RESEARCH - The association between periodontal disease and joint destruction in RA

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Ann Rheum Dis. 2006 Jul;65(7):905-9. Epub 2005 Nov 10.

The association between periodontal disease and joint destruction in

rheumatoid arthritis extends the link between the HLA-DR shared epitope and

severity of bone destruction.

Hospices Civils de Lyon-bioMerieux Research Unit on Rheumatoid Arthritis,

and Faculty of Odontology, University Lyon I, France.

OBJECTIVE: To evaluate a possible association between wrist and periodontal

destruction in rheumatoid arthritis, and between periodontal destruction,

dry mouth, and labial salivary gland biopsy and the contribution of genetic

factors (the shared epitope (SE) and IL1B (+3954) or TNFA (-238 or -308)

gene polymorphisms). METHODS: 147 patients with rheumatoid arthritis were

enrolled. Periodontal damage was defined according to the Hugoson and Jordan

criteria on panoramic dental x rays. Typing for the SE and cytokine

polymorphisms was undertaken by enzyme linked oligosorbent assay. Odds

ratios (OR), relative risk (RR), and chi2 values were calculated to quantify

associations. RESULTS: An association was observed between wrist and

periodontal bone destruction (chi2=11.82; p<0.001): 63 patients had both

wrist and periodontal destruction, 31 had wrist destruction alone, 20 had

periodontal destruction alone, and 33 had no destruction at either site. An

association was seen between a positive labial salivary gland biopsy and

periodontal bone destruction (RR=2.73 (95% CI, 1.35 to 5.51), p<0.01, n=41)

or wrist bone destruction (RR=4.52 (1.96 to 10.45), p<0.001, n=41). The SE

was associated with wrist bone destruction (OR=2.5 (1.16 to 5.42), p<0.05)

and periodontal bone destruction (OR=2.2 (1.04 to 4.84), p<0.05). No

association was found between the selected cytokine polymorphisms and bone

destruction.

CONCLUSIONS: A strong association was found between wrist and periodontal

bone destruction. The destruction risk was further increased in patients

with sicca syndrome. The SE appears to be a severity genetic marker for both

wrist and periodontal bone destruction.

PMID: 16284099

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=16284099

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