title: Clinical periodontal and microbiologic parameters in patients with rheumatoid arthritis.
abstract: BACKGROUND
  A limited number of studies suggest a prevalence of periodontal pathogens in patients with rheumatoid arthritis (RA); however, results are inconsistent. The aim of this study is to investigate clinical periodontal and microbiologic parameters in patients with RA.
  
  
  METHODS
  Sixty-six patients with RA, aged 49.5 ± 8.4 years, participated in the study. The periodontal classification was assessed with the periodontal screening index (PSR/PSI) allocated to the following parameters: 1) healthy; 2) gingivitis (PSR/PSI score 0 to 2, maximum one sextant score; 3) moderate periodontitis (>1 sextant PSR/PSI score 3, maximum one sextant score; or, 4) severe periodontitis (>1 sextant PSR/PSI score 4). Pool samples were taken for microbiologic (polymerase chain reaction) analysis for the presence of 11 periodontal pathogens. Statistical analysis was by non-parametric analysis of covariance.
  
  
  RESULTS
  No patients were periodontally healthy: 24 patients were classified as having gingivitis; 18 patients had moderate periodontitis; 23 patients had severe periodontitis; and one patient was toothless. For most patients, Fusobacterium nucleatum (98%), Eikenella corrodens (91%), and Parvimonas micra (previously Peptostreptococcus micros; 88%) were above the detection threshold. Strong periodontal pathogens were less frequently detected: Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans, 16%); Porphyromonas gingivalis (58%); and Tannerella forsythia (previously T. forsythensis, 78%). Statistical analysis showed no significant influence of rheumatic factor (P = 0.33) on periodontal classification and on microbiologic parameters (P >0.05). Only smoking showed a significant influence (P = 0.0004) on the periodontal classification and in the case of E. corrodens (P = 0.02).
  
  
  CONCLUSIONS
  Most patients with RA in this study showed moderate-to-severe periodontitis and the presence of periodontal pathogens. No association was found between rheumatic factor on periodontal classification and microbiologic parameters.
authors.affiliation: Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Goettingen, Goettingen, Germany. dirk.ziebolz@med.uni-goettingen.de
authors.forename: Dirk
authors.initials: D
authors.lastname: Ziebolz
authors.forename: Sven O
authors.initials: SO
authors.lastname: Pabel
authors.forename: Katharina
authors.initials: K
authors.lastname: Lange
authors.forename: Berndt
authors.initials: B
authors.lastname: Krohn-Grimberghe
authors.forename: Else
authors.initials: E
authors.lastname: Hornecker
authors.forename: Rainer F
authors.initials: RF
authors.lastname: Mausberg
mesh_terms: D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000382:microbiology*; D001421:Bacteria, Anaerobic / Q000302:isolation & purification; D058491:Bacterial Load; D004245:DMF Index; D005260:Female; D005891:Gingivitis / Q000150:complications* / Q000382:microbiology; D006801:Humans; D007375:Interleukin-1 / Q000235:genetics; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000382:microbiology; D010518:Periodontitis / Q000150:complications* / Q000382:microbiology; D012217:Rheumatoid Factor / Q000097:blood; D012907:Smoking / Q000009:adverse effects; D018709:Statistics, Nonparametric
chemical_list: D007375:Interleukin-1; D012217:Rheumatoid Factor