Analysis of periodontal status in Polish patients with rheumatoid arthritis treated with biological therapies.

Abstract

Introduction: Periodontitis, characterized by inflammation affecting the tooth-supporting tissues, may increase the risk of rheumatoid arthritis (RA) or cardiovascular diseases. The aim of the study was to evaluate the periodontal status in RA patients and its impact on the inflammatory markers and red cell parameters obtained from complete blood laboratory tests to study the risk of cardiovascular disease development.

Material and methods: The cross-sectional study included 50 patients with RA treated with biological therapies: tumor necrosis factor inhibitors, interleukin-6 blockers. Rheumatoid arthritis disease activity was assessed with Disease Activity Score with 28-joint count (DAS28). The periodontal indices modified Approximal Periodontal Index, modified Papillary Bleeding Index, and Periodontal Screening Index (PSI) were used to assess patients' periodontal status. Serum levels of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were used as inflammatory markers and a potential cardiovascular risk factor.

Results: No statistically significant correlation was found between the periodontal status and RA activity. However, a statistically significant correlation was found between the CRP results and the PSI scores (R = -0.264510, p = 0.048837). Evaluation of the red cell parameters showed statistically significant differences in the markers of inflammation ESR (R = 0.369398, p = 0.008289) and CRP (R = 0.367405, p = 0.008672). Red cell distribution width values were also correlated with RA activity (R = 0.286387, p = 0.043769) and duration of the disease (R = 0.339425, p = 0.015889).

Conclusions: A satisfactory periodontal status was found in most of the study group. Increased CRP levels in patients with periodontitis may indicate the negative impact of periodontal status on the general clinical condition of the patient.