Chronic Periodontitis Is Associated With Spinal Dysmobility in Patients With Ankylosing Spondylitis.
BACKGROUND
Although microbes have been suggested to play a role in the pathogenesis of ankylosing spondylitis (AS), several studies present contradictory results regarding the association between AS and chronic periodontitis (CP).


METHODS
Clinical, laboratory, and medication data were collected from 84 patients with AS and 84 age- and sex-matched controls. Periodontal measurements, including probing depths (PDs), clinical attachment loss (AL), serum anti-Porphyromonas gingivalis titers, and the detection of P. gingivalis DNA in gingival crevicular fluid, were recorded. All participants with periodontitis with PD ≥4 to <7 mm received scaling and root planing and were re-evaluated at 12 weeks; those still exhibiting periodontitis with PD of ≥4 to <7 mm at 12 weeks were followed at 24 weeks.


RESULTS
The prevalence of moderate-to-severe CP was not different between patients with AS and controls (70.2% versus 66.6%). The P. gingivalis detection rate was not different between patients with AS and controls or between patients with AS receiving and not receiving anti-tumor necrosis factor (TNF)-α agents. However, CP was positively associated with impaired spinal mobility of patients with AS in multivariate analyses. After periodontal treatment, PD and AL levels were improved in both groups, but the change was significantly greater in patients with AS than in controls. Patients with AS receiving anti-TNF-α agents exhibited a greater improvement in PD and AL than those who did not.


CONCLUSIONS
Although AS was not associated with the presence of CP, CP was associated positively with the severity of spinal dysmobility in Korean patients with AS. These results suggest that periodontitis can have a negative effect on axial movement in AS.
Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Eun Ha
EH
Kang
Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital.
Jung Tae
JT
Lee
Department of Periodontology, Section of Dentistry, Seoul National University Bundang Hospital.
Hyo-Jung
HJ
Lee
Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
Joo Youn
JY
Lee
Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Sung Hae
SH
Chang
Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Hyon Joung
HJ
Cho
Department of Internal Medicine, Seoul Medical Center Public Corporation, Seoul, Korea.
Byoong Yong
BY
Choi
Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
You-Jung
YJ
Ha
Department of Laboratory Medicine, Seoul National University Bundang Hospital.
Kyoung Un
KU
Park
Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.|Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Yeong Wook
YW
Song
Department of Applied Oral Sciences, Forsyth Institute, Cambridge, MA.
Thomas E
TE
Van Dyke
Division of Rheumatology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.|Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Yun Jong
YJ
Lee
D055113:Chronic Periodontitis; D003774:Dental Plaque Index; D012534:Dental Scaling; D005883:Gingival Crevicular Fluid; D006801:Humans; D017622:Periodontal Attachment Loss / Q000188:drug therapy; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000188:drug therapy; D010518:Periodontitis / Q000188:drug therapy; D013167:Spondylitis, Ankylosing; D014409:Tumor Necrosis Factor-alpha
D014409:Tumor Necrosis Factor-alpha
Chronic periodontitis; Porphyromonas gingivalis; range of motion, articular; spine; spondylitis, ankylosing