Oral health in patients with rheumatoid arthritis

Leena Äyräväinen

Tutkimustuotos: OpinnäyteVäitöskirjaArtikkelikokoelma


Background. Patients with rheumatoid arthritis (RA) suffer from an autoimmune disease with an increased susceptibility to extra-articular inflammation. The purpose of this study was to clarify the oral health in patients with early (ERA) and chronic (CRA) stage of RA. 53 ERA and 28 CRA patients were recruited to this prospective follow-up study at Helsinki University Hospital between 2005 and 2014. ERA patients were naïve to conventional disease- modifying antirheumatic drugs (cDMARDs). CRA patients had a long history of RA and currently an inadequate response to cDMARDs. CRA patients were starting biologic DMARDs mostly combined with cDMARDs. A group of 43 control subjects of age-, gender- and place of residence- matched volunteers was included. Methods. Dental and medical examinations were conducted twice (follow-up mean 16 months) in RA patients and once in controls. Dental examinations included evaluation of periodontitis, prevalence of periodontopathic bacteria from plaque samples, salivary and serum inflammatory biomarkers MMP-8, TIMP-1 and IL-6, saliva flow, Decayed Missing Teeth (DMFT), Decayed Missing Filled Surfaces (DMFS) and Total Dental Index. Dental data comprised also bite-wing and tomogram x-rays. Medical examinations consisted of clinical rheumatological status by disease activity score DAS 28 (28-joint count), total number of swollen (66) and tender (68) joints, blood tests [rheumatoid factor (RF), antibodies against cyclic citrullinated peptide (CCPAb), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), antinuclear antibody (ANA) and antibodies for anti-SSA/SSB (anti-Ro/La) and ribonucleoprotein (RNPAb)], radiographs of hands and feet and general function by Health Assessment Questionnaire (HAQ). Results. At baseline RA patients had significantly more periodontitis: 78.8 % of ERA and 85.7 % of CRA patients vs. 44.1 % of controls suffered from periodontitis (p=0.001). Periodontal findings were more common in RA patients than in controls. Antirheumatic medication seemed to have no influence on periodontal parameters. Salivary inflammatory biomarker MMP-8 was associated with periodontal parameters. MMP-8 (p=0.010) and also IL-6 (p=0.010) in saliva were significantly increased in ERA patients compared with CRA patients and controls at baseline, while MMP-8 and IL-6 in serum were significantly elevated in CRA patients during the study. Salivary MMP-8 and MMP-8/TIMP-1 ratio associated with Periodontal Inflammatory Burden Index (PIBI) in CRA patients at baseline (MMP-8: p
  • Meurman, Jukka, Valvoja
  • Leirisalo-Repo, Marjatta, Valvoja
Painoksen ISBN978-951-51-5343-2
Sähköinen ISBN978-951-51-5344-9
TilaJulkaistu - 2019
OKM-julkaisutyyppiG5 Tohtorinväitöskirja (artikkeli)


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