*Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus, Haifa, Israel.
†B. Shine Department of Rheumatology, Rambam Health Care Campus, Haifa, Israel.
‡Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel.
Background: The aim of this study was to evaluate the influence of anti TNF- α therapy on the clinical and immunological parameters of the periodontium.
Methods: 10 patients with Rheumatoid arthritis (RA) who received infusion of 200 mg infliximab routinely (RA+), 10 patients with RA without anti TNF-α therapy (RA-) and 10 healthy patients (C) were included. Clinical parameters PI, GI, PD, CAL and BOP were assessed and total GCF TNF-α level was determined using ELISA. ANOVA with Scheffe's modification and Pearson correlation test were used for statistical analysis.
Results: Patients’ age ranged between 22-76 years (mean 50.73 ± 9.1). Mean PI was similar between the groups. However, mean inflammatory parameters in the 3 groups varied significantly; GI was greater in the RA- compared with RA+ and C (P = 0.0042). RA+ exhibit less BOP than RA- and C (21.1%±3.0%, 45.9%±6.2% and 39.1%±7.2%; respectively, P = 0.0146) the mean PD in RA+ was shallower than RA- and C (3.22 ± 0.13, 3.85 ± 0.22, 3.77 ± 0.20; P = 0.055). CAL in RA+ was lower than RA- and C (3.68 ± 0.11, 4.52 ± 0.26, 4.35 ± 0.24; P = 0.0273). TNF-α levels in the GCF of RA+ were the lowest compared to RA- and C (0.663 ng/site, 1.23 ng/site and 0.949 ng/site; P = 0.0401). A significant positive correlation was found between TNF-α levels in the GCF and CAL (r = 0.448, P = 0.0283).
Conclusion: Rheumatoid arthritis patients receiving anti TNF-α medication have lower periodontal indices and GCF TNF-α level. Thus, suppression of pro-inflammatory cytokines might prove beneficial in suppressing periodontal diseases.