RESUMO
Background: Several studies have shown the association between periodontitis and rheumatoid arthritis (RA) and some similarities in the pathogenesis of these two diseases but clinical trials which have evaluated the effect of periodontal therapy on clinical signs of active RA are scarce, particularly in Iran. The aim of this study was to evaluate the effect of non-surgical periodontal treatment on the improvement of clinical signs of patients with RA. Methods: Fifty-six patients with active RA and generalized moderate-to-severe chronic periodontitis were selected and divided into case (periodontal treatment) and control (without periodontal treatment) groups. Periodontal parameters and RA disease activity scores (DAS28 index) were compared at 6- and 12-week intervals. Results: In the case group, a significant reduction in all the periodontal indices was observed 6 weeks after treatment. At the 12-week evaluation, periodontal indices showed a significant reduction in comparison with baseline and a little increase in comparison with 6-week interval. Six weeks after treatment, DAS28 decreased significantly in the case group (P<0.05). DAS28 also decreased at 12-week interval but its reduction was not significant in comparison with 6-week interval. DAS28 in the case group at 12-week interval was significantly less than that in the control group (P<0.05). Conclusion: Since periodontal care as a part of treatment protocol in RA patients can be effective in improving clinical signs, the recall intervals are better to be 3 months or shorter.
RESUMO
STATEMENT OF THE PROBLEM: Trichomonas tenax and Entamoeba gingivalis are commensal protozoa which inhabit the human oral cavity. These parasites are found in patients with poor oral hygiene and might be a reason for progressive periodontal diseases. PURPOSE: The aim of this study was to evaluate the effect of nonsurgical periodontal treatment on the frequency of these protozoa in saliva and plaque samples. MATERIALS AND METHOD: In this clinical trial, samples of saliva and dental plaque were collected from 46 patients with moderate to severe chronic periodontitis before and after periodontal therapy. The samples were assessed for the frequency of parasites. RESULTS: The frequency of Entamoeba gingivalis was reduced in saliva (p= 0.007) and plaque (p= 0.027) three weeks after the treatment. Likewise, the frequency of Trichomonas tenax reduced in saliva (p= 0.030); however, the decrease was not significant in plaque (p= 0.913). Trichomonas tenax frequency in dental plaque directly related to the severity of periodontitis (r= 0.565, p≤ 0.000). In contrast, the number of Entamoeba gingivalis in both saliva (r= -0.405, p≤ 0.005) and plaque (r= -0.304, p= 0.040) was inversely related with the severity of the periodontal disease. CONCLUSION: Nonsurgical periodontal treatment could reduce the number of Trichomonas Tenax and Entamoeba gingivalis in the oral environment of patients with chronic periodontitis.