Prevalence and severity of periodontitis in Indonesian patients with rheumatoid arthritis.
BACKGROUND
Patients with rheumatoid arthritis (RA) may have more prevalent and severe periodontitis than healthy controls. Periodontitis may increase the systemic inflammation in RA. The aim of this study is to assess periodontitis prevalence and severity and its potential association with systemic inflammation in Indonesian patients with RA.


METHODS
A full-mouth periodontal examination including probing depth, gingival recession, plaque index, and bleeding on probing was performed in 75 Indonesians with RA and 75 age-, sex-, and smoking-matched Indonesian controls. A validated questionnaire was used to assess smoking, body mass index, education, and medical conditions. In addition, in all participants, the use of drugs was noted, and erythrocyte sedimentation rates and serum levels of high-sensitivity C-reactive protein (hsCRP), rheumatoid factor, and anti-citrullinated protein antibodies were measured. Differences in periodontitis prevalence and 12 measures of periodontitis severity between patients with RA and controls were analyzed using univariate analyses.


RESULTS
No significant differences in periodontitis prevalence and 11 measures of periodontitis severity between patients with RA and controls were observed. Conversely, patients with RA had a significantly lower surface area of healthy pocket epithelium versus controls (P = 0.008), and a tendency toward higher hsCRP levels was observed in patients with RA with severe periodontitis compared with patients with RA with no mild or moderate periodontitis (P = 0.063). It has to be noted that all patients with RA were on anti-inflammatory drugs, whereas none of the controls used such drugs.


CONCLUSIONS
Prevalence and severity of periodontitis in Indonesian patients with RA is comparable to controls but with less healthy pocket epithelium than in controls and a tendency toward a higher inflammatory state in patients with RA and severe periodontitis.
Department of Oral Medicine, Faculty of Dentistry, Gadjah Mada University, Yogyakarta, Indonesia.
Hendri
H
Susanto
Willem
W
Nesse
Nyoman
N
Kertia
Juwono
J
Soeroso
Yvonne
Y
Huijser van Reenen
Eveliene
E
Hoedemaker
Dewi
D
Agustina
Arjan
A
Vissink
Frank
F
Abbas
Pieter U
PU
Dijkstra
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000453:epidemiology*; D001799:Blood Sedimentation; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D002908:Chronic Disease; D003774:Dental Plaque Index; D004522:Educational Status; D005260:Female; D005889:Gingival Recession / Q000145:classification / Q000453:epidemiology; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007214:Indonesia / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000145:classification / Q000453:epidemiology; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000145:classification / Q000453:epidemiology; D010518:Periodontitis / Q000145:classification / Q000453:epidemiology*; D015995:Prevalence; D012217:Rheumatoid Factor / Q000097:blood; D012907:Smoking / Q000453:epidemiology; D012923:Social Class
D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D007074:Immunoglobulin G; D002097:C-Reactive Protein; D012217:Rheumatoid Factor