Periodontal Therapy Reduces the Severity of Active Rheumatoid Arthritis in Patients Treated With or Without Tumor Necrosis Factor Inhibitors
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Background: Rheumatoid arthritis (RA) and periodontitis are common chronic inflammatory conditions. Recent studies showed a beneficial effect of periodontal treatment on the severity of active RA. This study was undertaken to further examine the effect of non‐surgical periodontal treatment on the signs and symptoms of RA in patients treated with or without anti‐tumor necrosis factor‐alpha (anti‐TNF‐α) medications. The effect of anti‐TNF‐α therapy on periodontitis also was assessed. Methods: Forty participants diagnosed with moderate/severe RA (under treatment for RA) and severe periodontitis were randomly assigned to receive initial non‐surgical periodontal therapy with scaling/root planing and oral hygiene instructions (n = 20) or no periodontal therapy (n = 20). To control RA, all participants had been using disease‐modifying anti‐rheumatic drugs, and 20 had also been using anti‐TNF‐α before randomization. Probing depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), gingival index (GI), plaque index (PI), RA disease activity score 28 (DAS28), and erythrocyte sedimentation rate (ESR) were measured at baseline and 6 weeks later. Linear mixed models were used to identify significant differences between subjects who received periodontal treatment and those who did not. Results: Patients receiving periodontal treatment showed a significant decrease in the mean DAS28, ESR (P <0.001), and serum TNF‐α (P <0.05). There was no statistically significant decrease in these parameters in patients not receiving periodontal treatment. Anti‐TNF‐α therapy resulted in a significant improvement in CAL, PD, BOP, and GI. Conclusions: Non‐surgical periodontal therapy had a beneficial effect on the signs and symptoms of RA, regardless of the medications used to treat this condition. Anti‐TNF‐α therapy without periodontal treatment had no significant effect on the periodontal condition.
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Antibodies against P gingivalis virulence factors are elevated in patients with rheumatoid arthritis in a way that correlates with disease severity.
“Antibodies against P gingivalis virulence factors are elevated in patients with rheumatoid arthritis in a way that correlates with disease severity.209, 210”
From The oral microbiome: Role of key organisms and complex networks in oral health and disease (2021) · cites this paper as [209]
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- Authors
- Ortiz, P., Bissada, N. F., Palomo, L., Han, Y. W., Al‐Zahrani, M. S., Panneerselvam, A., & Askari, A.
- Affiliations
- Case Western Reserve University (US)
- King Abdulaziz University (SA)
- University Hospitals Cleveland Medical Center (US)
- Corresponding author
- Palomo, L.
- Venue
- Journal of Periodontology
- Publisher
- Wiley
- Published
- 2009-04
- Volume
- 80
- Issue
- 4
- Pages
- 535-540
- ISSN
- 0022-3492 (ISSN-L)
- 1943-3670
- PMC
- PMC2884010
- OpenAlex
- W2136070771
- Cited by
- 342
- References
- 34
- Citations by year
- 2026: 8 · 2025: 10 · 2024: 16 · 2023: 15 · 2022: 16 · 2021: 27 · 2020: 15 · 2019: 30 · 2018: 21 · 2017: 21 · 2016: 28 · 2015: 27 · 2014: 26 · 2013: 29 · 2012: 25
- FWCI
- 18.54
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Periodontology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Dental and Craniofacial Research (K02DE016102, R01DE014924, R21DE017165)
- Topics
- Health Sciences › Dentistry › Periodontics › Oral microbiology and periodontitis research
- Health Sciences › Medicine › Rheumatology › Rheumatoid Arthritis Research and Therapies
- Health Sciences › Medicine › Urology › Periodontal Regeneration and Treatments
- Keywords
- periodontal treatment, rheumatoid arthritis, periodontitis, anti-TNF therapy, scaling and root planing, dental hygiene education, disease activity, serum TNF-alpha, erythrocyte sedimentation rate, clinical attachment level, probing depth, bleeding on probing, gingival index, plaque index
- MeSH terms
- Adult, Aged, Aged, 80 and over, Arthritis, Rheumatoid, Dental Plaque Index, Female, Humans, Male, Middle Aged, Periodontal Index, Rheumatoid Factor, Dental Scaling, Severity of Illness Index, Tumor Necrosis Factor-alpha, Linear Models, Antirheumatic Agents, Chronic Periodontitis
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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