title: Influence of periodontal treatment on rheumatoid arthritis: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To evaluate the influence of periodontal treatment on rheumatoid arthritis activity.
  
  
  METHODS
  MEDLINE/PUBMED, The Cochrane Library, Clinical Trials, SciELO and LILACS were searched for studies published until December 2014. Included articles were: prospective studies; including patients older than 18 years, diagnosed with periodontitis and rheumatoid arthritis submitted to non-surgical periodontal treatment; with a control group receiving no periodontal treatment; with outcomes including at least one marker of rheumatoid arthritis activity. Methodological quality of the studies was assessed using PEDro scale. Quantitative data were pooled in statistical meta-analysis using Review Manager 5.
  
  
  RESULTS
  Four articles were included. Non-surgical periodontal treatment was associated with a significant reduction of DAS28 (OR: -1.18; 95% CI: -1.43, -0.93; p <0.00001). Erythrocyte sedimentation rate, C-reactive protein, patient's assessment of rheumatoid activity using visual analogical scale, tender and swollen joint counts showed a trend towards reduction (not statistically significant).
  
  
  CONCLUSIONS
  The reduction of DAS 28 in patients with rheumatoid arthritis after periodontal treatment suggests that the improvement of periodontal condition is beneficial to these patients. Further randomized controlled clinical trials are necessary to confirm this finding.
authors.affiliation: Universidade Federal de Minas Gerais, Hospital das Clínicas, Serviço de Reumatologia, Belo Horizonte, MG, Brasil. Electronic address: dccalderaro@gmail.com.
authors.forename: Débora Cerqueira
authors.initials: DC
authors.lastname: Calderaro
authors.affiliation: Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Programa de Pós-Graduação em Biologia Celular, Belo Horizonte, MG, Brasil.
authors.forename: Jôice Dias
authors.initials: JD
authors.lastname: Corrêa
authors.affiliation: Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento do Aparelho Locomotor, Belo Horizonte, MG, Brasil.
authors.forename: Gilda Aparecida
authors.initials: GA
authors.lastname: Ferreira
authors.affiliation: Hospital do Instituto de Previdência dos Servidores do Estado de Minas Gerais, Serviço de Psiquiatria, Belo Horizonte, MG, Brasil.
authors.forename: Izabela Guimarães
authors.initials: IG
authors.lastname: Barbosa
authors.affiliation: Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Odontopediatria e Ortodontia, Belo Horizonte, MG, Brasil.
authors.forename: Carolina Castro
authors.initials: CC
authors.lastname: Martins
authors.affiliation: Universidade Federal de Minas Gerais, Faculdade de Odontologia, Departamento de Clínica, Patologia e Cirurgia Odontológicas, Belo Horizonte, MG, Brasil.
authors.forename: Tarcília Aparecida
authors.initials: TA
authors.lastname: Silva
authors.affiliation: Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Medicina Interna, Belo Horizonte, MG, Brasil.
authors.forename: Antônio Lúcio
authors.initials: AL
authors.lastname: Teixeira
keywords: Artrite reumatoide; Interações doença periodontal‐sistêmica; Metanálise; Meta‐analysis; Periodontal‐systemic disease interactions; Periodontite; Periodontitis; Rheumatoid arthritis