Paul Monsarrat1, Gabriel Fernandez de Grado2, Arnaud Constantin3, Claire Willmann4, Cathy Nabet2, Michel Sixou5, Alain Cantagrel3, Thomas Barnetche6, Nadia Mehsen-Cetre6, Thierry Schaeverbeke6, Elise Arrivé7, Jean-Noel Vergnes8. 1. Paul Sabatier University, Dental Faculty, Toulouse University Hospital (CHU de Toulouse), 31062 Toulouse, France; Department of oral rehabilitation, Dental Faculty, 31062 Toulouse, France; STROMALab, Université de Toulouse, CNRS ERL 5311, EFS, ENVT, Inserm U1031, UPS, 31100 Toulouse, France. Electronic address: paul.monsarrat@univ-tlse3.fr. 2. Paul Sabatier University, Dental Faculty, Toulouse University Hospital (CHU de Toulouse), 31062 Toulouse, France; Inserm UMR1027, Paul-Sabatier University, 31000 Toulouse, France; Department of epidemiology and public health, Dental Faculty, 31062 Toulouse, France. 3. Department of rheumatology, Hôpitaux de Toulouse, France and Université Paul Sabatier Toulouse III, 31300 Toulouse, France. 4. Paul Sabatier University, Dental Faculty, Toulouse University Hospital (CHU de Toulouse), 31062 Toulouse, France. 5. Paul Sabatier University, Dental Faculty, Toulouse University Hospital (CHU de Toulouse), 31062 Toulouse, France; Department of epidemiology and public health, Dental Faculty, 31062 Toulouse, France. 6. Rheumatology department, FHU ACRONIM, Bordeaux university hospital, 33076 Bordeaux, France. 7. Department of dentistry and oral health, Bordeaux university hospital, 33000 Bordeaux, France; Department of odontology, Bordeaux university, 33000 Bordeaux, France. 8. Paul Sabatier University, Dental Faculty, Toulouse University Hospital (CHU de Toulouse), 31062 Toulouse, France; Department of epidemiology and public health, Dental Faculty, 31062 Toulouse, France; Division of oral health and society, faculty of dentistry, McGill university, Montreal, Quebec H3A 0C7, Canada.
Abstract
OBJECTIVES: To assess the effect of periodontal treatment on clinical and biochemical parameters of rheumatoid arthritis (RA) and quality of life (QoL) in patients with moderately active RA who were diagnosed with periodontitis. METHODS: In this open-label randomised controlled trial, RA subjects (n = 22) were allocated to "immediate" or "delayed" periodontal treatment (full-mouth non-surgical scaling and root planing, systemic antibiotics, and oral hygiene instructions). The main outcome was the 3-month change on the Disease Activity Score 28 based on the Erythrocyte Sedimentation Rate (DAS28-ESR). The Health Assessment Questionnaire and the General Oral Health Assessment Index were used to assess general and oral health QoL, respectively. RESULTS:Periodontal health significantly improved after periodontal treatment (P = 0.03). Periodontal treatment appeared to be safe but led to no significant effects on the DAS28-ESR (adjusted mean difference with 95% confidence interval (aMD) of -0.03 [-0.98; 0.92]). There was no evidence of improvement in the general QoL after periodontal treatment and no significant effect was found for the oral health QoL, despite a positive trend in the "psychological impacts" domain (aMD of 0.13 [-0.07; 0.33], P = 0.20). CONCLUSIONS: Although no clinical effect of periodontal treatment on RA was identified, this trial provides important data to support periodontal care in RA patients. Periodontal treatment is safe and reduces oral inflammation with a possible effect on oral health QoL. Since both periodontitis and RA are complex and multifactorial chronic diseases, it is likely that patient-centred approaches involving both oral health professionals and rheumatologists will contribute to optimal patient care. ISRCTN79186420.
RCT Entities:
OBJECTIVES: To assess the effect of periodontal treatment on clinical and biochemical parameters of rheumatoid arthritis (RA) and quality of life (QoL) in patients with moderately active RA who were diagnosed with periodontitis. METHODS: In this open-label randomised controlled trial, RA subjects (n = 22) were allocated to "immediate" or "delayed" periodontal treatment (full-mouth non-surgical scaling and root planing, systemic antibiotics, and oral hygiene instructions). The main outcome was the 3-month change on the Disease Activity Score 28 based on the Erythrocyte Sedimentation Rate (DAS28-ESR). The Health Assessment Questionnaire and the General Oral Health Assessment Index were used to assess general and oral health QoL, respectively. RESULTS: Periodontal health significantly improved after periodontal treatment (P = 0.03). Periodontal treatment appeared to be safe but led to no significant effects on the DAS28-ESR (adjusted mean difference with 95% confidence interval (aMD) of -0.03 [-0.98; 0.92]). There was no evidence of improvement in the general QoL after periodontal treatment and no significant effect was found for the oral health QoL, despite a positive trend in the "psychological impacts" domain (aMD of 0.13 [-0.07; 0.33], P = 0.20). CONCLUSIONS: Although no clinical effect of periodontal treatment on RA was identified, this trial provides important data to support periodontal care in RA patients. Periodontal treatment is safe and reduces oral inflammation with a possible effect on oral health QoL. Since both periodontitis and RA are complex and multifactorial chronic diseases, it is likely that patient-centred approaches involving both oral health professionals and rheumatologists will contribute to optimal patient care. ISRCTN79186420.
Authors: William Buwembo; Ian Guyton Munabi; Mark Kaddumukasa; Haruna Kiryowa; Muhammad Mbabali; Ethel Nankya; William Evan Johnson; Emmy Okello; Nelson K Sewankambo Journal: J Dent Res Dent Clin Dent Prospects Date: 2020
Authors: Rafael Scaf de Molon; Carlos Rossa; Rogier M Thurlings; Joni Augusto Cirelli; Marije I Koenders Journal: Int J Mol Sci Date: 2019-09-13 Impact factor: 5.923