title: Cross-Sectional Evaluation of Periodontal Status and Microbiologic and Rheumatoid Parameters in a Large Cohort of Patients With Rheumatoid Arthritis.
abstract: This study evaluates periodontal conditions and microbiologic findings and their influence on rheumatologic disease parameters in patients with rheumatoid arthritis (RA).
  
  
  
  One hundred and sixty-eight patients with RA were included. A healthy control group (HC, n = 168) was composed according to age, sex, and smoking habits. Rheumatologic data (duration of illness, Disease Activity Score 28, rheumatic factor [RF], anti-cyclic citrullinated peptide [aCCP], medications) were extracted from patients' records. Dental examination included: 1) dental findings (decayed, missing, and/or filled adult teeth [DMF-T] index); 2) gingival inflammation (papillary bleeding index [PBI]); and 3) periodontal status (probing depth [PD], attachment loss [AL]). Periodontal condition was classified as healthy/mild, moderate, or severe periodontitis. Subgingival biofilm was analyzed regarding 11 periodontopathogenic bacteria. Statistical analyses included: 1) Kolmogorov-Smirnov test; 2) Mann-Whitney U test; 3) Pearson χ2test; 4) Kruskal-Wallis test; and 5) regression analysis; level of significance α = 5%.
  
  
  
  Mean DMF-T was significantly higher in patients with RA (19.3 ± 4.8) than in HC group (16.9 ± 5.8), especially owing to number of missing teeth (RA = 6.0 ± 5.4, HC = 3.1 ± 3.3; P <0.01). Patients with RA had a significantly higher proportion of increased PD (P <0.01) and AL compared with HC group (P <0.01). Moderate to severe periodontitis was noted in 98% of patients with RA and 82% of the HC group (P <0.01). RF-positive patients with RA suffered from worse periodontal conditions than RF-negative patients (P = 0.01). Age, PBI, and presence of Treponema denticola (P <0.03) are related to periodontal condition in patients with RA. Although not statistically significant, Porphyromonas gingivalis and Fusobacterium nucleatum occur in higher concentrations more often in aCCP-positive patients with RA (P = 0.06).
  
  
  
  Patients with RA had worse periodontal conditions than HC participants. Although a trend for higher F. nucleatum and P. gingivalis concentrations in aCCP-positive patients with RA was found, importance of periodontal pathogenic bacteria and rheumatoid parameters in the interrelationship between periodontitis and RA remains unclear.
authors.affiliation: Department of Cariology, Endodontology, and Periodontology, University Leipzig, Leipzig, Germany.
authors.forename: Jan
authors.initials: J
authors.lastname: Schmickler
authors.affiliation: Department of Cariology, Endodontology, and Periodontology, University Leipzig, Leipzig, Germany.
authors.forename: Annegret
authors.initials: A
authors.lastname: Rupprecht
authors.affiliation: Department of Nephrology and Rheumatology, University Medical Center Goettingen, Goettingen, Germany.
authors.forename: Susann
authors.initials: S
authors.lastname: Patschan
authors.affiliation: Department of Nephrology and Rheumatology, University Medical Center Goettingen, Goettingen, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Patschan
authors.affiliation: Department of Nephrology and Rheumatology, University Medical Center Goettingen, Goettingen, Germany.
authors.forename: Gerhard A
authors.initials: GA
authors.lastname: Müller
authors.affiliation: Department of Cariology, Endodontology, and Periodontology, University Leipzig, Leipzig, Germany.
authors.forename: Rainer
authors.initials: R
authors.lastname: Haak
authors.affiliation: Department of Preventive Dentistry, Periodontology, and Cariology; University Medical Center Goettingen.
authors.forename: Rainer F
authors.initials: RF
authors.lastname: Mausberg
authors.affiliation: Department of Cariology, Endodontology, and Periodontology, University Leipzig, Leipzig, Germany.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schmalz
authors.affiliation: Clinical Research Organization, Hamm, Germany.
authors.forename: Tanja
authors.initials: T
authors.lastname: Kottmann
authors.affiliation: Department of Cariology, Endodontology, and Periodontology, University Leipzig, Leipzig, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Ziebolz
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000382:microbiology*; D003430:Cross-Sectional Studies; D004245:DMF Index; D005260:Female; D016967:Fusobacterium nucleatum / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D010512:Periodontal Index; D010518:Periodontitis / Q000382:microbiology*; D016966:Porphyromonas gingivalis / Q000302:isolation & purification; D048373:Treponema denticola / Q000302:isolation & purification
keywords: Arthritis, rheumatoid; Porphyromonas gingivalis; bacteremia; biofilms; citrulline; periodontitis