Association between chronic periodontitis and rheumatoid arthritis: a hospital-based case–control study
DOI: 10.1007/s00296-011-2284-1
Abstract
Rheumatoid
arthritis (RA) and chronic periodontitis are the most common chronic
inflammatory diseases with remarkable pathological
and clinical similarities. A lot of similarities exist
between RA and periodontitis at cellular and molecular levels. The
relationship between these two chronic inflammatory diseases
is still unclear. This case–control study was undertaken to determine
the possible association between chronic inflammatory
diseases like RA and periodontitis. The case group consisted of 100
patients attending the Rheumatology clinic who have
rheumatoid arthritis (RA group). Age- and gender-matched 112 patients
without RA attending the Outpatient wing of Department of
General Medicine formed the control group (NRA group). The number
of missing teeth, gingival index (GI), oral hygiene
index-simplified (OHI-S), probing pocket depth (PPD) and clinical
attachment
levels (CAL) were evaluated in both the groups. Rheumatoid
disease activity was assessed by DAS-28 score system. Systemic
markers of inflammation like erythrocytic sedimentation rate
(ESR) and serum levels of C-reactive protein (CRP) were assessed.
There was a statistically significant difference in GI,
OHI-S, PPD, CAL, ESR and CRP levels between cases (RA group) and
controls
(NRA group) (P < 0.05). Among subjects with RA,
there was no association between the rheumatoid disease activity and the
severity of periodontal
disease. The occurrence and severity of periodontitis was
found to be higher in RA subjects as compared to subjects without
RA, suggesting a positive relation between these two chronic
inflammatory diseases.
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