title: Periodontal disease and rheumatoid arthritis: the evidence accumulates for complex pathobiologic interactions.
abstract: OBJECTIVE
  This review was conducted to focus on the recent clinical and translational research related to the associations between periodontal disease and rheumatoid arthritis.
  
  
  RESULTS
  There is a growing interest in the associations between oral health and autoimmune and inflammatory diseases. A number of epidemiologic studies have described associations between rheumatoid arthritis and periodontal disease. Recent clinical studies continue to support these reports, and are increasingly linked with biological assessments to better understand the nature of these relationships. A number of recent studies have evaluated the periopathogenic roles of Porphyromonas gingivalis, the oral microbiome, and mechanisms of site-specific and substrate-specific citrullination. These are helping to further elucidate the interactions between these two inflammatory disease processes.
  
  
  CONCLUSIONS
  Studies of clinical oral health parameters, the gingival microenvironment, autoantibodies and biomarkers, and rheumatoid arthritis disease activity measures are providing a better understanding of the potential mechanisms responsible for rheumatoid arthritis and periodontal disease associations. The cumulative results and ongoing studies have the promise to identify novel mechanisms and interventional strategies to improve patient outcomes for both conditions.
authors: Department of Medicine, Division of Rheumatology, Johns Hopkins University, Baltimore, Maryland, USA. Clifton.bingham@jhmi.edu
authors: Clifton O
authors: CO
authors: Bingham
authors: Malini
authors: M
authors: Moni
mesh_terms: D000818:Animals; D001169:Arthritis, Experimental / Q000209:etiology; D001172:Arthritis, Rheumatoid / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology; D016866:Bacteroidaceae Infections / Q000150:complications; D002956:Citrulline / Q000378:metabolism; D004195:Disease Models, Animal; D019317:Evidence-Based Medicine / Q000379:methods; D006801:Humans; D010510:Periodontal Diseases / Q000150:complications* / Q000453:epidemiology; D016966:Porphyromonas gingivalis
chemical_list: D002956:Citrulline