Journal of Periodontal and Implant Science

Korean Academy of Periodontology (대한치주과학회)
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Periodontal pathogens and the association between periodontitis and rheumatoid arthritis in Korean adults

  • Kim, Jin-Hee (Department of Periodontology, Seoul National University School of Dentistry) ;
  • Choi, In Ah (Department of Internal Medicine, Chungbuk National University Hospital) ;
  • Lee, Joo Youn (Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University) ;
  • Kim, Kyoung-Hwa (Department of Periodontology, Seoul National University School of Dentistry) ;
  • Kim, Sungtae (Department of Periodontology, Seoul National University School of Dentistry) ;
  • Koo, Ki-Tae (Department of Periodontology, Seoul National University School of Dentistry) ;
  • Kim, Tae-Il (Department of Periodontology, Seoul National University School of Dentistry) ;
  • Seol, Yang-Jo (Department of Periodontology, Seoul National University School of Dentistry) ;
  • Ku, Young (Department of Periodontology, Seoul National University School of Dentistry) ;
  • Rhyu, In-Chul (Department of Periodontology, Seoul National University School of Dentistry) ;
  • Song, Yeong Wook (Department of Molecular Medicine and Biopharmaceutical Sciences, Seoul National University) ;
  • Lee, Yong-Moo (Department of Periodontology, Seoul National University School of Dentistry)
  • Received : 2018.08.20
  • Accepted : 2018.11.22
  • Published : 2018.12.31
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Abstract

Purpose: Periodontitis and rheumatoid arthritis (RA) share a similar inflammatory pathogenesis. Porphyromonas gingivalis (Pg) can induce anticyclic-citrullinated peptide autoantibodies (anti-CCP antibodies), a key factor in the development of RA. This study aimed at evaluating the relationships between the 2 diseases and identifying the clinical implications thereof, with a focus on periodontal pathogens in Korean adults. Methods: A total of 260 RA patients and 86 age- and sex-matched control patients without arthritis were enrolled in this prospective cross-sectional study. Periodontal indices and the prevalence and amount of periodontal pathogens were compared between the groups. Correlations between periodontal and RA indices were examined, as were correlations between 9 periodontal pathogens and RA indices. Results: The RA group had significantly higher values than the control group for all investigated periodontal indices (P<0.05) except the number of teeth. The gingival index (GI) was correlated with the disease activity score 28 (DAS28) (r=0.125, P=0.049), RA disease duration (r=0.253, P<0.001), erythrocyte sedimentation rate (ESR) (r=0.162, P=0.010), and anti-CCP antibody titer (r=0.205, P=0.004). Probing pocket depth (PPD) was correlated with ESR (r=0.139, P=0.027) and anti-Pg antibody titer (r=0.203, P=0.001). Bleeding on probing (BOP) was correlated with DAS28 (r=0.137, P=0.030), RA disease duration (r=0.202, P=0.001), ESR (r=0.136, P=0.030), anti-Pg antibody titer (r=0.177, P=0.005), and anti-CCP antibody titer (r=0.188, P=0.007). Clinical attachment level (CAL) and periodontitis severity were correlated with anti-Pg antibody titer (the former r=0.201, P=0.002; the latter r=0.175, P=0.006). The quantity of Pg was positively correlated with the serum anti-Pg antibody titer (r=0.148, P=0.020). Conclusions: The GI, BOP, and PPD showed positive relationships with several RA indices. The anti-Pg antibody titer had positive relationships with PPD, BOP, CAL, and periodontitis severity. Thus, increasing values of periodontal indices could be used as a risk indicator of disease development in RA patients, and an increasing anti-Pg antibody titer could be considered as a warning sign in RA patients suffering with periodontitis.

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References

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