Periodontal Conditions during Arthritis Therapy with TNF-α Blockers ZC27-ZC31
Dr, Centre for Periodontology, Department of Cariology, Endodontology and Periodontology, University Hospital of Leipzig
BussardstraÃŸe, 26349 Jade, lower saxony, Germany.
Introduction: Chronic Periodontitis (CP) and Rheumatoid Arthritis (RA) are both inflammatory diseases, characterised by severe inflammation of the associated tissues. Patients with RA have been reported to have poorer periodontal conditions such as more gingival bleeding, higher probing depth (PD) and Clinical Attachment Level (CAL) or missing teeth. However TNF-a blockers used in the treatment of RA seemed to positively influence the immune response of the periodontium.
Aim:The aim of the present study was to verify if RA-patients under continuous medication with TNF-a blockers had better or worse periodontal health than non-RA-patients with periodontitis.
Materials and Methods: The present case-controlled study included 13 patients with RA and 13 age and sex-matched non-RA periodontitis patients. In the RA-patients, RA-medication and duration of use were registered. In all patients Gingival Bleeding (GBI), Plaque Control Record (PCR), Bleeding on Probing (BOP), Probing Depth (PD), Clinical Attachment Level (CAL) and the number of teeth were recorded. For all patients the severity and extent of periodontitis was recorded respecting the classification system for periodontal diseases as well as serum level of C-Reactive Protein (CRP). Wilcoxon and Chi-square tests were performed for statistical analysis.
Results: RA-patients had significantly less BOP (15.38% vs. 27.23%, p=0.045). RA-patients had a tendency to lower PD-values (2.54 mm vs. 3.15 mm, p=0.068) and fewer sites with PD=5 mm (6.00 vs. 17.46, p=0.099). Comparing severity and extent of periodontitis RA-patients had significantly better periodontal conditions (p=0.033). No significant influence of the duration of RA-medication was found.
Conclusion: RA-patients treated with TNF-a blockers for more than 12 months have better periodontal health than non-RA-patients with periodontitis. These findings can be explained through the benefits of the TNF-a medication for host immune modulation.