Jia Sun1,2, Youli Zheng3, Xiaowei Bian3, Huijian Ge4, Jun Wang1,2, Zheng Zhang5,6. 1. Tianjin Stomatological Hospital, School of Medicine, Nankai University, 75th Dagubei Road, Tianjin, 300041, China. 2. Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, 75th Dagubei Road, Tianjin, China. 3. The School and Hospital of Stomatology, Tianjin Medical University, 12th Qixiangtai Road, Tianjin, China. 4. Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, 119th Nansihuanxi Road, Beijing, China. 5. Tianjin Stomatological Hospital, School of Medicine, Nankai University, 75th Dagubei Road, Tianjin, 300041, China. zhangzheng@nankai.edu.cn. 6. Tianjin Key Laboratory of Oral and Maxillofacial Function Reconstruction, 75th Dagubei Road, Tianjin, China. zhangzheng@nankai.edu.cn.
Abstract
OBJECTIVES: The aim of the meta-analysis was to clarify the efficacy of non-surgical periodontal treatment (NSPT) in improving rheumatoid arthritis (RA) disease activity. METHODS: A systematic literature search was conducted using the PubMed, Embase, and Cochrane databases up to October 2020. A total of nine studies were included for the comparison of RA-related indicator changes between the NSPT group and no treatment (NT) group. Mean differences (MD) and 95% confidence intervals (CI) were calculated for disease activity score (DAS28), erythrocyte sedimentation rate (ESR), tender joint counts (TJC), swollen joint counts (SJC), visual analogical scale (VAS), morning stiffness (MS), rheumatoid factor (RF), C-reactive protein (CRP), tumor necrosis factor α (TNF-α), and interleukin-6 (IL-6). RESULTS: NSPT induced significant reductions of DAS28 (MD: 0.61, 95% CI: 0.37, 0.85, P < 0.001), TJC (MD: 0.65, 95% CI: 0.37, 0.93, P < 0.001), SJC (MD: 0.67, 95% CI: 0.18, 1.17, P = 0.008), VAS (MD: 0.48, 95% CI: 0.08, 0.88, P = 0.02), and CRP (MD: 0.34, 95% CI: 0.07, 0.64, P = 0.01) in RA patients with periodontitis. Other parameters showed a trend toward reduction, but results were not statistically significant. CONCLUSIONS: This meta-analysis indicates that NSPT could improve RA activity as assessed by DAS28, TJC, SJC, VAS, and CRP. CLINICAL RELEVANCE: The results emphasize the effectiveness and need for periodontal diagnosis and periodontal therapy in rheumatoid arthritis patients to reduce disease activity.
OBJECTIVES: The aim of the meta-analysis was to clarify the efficacy of non-surgical periodontal treatment (NSPT) in improving rheumatoid arthritis (RA) disease activity. METHODS: A systematic literature search was conducted using the PubMed, Embase, and Cochrane databases up to October 2020. A total of nine studies were included for the comparison of RA-related indicator changes between the NSPT group and no treatment (NT) group. Mean differences (MD) and 95% confidence intervals (CI) were calculated for disease activity score (DAS28), erythrocyte sedimentation rate (ESR), tender joint counts (TJC), swollen joint counts (SJC), visual analogical scale (VAS), morning stiffness (MS), rheumatoid factor (RF), C-reactive protein (CRP), tumor necrosis factor α (TNF-α), and interleukin-6 (IL-6). RESULTS: NSPT induced significant reductions of DAS28 (MD: 0.61, 95% CI: 0.37, 0.85, P < 0.001), TJC (MD: 0.65, 95% CI: 0.37, 0.93, P < 0.001), SJC (MD: 0.67, 95% CI: 0.18, 1.17, P = 0.008), VAS (MD: 0.48, 95% CI: 0.08, 0.88, P = 0.02), and CRP (MD: 0.34, 95% CI: 0.07, 0.64, P = 0.01) in RA patients with periodontitis. Other parameters showed a trend toward reduction, but results were not statistically significant. CONCLUSIONS: This meta-analysis indicates that NSPT could improve RA activity as assessed by DAS28, TJC, SJC, VAS, and CRP. CLINICAL RELEVANCE: The results emphasize the effectiveness and need for periodontal diagnosis and periodontal therapy in rheumatoid arthritis patients to reduce disease activity.
Authors: Panos N Papapanou; Mariano Sanz; Nurcan Buduneli; Thomas Dietrich; Magda Feres; Daniel H Fine; Thomas F Flemmig; Raul Garcia; William V Giannobile; Filippo Graziani; Henry Greenwell; David Herrera; Richard T Kao; Moritz Kebschull; Denis F Kinane; Keith L Kirkwood; Thomas Kocher; Kenneth S Kornman; Purnima S Kumar; Bruno G Loos; Eli Machtei; Huanxin Meng; Andrea Mombelli; Ian Needleman; Steven Offenbacher; Gregory J Seymour; Ricardo Teles; Maurizio S Tonetti Journal: J Periodontol Date: 2018-06 Impact factor: 6.993