Assessment of periodontal status in patients with rheumatoid arthritis treated with disease-modifying anti-rheumatic drugs and periodontitis

Tomasz Kaczyński, Jakub Wroński, Bartłomiej Górski, Piotr Głuszko, Artur Rasiński, Renata Górska

Streszczenie
Cel. Celem badania była ocena wpływu reumatoidalnego zapalenia stawów (RZS) leczonego lekami modyfikującymi przebieg choroby (DMARDs) na stan tkanek przyzębia u pacjentów z zapaleniem przyzębia (ZP).
Metody. W badaniu przekrojowym oceniono stan tkanek przyzębia 35 pacjentów z RZS i ZP (grupa RZS) oraz 35 pacjentów z ZP (grupa ZP). U wszystkich pacjentów oceniono parametry kliniczne przyzębia, a u pacjentów z RZS także wpływ stosowanych DMARDs
Wyniki. Pacjenci z grupy RZS mieli znamiennie gorszą higienę jamy ustnej i wykazywali istotnie niższe wartości wskaźnika krwawienia przy sondowaniu, średniej głębokości kieszonek (PD) i liczby kieszonek o głębokości ³ 4 mm. Pacjenci stosujący metotreksat mieli więcej zębów i mieli niższe wartości PD oraz utraty przyczepu klinicznego (CAL), natomiast pacjenci stosujący glikokortykosteroidy w połączeniu z DMARDs mieli niższe wartości PD i CAL.
Wnioski. U pacjentów z RZS, mimo gorszej higieny, stwierdzono mniej nasilony stan zapalny tkanek przyzębia. Stosowanie DMARDs może potencjalnie korzystnie wpływać na redukcję stanu zapalnego tkanek przyzębia.
 
Abstract
Aim. The study evaluates ­influence of rheumatoid arthritis (RA) treated with disease-modifying anti-rheumatic drugs (DMARDs) on periodontal status in patients with periodontal disease (PD).
Methods. The cross-sectional study involved 35 subjects diagnosed with both RA and PD (RA group) and 35 subjects with PD (PD group). Clinical measurements of periodontal disease were recorded in all the patients, while RA patients were analyzed for influence of DMARDs on periodontal status.
Results. RA patients despite poor oral hygiene displayed significantly lower bleeding on probing, mean pocket depth (PD) and number of PD ³ Subjects treated with methotrexate demonstrated higher number of teeth and lower PD and clinical attachment loss (CAL), while glucocorticoid therapy combined with DMARDs was associated with lower PD and CAL values.
Conclusions. RA patients displayed lower level of periodontal inflammation despite inferior oral hygiene. DMARDs treatment may have beneficial effect on periodontal tissues.
 

Hasła indeksowe: zapalenie przyzębia, reumatoidalne zapalenie stawów, leki modyfikujące przebieg choroby, metotreksat

Key words: periodontitis, rheumatoid arthritis, disease-modifying anti-rheumatic drugs, methotrexate

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