Diagnostic Significance of Cone Beam Computed Tomography in the Assessment of Chronic Generalized Periodontitis in Patients with Seropositive and Seronegative Rheumatoid Arthritis

Objective . To evaluate the diagnostic value of cone beam computed tomography in the assessment of chronic generalized periodontitis in patients with seropositive and seronegative rheumatoid arthritis. Materials and methods . From February 2023 to May 2024 92 patients diagnosed with chronic generalized periodontitis and rheumatoid arthritis participated in the study, the average age of patients was 50 ± 6.9 years: 53 women (57.6 %), 39 men (42.4 %); the comparison group was represented by 49 patients with chronic generalized periodontitis without RA. Patients underwent cone beam computed tomography (CBCT) (n = 92), orthopantomography (n = 45). Results . The main dental indices were analyzed before and after RA treatment. It was found that RA remission was achieved within 1 month with joint management of a rheumatologist and dentist in 75 (81.5 %) patients. According to objective criteria, chronic generalized periodontitis of moderate severity prevailed in the main group. In an intergroup analysis, caries were most common in the group of male patients with seropositive RA (p < 0.05). A decrease in densitometric parameters in both groups was noted in the area of the interdental septum between teeth 1.1 and 1.2. A decrease in densitometric parameters of the compact layer of bone tissue in the area of the lateral sections of the upper and lower jaws was more common in women from the seropositive RA group. Conclusions . 1. During RA therapy, there was a worsening in the main dental indices, which was associated with the characteristic of RA treatment. 2. In men with seropositive and seronegative RA, plaque was most common in the dentogingival area compared to the control group (p < 0.05); in women with seropositive RA, periodontal destruction predominated in areas of inflammation, in women with seronegative RA — plaque in the dentogingival area predominated, which was statistically significant in comparison with the control group (p < 0.05); adentia was most common in patients with seropositive RA, which was statistically significant in comparison with patients with seronegative RA (p < 0.001) and the control group (p < 0.05). 3. When analyzing the radiation pattern, the greatest changes according to CBCT data prevailed in the group of patients with seropositive RA in comparison with the group of patients with seronegative RA (p < 0.01) and the control group (p < 0.05).