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Association of different immunosuppressive medications with periodontal condition in patients with rheumatoid arthritis: Results from a cross-sectional study.
Ziebolz, Dirk; Rupprecht, Annegret; Schmickler, Jan; Bothmann, Laura; Krämer, Juliane; Patschan, Daniel; Müller, Gerhard A; Mausberg, Rainer F; Schmidt, Jana; Schmalz, Gerhard; Patschan, Susann.
Afiliación
  • Ziebolz D; Department of Cariology, Endodontology, and Periodontology, University of Leipzig, Leipzig, Germany.
  • Rupprecht A; Department of Cariology, Endodontology, and Periodontology, University of Leipzig, Leipzig, Germany.
  • Schmickler J; Department of Cariology, Endodontology, and Periodontology, University of Leipzig, Leipzig, Germany.
  • Bothmann L; Dental Practice Dr. Frank Paschereit, Northeim, Germany.
  • Krämer J; Dental Practice Rümenapp & Kollegen, Northeim, Germany.
  • Patschan D; Department of Cardiology, Pulmonology, Angiology, and Nephrology, Brandenburg Medical School, University Hospital Brandenburg, Brandenburg, Germany.
  • Müller GA; Department of Nephrology and Rheumatology, University Medical Center Goettingen, Goettingen, Germany.
  • Mausberg RF; Department of Preventive Dentistry, Periodontology, and Cariology, University Medical Center Goettingen, Goettingen, Germany.
  • Schmidt J; Department of Cariology, Endodontology, and Periodontology, University of Leipzig, Leipzig, Germany.
  • Schmalz G; Department of Cariology, Endodontology, and Periodontology, University of Leipzig, Leipzig, Germany.
  • Patschan S; Department of Nephrology and Rheumatology, University Medical Center Goettingen, Goettingen, Germany.
J Periodontol ; 89(11): 1310-1317, 2018 11.
Article en En | MEDLINE | ID: mdl-29786138
BACKGROUND: The aim of this cross-sectional study was to investigate clinical periodontal findings as well as prevalence of selected potentially periodontal pathogenic bacteria in patients with rheumatoid arthritis (RA) treated with different immunosuppressive rheumatic medications. METHODS: One hundred sixty-eight patients with RA undergoing different immunosuppressive medications were included and divided into subgroups according to their medication, which was taken in the past 6 months, in detail, 1) non-steroidal anti-inflammatory drugs (NSAID) and glucocorticoids combined, and the following different disease modifying anti-rheumatic drugs (DMARDs): 2) methotrexate (MTX), 3) leflunomide, 4) MTX and TNF-α antagonists combined, 5) interleukin-6 (IL-6) antagonist, 6) MTX and rituximab combined, and 7) combination therapies of > 2 of these DMARDs. Periodontal examination consisted of papilla bleeding index (PBI), periodontal status with periodontal probing depth (PD), bleeding on probing (BOP), and clinical attachment loss (AL). Periodontitis was classified as none/mild, moderate, or severe. Samples obtained from gingival crevicular fluid were analyzed for presence of 11 periodontal pathogenic bacteria. RESULTS: Patients with MTX + TNF-α antagonists therapy showed higher PBI and BOP values compared with leflunomide (P < 0.01) and higher BOP than MTX + rituximab (P = 0.02). Porphyromonas gingivalis (P < 0.01), Treponema denticola (P < 0.01), Fusobacterium nodatum (P = 0.02) and Capnocytophaga species (P = 0.05) was associated with medication subgroup, whereby post hoc testing confirmed singular differences for several medication subgroups. CONCLUSIONS: RA medication is associated with periodontal inflammation, without differences in periodontal disease severity. Thereby, combination of MTX + TNF-α shows an increased potential to periodontal inflammation. Additionally, several differences in prevalence of selected bacteria were detected.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Periodontales / Artritis Reumatoide / Antirreumáticos Tipo de estudio: Observational_studies / Prevalence_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Periodontol Año: 2018 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedades Periodontales / Artritis Reumatoide / Antirreumáticos Tipo de estudio: Observational_studies / Prevalence_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: J Periodontol Año: 2018 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Estados Unidos