
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  2. Roxana Tristiu
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  9. Sigrun Eick
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Correspondence to Raluca Cosgarea.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards (application—approval no. 580/13.04.2012).

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Informed consent was obtained from all individual participants included in the study.

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Cosgarea, R., Tristiu, R., Dumitru, R.B. et al. Effects of non-surgical periodontal therapy on periodontal laboratory and clinical data as well as on disease activity in patients with rheumatoid arthritis. Clin Oral Invest 23, 141–151 (2019). https://doi.org/10.1007/s00784-018-2420-3

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