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Background: Periodontitis has been regarded as a potential risk factor for rheumatoid arthritis (RA). A systematic
review is made to determine whether nonsurgical periodontal treatment in patients with RA offers benefits in
terms of the clinical activity and inflammatory markers of the disease.
Material and Methods: A search was made of the Medline-PubMed, Cochrane, Embase and Scopus databases to
identify studies on the relationship between the two disease processes, and especially on the effects of nonsurgical
treatment in patients of this kind. The search was based on the following keywords:
rheumatoid arthritis
AND
periodontitis
(MeSH),
rheumatoid arthritis
AND
periodontal treatment
.
Results: Eight articles on the nonsurgical treatment of patients with periodontitis and RA were finally included
in the study. All of them evaluated clinical (DAS28) and laboratory test activity (ESR, CRP, IL-6, TNFα) before
and after treatment. A clear decrease in DAS28 score and ESR was recorded, while other parameters such as CRP,
IL-6 and TNFα showed a nonsignificant tendency to decrease as a result of treatment.
Conclusions: Nonsurgical treatment improved the periodontal condition of patients with periodontitis and RA,
with beneficial effects upon the clinical and laboratory test parameters (DAS28 and ESR), while other inflammatory markers showed a marked tendency to decrease. However, all the studies included in the review involved
small samples sizes and follow-up periods of no more than 6 months. Larger and particularly longitudinal studies
are therefore needed to more firmly establish possible significant relations between the two disease processes.
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