Clinical Significance of Periodontitis in Rheumatoid Arthrit | 47140

Journal of Arthritis

ISSN - 2167-7921


Clinical Significance of Periodontitis in Rheumatoid Arthritis Patients: Association with Disease Activity and Functional Status

Hanan M Fathi, Nermeen Khairy, Tamer A Gheita, Weam A El Battawy and Radwa Taha

Objectives: To evaluate frequency of periodontitis (PD) in rheumatoid arthritis (RA) patients and relate it with clinical characteristics, disease activity, functional status, anti-cyclic citrullinated peptide (anti-CCP) and radiographic scores.
Methods: The study included 60 RA patients and 30 controls. Clinical Disease activity index (CDAI), Modified Health Assessment Questionnaire (MHAQ), visual analogue scale of pain and Scott's modification to Larsen scoring method were assessed. Rheumatoid factor (RF) positivity and anti-CCP titer were measured. Periodontal examination was performed and relevant indices calculated.
Results: The mean age of the patients was 49.1 ± 13 years and they were 52 females and 8 males. PD was present in 71.7% of RA patients versus 46.7% in control (p=0.02). PD was predominantly generalized (p=0.004) with moderate-severe degree (p=0.01). Age (p=0.007), disease duration (p<0.0001), morning stiffness (p=0.01), CDAI (p<0.0001), MHAQ (p=0.02), CRP (p=0.02), anti-CCP titer (p=0.01) and methotrexate treatment (p=0.005) were significantly higher in RA-PD versus RA. However, gender, smoking, oral hygiene, erythrocyte sedimentation rate, RF, anti-CCP positivity and radiographic scoring were insignificantly different. PD positivity was 96.3%, predominant generalized in 92.6%, moderate (40.7%) and severe degree (37%) in early RA versus (51.5%, 24.2%, 24.2%, 12.1% respectively) in late RA patients. All PD indices were higher in early patients (p ≤ 0.05) while teeth loss (p=0.03) was higher in late cases. CDAI, VAS and ACPA titer all significantly correlated with PD indices (p<0.05).
Conclusion: Periodontitis is frequent in RA patients’ especially in early cases and is remarkably associated to disease activity and reduced functional status.