Impact of Periodontal Treatment on Early Rheumatoid Arthritis and the Role of Porphyromonas gingivalis Antibody Titers

BACKGROUND Periodontal disease and rheumatoid arthritis (RA) are closely related, and periodontal therapy can potentially improve RA activity. However, it is not clear in which RA patient populations are more effective periodontal therapy for RA treatment. This study aimed to evaluate the effects of treatment for periodontal disease in 30 patients with rheumatoid arthritis and the titers of antibodies to Porphyromonas gingivalis (P. gingivalis). MATERIAL AND METHODS Thirty patients with RA with mild to severe periodontitis were divided into 3 groups based on the timing of periodontal therapy initiation. RA activity was assessed at baseline and at 3, 6, 9, and 12 months for comparison across groups. Additionally, serum P. gingivalis antibody titers were measured at baseline, patients were divided into 3 groups based on their levels, and their RA activity was compared after 12 months. RESULTS Patients who started periodontal therapy concurrently with RA treatment initiation at baseline showed greater improvement in RA activity, measured by disease activity score, including 28 joints using C-reactive protein (DAS28-CRP), from baseline to 3 months than those who started periodontal therapy after RA treatment. Additionally, RA activity by DAS28-CRP after 12 months of RA treatment with periodontal therapy was significantly improved in patients with higher baseline serum IgG antibody titers against P. gingivalis than in those with lower titers. CONCLUSIONS Treatment for periodontal disease in patients with RA is more effective in patients with early-phase RA and higher serum P. gingivalis antibody titers.