title: Periodontitis Response to Anti-TNF Therapy in Ankylosing Spondylitis.
abstract: BACKGROUND
  Recently, it has been demonstrated that patients with ankylosing spondylitis (AS) and rheumatoid arthritis (RA) have a higher risk of periodontitis; however, the effect of anti-TNF therapy in periodontal status of patients with AS and particularly in dental attachment is not known.
  
  
  OBJECTIVE
  To evaluate longitudinally the local periodontal effect of TNF-antagonist in AS and compare to patients with RA.
  
  
  METHODS
  Fifteen patients with AS and 15 RA control patients were prospectively evaluated at baseline and after 6 months (6 M) of anti-TNF therapy. Periodontal assessment included: probing pocket depth (PPD), clinical attachment level (CAL), gingival bleeding index, and plaque index. Rheumatologic clinical and laboratory evaluations were the following: Bath AS Disease Activity Index, Bath AS Metrology Index, Bath AS Functional Index, C-reactive protein and erythrocyte sedimentation rate for AS and Disease Activity Score 28 joints, and C-reactive protein and erythrocyte sedimentation rate for patients with RA.
  
  
  RESULTS
  At baseline, periodontal parameters were alike in AS and RA (P > 0.05). After 6 M of anti-TNF therapy, clinical and laboratory parameters of rheumatic diseases decreased significantly in the patients with AS and RA (P < 0.05). A significant improvement in periodontal attachment measurements were observed in the patients with AS (PPD, 2.18 vs 1.94 mm; P = 0.02; CAL, 2.29 vs.2.02 mm; P = 0.03), but not in RA (PPD, 1.92 vs 2.06 mm; P = 0.06; CAL, 2.14 vs 2.28 mm; P = 0.27). Oral hygiene and gingival inflammation remained unchanged from baseline to 6-M evaluation in AS and RA (P > 0.05).
  
  
  CONCLUSIONS
  Patients with AS under anti-TNF improved periodontal attachment. The mechanism for this effect needs further studies.
authors.affiliation: From the *School of Dentistry, Universidade Federal de Juiz de Fora, Juiz de Fora Minas Gerais, Brazil; †Rheumatology Division, and ‡Dentistry Division, Hospital das Clínicas da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Gisele Maria C
authors.initials: GM
authors.lastname: Fabri
authors.forename: Rosa Maria R
authors.initials: RM
authors.lastname: Pereira
authors.forename: Cynthia
authors.initials: C
authors.lastname: Savioli
authors.forename: Carla G S
authors.initials: CG
authors.lastname: Saad
authors.forename: Júlio Cesar B
authors.initials: JC
authors.lastname: de Moraes
authors.forename: José Tadeu T
authors.initials: JT
authors.lastname: Siqueira
authors.forename: Eloisa
authors.initials: E
authors.lastname: Bonfa
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D010518:Periodontitis / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control*; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors*
chemical_list: D018501:Antirheumatic Agents; D014409:Tumor Necrosis Factor-alpha