Syed Basit Hussain1, João Botelho2, Vanessa Machado2, Syeda Ambreen Zehra3, José João Mendes2, Coziana Ciurtin4, Marco Orlandi5, Francesco D'Aiuto5. 1. Periodontology Unit, UCL Eastman Dental Institute 256 Gray's Inn Road, London WC1X 8LD, UK. Electronic address: syed.hussain.16@ucl.ac.uk. 2. Periodontology Department, Clinical Research Unit (CRU), Egas Moniz Interdisciplinary Research Centre, Egas Moniz, Almada, Portugal. 3. Department of Dental Physical Sciences, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, UK. 4. Department of Rheumatology, University College London Hospital, London, UK. 5. Periodontology Unit, UCL Eastman Dental Institute 256 Gray's Inn Road, London WC1X 8LD, UK.
Abstract
BACKGROUND: Several lines of evidence suggest a bi-directional association between Rheumatoid Arthritis (RA) and Periodontitis (PD). Our aim was to systematically appraise the evidence on the association between RA and PD in terms of clinical and laboratory outcomes. METHODS: An electronic search of several databases (PubMed, EMBASE, MEDLINE, LILACS, CINHL, Scopus, Web of Science, The Cochrane Library, OpenGrey and Google Scholar) was conducted up to March 2019 (PROSPERO CRD42018107817) by two independent reviewers. Observational studies included in the review were quality-appraised using the Newcastle-Ottawa Scale (NOS) tool. Random effects models were used for quantitative analyses. RESULTS: A total of 8 case-control studies were identified after the final search of 1491 titles. Following quality assessment, 2 studies were excluded due to the high risk of bias, while the remaining 6 were further analysed. Meta-analyses revealed no substantial effect of RA on the Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL) of patients with PD when compared to controls but high degree of study heterogeneity was found. To the contrary, PD was associated with substantially worse RA disease activity as assessed by an increase in the DAS28 score of 0.74 (0.25-1.24, 95%CI, p < 0.001). CONCLUSION: There is consistent evidence suggesting that PD is associated with worse RA clinical activity as assessed by DAS28 scores whereas, RA patients do not have worsen PD clinical outcomes.
BACKGROUND: Several lines of evidence suggest a bi-directional association between Rheumatoid Arthritis (RA) and Periodontitis (PD). Our aim was to systematically appraise the evidence on the association between RA and PD in terms of clinical and laboratory outcomes. METHODS: An electronic search of several databases (PubMed, EMBASE, MEDLINE, LILACS, CINHL, Scopus, Web of Science, The Cochrane Library, OpenGrey and Google Scholar) was conducted up to March 2019 (PROSPERO CRD42018107817) by two independent reviewers. Observational studies included in the review were quality-appraised using the Newcastle-Ottawa Scale (NOS) tool. Random effects models were used for quantitative analyses. RESULTS: A total of 8 case-control studies were identified after the final search of 1491 titles. Following quality assessment, 2 studies were excluded due to the high risk of bias, while the remaining 6 were further analysed. Meta-analyses revealed no substantial effect of RA on the Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL) of patients with PD when compared to controls but high degree of study heterogeneity was found. To the contrary, PD was associated with substantially worse RA disease activity as assessed by an increase in the DAS28 score of 0.74 (0.25-1.24, 95%CI, p < 0.001). CONCLUSION: There is consistent evidence suggesting that PD is associated with worse RA clinical activity as assessed by DAS28 scores whereas, RApatients do not have worsen PD clinical outcomes.
Authors: Menke J de Smit; Poerwati Soetji Rahajoe; Elisabeth Raveling-Eelsing; Paola Lisotto; Hermie J M Harmsen; Nyoman Kertia; Arjan Vissink; Johanna Westra Journal: Front Oral Health Date: 2022-06-16
Authors: Vanessa Machado; Eva Muñoz Aguilera; João Botelho; Syed Basit Hussain; Yago Leira; Luís Proença; Francesco D'Aiuto; José João Mendes Journal: J Clin Med Date: 2020-05-23 Impact factor: 4.241