STUDY ON THE CLINICAL CHANGES IN GENERAL AND ORAL STATUS IN PATIENTS WITH RHEUMATOID ARTHRITIS

Alexandra Martu, Elena Rezus, Irina Sufaru, Claudia Banu, Silvia Martu,
Liliana Foia

Abstract

Rheumatoid arthritis (RA) and periodontitis use similar destructive mechanisms; the pattern of inflammatory cells and proinflammatory cytokines that lead chronic bone erosion to RA and chronic tissue destruction in periodontitis are similar. It is argued that periodontitis could be a factor in initiating and maintaining autoimmune inflammatory responses that arise in RA. This study proposes an examination of the local inflammatory status by evaluating Quigley Hein, GI Lõe and Silness, papillary bleeding index (PBI) and CPITN, accompanied by a detailed assessment of systemic status in patients with rheumatoid arthritis. In the retrospective study, 220 patients were admitted to the Clinical Recovery Hospital in Iasi with a definite diagnosis of rheumatoid arthritis. In terms of dental-periodontal health indices, we used the following indices: Quigley Hein, GI Lõe and Silness, papillary bleeding index (PBI) and CPITN. The study was observational, retrospective, and attempted to establish the cumulative risk factors underlying the evolution of oral pathology in patients with rheumatoid arthritis. In 20.3% of patients, the higher Quigley Hein plate index significantly correlated with a higher VAS. In approximately 20% of patients, the higher Quigley Hein index significantly correlated with a higher number of painful joints, and in 27.5% of patients with swollen joint counts. Approximately 19% of patients associated higher individual values ​​of the Quigley Hein plaque index with higher scores of DAS28. In 41% of patients, the Lõe and Silnes GI index increased significantly with a higher VAS level. In 25.8% of patients, the Lõe and Silnes GI index increased significantly with a higher number of painful joints and 30.5% of patients with swollen joint counts. A significant number of patients experienced rheumatoid factor and antiCCP antibodies, which could have significant effects on periodontal status. Also, in a significant number of patients, the individual VSH and CRP values ​​exceeded the maximum reference limit, the mean level being significantly higher in the advanced stages of rheumatic disease, values ​​that may exert adverse effects on periodontal health but also increase the overall inflammatory burden in the body.

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