Nonsurgical Periodontal Treatment Combined With Anti-TNF-α in Patients With Rheumatoid Arthritis and Periodontitis

Hatice Yemenoğlu

Status: Completed

Conditions: Rheumatic Arthritis; Peridontal Disease

Treatments: Other: No medication will be administered to patients.; Procedure: Non Surgical Periodontal Treatment; Other: Periodontal measurements will be performed; Other: biochemical measurements

Study type: Interventional

Funder types: Other

Identifiers

NCT06818045

RecepTayyipErdogan University

Details and patient eligibility

About

Periodontitis is a multifactorial disease of the periodontium that can lead to destruction of the alveolar bone and supporting connective tissue and subsequent tooth loss. Recent studies have shown that periodontitis is associated with age, smoking habits, genetic predisposition, socioeconomic status, and various systemic diseases such as diabetes mellitus, atherosclerosis, obesity, osteoporosis, and rheumatoid arthritis (RA). RA is a chronic, systemic inflammatory disease of unknown etiology that primarily affects the joints. Periodontitis and RA have similar clinical and pathogenic features. Clinically, both diseases are characterized by local destruction of hard and soft tissues. Their pathogenesis involves the release of cytokines and matrix metalloproteinases (MMPs) from inflammatory cells. Expression of proinflammatory cytokines such as tumor necrosis factor-alpha (TNF-α) leads to the release of high levels of inflammatory mediators that cause bone destruction and the spread of inflammation. TNF-α is the main regulatory cytokine in both RA and periodontitis. TNF-α inhibitors (anti-TNF-α) reduce the number of inflammatory cells, osteoclast formation and bone loss. In addition, many immunological processes have been identified that are similar to both diseases. Autoreactive T cells, natural killer cells, heat shock proteins, autoantibodies and genetic factors are reported to play an important role in the inflammatory pathway of RA and periodontitis.

Recently, TNF-α blocking agents (anti-TNF-α) have been developed and used for the treatment of RA. Animal and human studies have suggested that anti-TNF-α treatment may reduce the severity of periodontitis.

The aim of this study was to investigate the effect of nonsurgical periodontal treatment combined with anti-TNF-α on alveolar bone loss and oxidative stress in individuals with RA and periodontitis.

Enrollment: 46 patients

Sex: All

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Being between the ages of 18-65,
• Having a confirmed diagnosis of Rheumatoid Arthritis (RA),
• Having a diagnosis of Stage III-IV periodontitis,
• Having at least 20 teeth,

Exclusion criteria

• Having used antibiotics for the 3 months before the study,
• Being pregnant and lactating,
• Having received periodontal treatment in the last 6 months,
• Being diabetic.
• Smoking.

Trial design

Primary purpose: Prevention

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

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46 participants in 1 patient group

control

Experimental group

Treatment:

Other: biochemical measurements

Other: Periodontal measurements will be performed

Procedure: Non Surgical Periodontal Treatment

Other: No medication will be administered to patients.