Influência do tratamento periodontal na artrite reumatoide: revisão sistemática e metanálise

Q Medicine Revista Brasileira De Reumatologia Pub Date : 2017-05-01 DOI:10.1016/j.rbr.2016.10.002

Débora Cerqueira Calderaro , Jôice Dias Corrêa , Gilda Aparecida Ferreira , Izabela Guimarães Barbosa , Carolina Castro Martins , Tarcília Aparecida Silva , Antônio Lúcio Teixeira

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引用次数: 10

Abstract

Objective

To evaluate the influence of periodontal treatment on rheumatoid arthritis activity.

Methods

MEDLINE/PUBMED, The Cochrane Library, Clinical Trials, SciELO and LILACS were searched for studies published until December 2014. Included articles were: prospective studies; including patients older than 18 years, diagnosed with periodontitis and rheumatoid arthritis submitted to non‐surgical periodontal treatment; with a control group receiving no periodontal treatment; with outcomes including at least one marker of rheumatoid arthritis activity. Methodological quality of the studies was assessed using PEDro scale. Quantitative data were pooled in statistical meta‐analysis using Review Manager 5.

Results

Four articles were included. Non‐surgical periodontal treatment was associated with a significant reduction of DAS28 (OR: −1.18; 95% CI: −1.43, −0.93; p <0.00001). Erythrocyte sedimentation rate, C‐reactive protein, patient's assessment of rheumatoid activity using visual analogical scale, tender and swollen joint counts showed a trend towards reduction (not statistically significant).

Conclusions

The reduction of DAS 28 in patients with rheumatoid arthritis after periodontal treatment suggests that the improvement of periodontal condition is beneficial to these patients. Further randomized controlled clinical trials are necessary to confirm this finding.

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牙周治疗对类风湿性关节炎的影响：系统综述和荟萃分析

目的探讨牙周治疗对类风湿关节炎活动性的影响。方法检索medline /PUBMED、Cochrane Library、Clinical Trials、SciELO和LILACS，检索截至2014年12月发表的研究。纳入的文章有:前瞻性研究;包括年龄大于18岁，诊断为牙周炎和类风湿关节炎且接受非手术牙周治疗的患者;对照组不接受牙周治疗;其结果包括至少一个类风湿关节炎活动的标志物。采用PEDro量表评估研究的方法学质量。使用Review Manager 5对定量数据进行统计荟萃分析。结果共纳入4篇文章。非手术牙周治疗与DAS28显著降低相关(OR: - 1.18;95% ci:−1.43，−0.93;p & lt; 0.00001)。红细胞沉降率、C反应蛋白、患者类风湿活动性评估(使用视觉类比量表)、关节压痛和肿胀计数均呈下降趋势(无统计学意义)。结论类风湿关节炎患者牙周治疗后DAS 28降低，提示牙周状况的改善有利于类风湿关节炎患者。需要进一步的随机对照临床试验来证实这一发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Revista Brasileira De Reumatologia RHEUMATOLOGY-

CiteScore

0.82

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： RBR nasceu da necessidade de se criar um órgão oficial da SBR que pudesse divulgar a produção científica dos reumatologistas brasileiros. O primeiro número foi publicado em setembro de 1957. A partir do volume 18 (1978), passou a seis números, com periodicidade atual. A RBR, em sua trajetória, tem sido objeto de constantes mudanças, sempre visando ao seu aprimoramento e revitalização, tanto em sua apresentação como em seu conteúdo.