Débora Cerqueira Calderaro1, Jôice Dias Corrêa2, Gilda Aparecida Ferreira3, Izabela Guimarães Barbosa4, Carolina Castro Martins5, Tarcília Aparecida Silva6, Antônio Lúcio Teixeira7. 1. Universidade Federal de Minas Gerais, Hospital das Clínicas, Serviço de Reumatologia, Belo Horizonte, MG, Brazil. Electronic address: dccalderaro@gmail.com. 2. Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Programa de Pós-Graduação em Biologia Celular, Belo Horizonte, MG, Brazil. 3. Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento do Aparelho Locomotor, Belo Horizonte, MG, Brazil. 4. Hospital do Instituto de Previdência dos Servidores do Estado de Minas Gerais, Serviço de Psiquiatria, Belo Horizonte, MG, Brazil. 5. Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Odontopediatria e Ortodontia, Belo Horizonte, MG, Brazil. 6. Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Clínica, Patologia e Cirurgia Odontológicas, Belo Horizonte, MG, Brazil. 7. Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Medicina Interna, Belo Horizonte, MG, Brazil.
Abstract
OBJECTIVE: To evaluate the influence of periodontal treatment on rheumatoid arthritis activity. METHODS: MEDLINE/PUBMED, The Cochrane Library, Clinical Trials, SciELO and LILACS were searched for studies published until December 2014. Included articles were: prospective studies; including patients older than 18 years, diagnosed with periodontitis and rheumatoid arthritis submitted to non-surgical periodontal treatment; with a control group receiving no periodontal treatment; with outcomes including at least one marker of rheumatoid arthritis activity. Methodological quality of the studies was assessed using PEDro scale. Quantitative data were pooled in statistical meta-analysis using Review Manager 5. RESULTS: Four articles were included. Non-surgical periodontal treatment was associated with a significant reduction of DAS28 (OR: -1.18; 95% CI: -1.43, -0.93; p<0.00001). Erythrocyte sedimentation rate, C-reactive protein, patient's assessment of rheumatoid activity using visual analogical scale, tender and swollen joint counts showed a trend toward reduction (not statistically significant). CONCLUSIONS: The reduction of DAS 28 in patients with rheumatoid arthritis after periodontal treatment suggests that the improvement of periodontal condition is beneficial to these patients. Further randomized controlled clinical trials are necessary to confirm this finding.
OBJECTIVE: To evaluate the influence of periodontal treatment on rheumatoid arthritis activity. METHODS: MEDLINE/PUBMED, The Cochrane Library, Clinical Trials, SciELO and LILACS were searched for studies published until December 2014. Included articles were: prospective studies; including patients older than 18 years, diagnosed with periodontitis and rheumatoid arthritis submitted to non-surgical periodontal treatment; with a control group receiving no periodontal treatment; with outcomes including at least one marker of rheumatoid arthritis activity. Methodological quality of the studies was assessed using PEDro scale. Quantitative data were pooled in statistical meta-analysis using Review Manager 5. RESULTS: Four articles were included. Non-surgical periodontal treatment was associated with a significant reduction of DAS28 (OR: -1.18; 95% CI: -1.43, -0.93; p<0.00001). Erythrocyte sedimentation rate, C-reactive protein, patient's assessment of rheumatoid activity using visual analogical scale, tender and swollen joint counts showed a trend toward reduction (not statistically significant). CONCLUSIONS: The reduction of DAS 28 in patients with rheumatoid arthritis after periodontal treatment suggests that the improvement of periodontal condition is beneficial to these patients. Further randomized controlled clinical trials are necessary to confirm this finding.
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