Periodontal therapy reduces the severity of active rheumatoid arthritis in patients treated with or without tumor necrosis factor inhibitors.
Periodontal therapy reduces the severity of active rheumatoid arthritis in patients treated with or without tumor necrosis factor inhibitors.
复制标题
DOI：
10.1902/jop.2009.080447
复制
发表时间：
2009-04
影响因子：
4.3
通讯作者：
Askari A
中科院分区：
文献类型：
--
作者：
Ortiz P;Bissada NF;Palomo L;Han YW;Al-Zahrani MS;Panneerselvam A;Askari A
风湿性关节炎（RA）和牙周炎（PD）是常见的慢性炎症性疾病。最近的研究表明，牙周治疗对降低活动性RA的严重程度有有益的影响。本研究旨在进一步研究非手术牙周治疗对接受或不接受抗肿瘤坏死因子（TNF）-α药物治疗的RA患者的体征和症状的影响。抗TNF-α治疗牙周炎的效果也进行了评估。40名被诊断患有中度/重度RA（正在接受RA治疗）和重度牙周炎的参与者被随机分配到接受初始非手术牙周治疗（n=20）或不接受牙周治疗（n=20）。为了控制类风湿关节炎，所有受试者在随机分组前一直使用疾病缓解抗风湿药物（DMARDs），20名受试者在DMARDs之外还使用抗TNF-α。分别于治疗前和治疗后6周测量牙周探诊深度（PD）、临床附着丧失（CAL）、探诊出血（BOP）、牙龈指数（GI）、菌斑指数（PI）、RA疾病活动性评分（DAS-28）和血沉（ESR）。线性混合模型被用来确定受试者接受牙周治疗和那些谁没有显着差异。牙周治疗组患者的平均DAS 28、ESR（p < 0.001）和血清TNF-α（p < 0.05）均显著降低。没有接受牙周治疗的患者，这些参数没有统计学显著下降。抗TNF-α治疗可显著改善CAL、PD、BOP和GI。非手术牙周治疗对RA的体征和症状有有益的影响，无论用于治疗这种情况的药物。抗TNF-α治疗对牙周状况无明显影响。
Rheumatoid arthritis (RA) and periodontitis (PD) are common chronic inflammatory conditions. Recent studies have shown a beneficial effect of periodontal treatment on reducing the severity of active RA. This study was undertaken to further examine the effect of non-surgical periodontal treatment on signs and symptoms of RA in patients treated with or without anti-Tumor Necrosis Factor (TNF)-α medications. The effect of anti-TNF-α therapy on periodontitis also was assessed. Forty participants diagnosed with moderate/severe RA (under treatment for RA) and severe periodontitis were randomly assigned to receive initial non-surgical periodontal therapy with scaling/root planing and oral hygiene instructions (n=20) or no periodontal therapy (n=20). To control RA, all participants had been using disease-modifying anti-rheumatic drugs (DMARDs), and 20 had been using anti-TNF-α in addition to DMARDs before randomization. Periodontal probing depth (PD), clinical attachment loss (CAL), bleeding on probing (BOP), gingival (GI) and plaque (PI) indices, RA disease activity score (DAS-28) and erythrocyte sedimentation rate (ESR) were measured at baseline and six weeks afterwards. Linear mixed models were used to identify significant differences between subjects receiving periodontal treatment and those who did not. Patients receiving periodontal treatment showed a significant decrease in the mean DAS28, ESR (p < 0.001) and serum TNF-α (p < 0.05). There was no statistically significant decrease in these parameters in those patients not receiving periodontal treatment. Anti- TNF-α therapy resulted in a significant improvement in CAL, PD, BOP and GI. Non-surgical periodontal therapy had a beneficial effect on signs and symptoms of RA regardless of the medications used to treat this condition. Anti-TNF-α therapy without periodontal treatment has no significant effect on the periodontal condition.
登录
查看更多内容
影响因子：
--
作者：
Slade, GD;Ghezzi, EM;Offenbacher, S
通讯作者：
Offenbacher, S
影响因子：
7.6
作者：
D'Aiuto, F;Nibali, L;Tonetti, MS
通讯作者：
Tonetti, MS
影响因子：
4.3
作者：
Noack, B;Genco, RJ;De Nardin, E
通讯作者：
De Nardin, E
影响因子：
6.7
作者：
Ide, M;McPartlin, D;Wilson, RF
通讯作者：
Wilson, RF
影响因子：
3.3
作者：
Grassi, W;De Angelis, R;Cervini, C
通讯作者：
Cervini, C