Periodontal Indices in Patients with Rheumatoid Arthritis Undergoing Immunosuppressive Therapy

Periodontitis and rheumatoid arthritis are two chronic inflammatory diseases that are interrelated. Given the similarities between these conditions, the medications used by patients with rheumatoid arthritis (RA) may affect their periodontal indices. This study aimed to evaluate the periodontal index status in patients with RA undergoing immunosuppressive therapy.

This comparative cross-sectional study was conducted on 68 patients with RA in three treatment groups (20 on monotherapy, 24 on dual therapy, and 24 on triple treatment) and 20 healthy individuals with a plaque index (PI) below 35% in Ardabil, Iran during the second half of 2021. The monotherapy group included methotrexate or hydroxychloroquine; the dual therapy group included combinations of methotrexate with hydroxychloroquine, adalimumab, or infliximab; and the triple therapy group included combinations of methotrexate and hydroxychloroquine with adalimumab, etanercept, sulfasalazine, or leflunomide. Periodontal indices, including Plaque Index (PI), Clinical Attachment Loss (CAL), Gingival Index (GI), and Bleeding on Probing (BOP), were assessed.

There were no statistically significant differences in periodontal indices among the three treatment groups (monotherapy, dual therapy, and triple therapy). The mean BOP index in the control group was significantly higher compared to the three medication groups (P<0.05). There were no statistically significant differences in the mean CAL and GI indices between the control group and the medication groups. The median PI in the control group was 29.6, and in the dual therapy group, it was 42.3, which was statistically significant (P<0.05).

The use of immunosuppressive drugs did not have a significant effect on the periodontal indices of patients with rheumatoid arthritis.