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The Effect of Non-Surgical Periodontal Therapy on Rheumatoid Arthritis

Not Applicable
Not yet recruiting
Conditions
Periodontitis
Rheumatoid Arthritis
Interventions
Other: ELISA (Enzyme-Linked ImmunoSorbent Assay)
Registration Number
NCT06245265
Lead Sponsor
Biruni University
Brief Summary

Periodontitis is a common chronic inflammatory disease characterised by the destruction of the soft and hard tissues supporting the tooth, including alveolar bone, periodontal ligament and cementum. Periodontitis has been associated with different host characteristics such as diabetes or neutrophil disorders and environmental factors such as smoking, alcohol consumption and stress. On the other hand, periodontal bacterial infection triggers a systemic immune response that is associated with an increased risk of different disorders such as bacterial pneumonia, cardiovascular disease and autoimmune diseases. Rheumatoid arthritis (RA) is a severe chronic autoimmune disease of unknown etiology, characterised by symmetrical, erosive synovitis of the joints, sometimes with multisystem organ involvement, joint destruction and excessive bone loss. Although the etiology of RA is unknown, it is thought to occur in individuals with genetic predisposition as a result of exposure to various environmental factors. RA and periodontitis are chronic destructive inflammatory diseases with common genetic and environmental risk factors, pathogenesis mechanisms and complex multifactorial pathological processes. Several studies suggest that periodontitis, a common inflammatory disease of the periodontium surrounding the teeth and triggered by bacteria in the mouth, is associated with RA and may initiate and worsen inflammation in RA. Non-surgical periodontal treatment (COPT), which is considered the gold standard in the treatment of periodontitis with hand instruments and ultrasonic instruments, has been shown to provide significant improvements in the clinical outcomes of periodontitis patients with RA. COPT is performed to stop the progression of periodontal diseases. Considering the studies supporting the bidirectional relationship between periodontitis and RA, it is thought that COPT may affect the clinical and biochemical values of RA. Based on these points, the aim of our study was to investigate the relationship between serum and salivary ANGPTL-4, MMP-13, TNF-α and IL-6 levels and periodontal disease in individuals with RA and to evaluate the effects of COPT on RA disease severity in vivo.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
60
Inclusion Criteria
  • To be between the ages of 18-65,
  • Having at least 8 teeth excluding wisdom teeth,
  • No periodontal treatment in the last 3 months,
  • Not having used antibiotics in the last 3 months,
  • Not being pregnant or breastfeeding,
  • The individuals to be included in the control group should not have any systemic disease that may change the periodontal status, and the individuals to be included in the experimental group should not have any systemic disease that may affect periodontal health except RA.
Exclusion Criteria
  • Under 18 years of age and over 65 years of age,
  • Having less than 8 teeth,
  • Having undergone periodontal treatment in the last 3 months,
  • Having used antibiotics in the last 3 months,
  • Being pregnant or breastfeeding,
  • Individuals to be included in the control group should have any systemic disease that may change the periodontal status, and individuals to be included in the test group should have any systemic disease that may affect periodontal health except RA.
  • Abnormal body mass index (more than 29.9 kg/m2).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PeriodontitisELISA (Enzyme-Linked ImmunoSorbent Assay)Non-surgical periodontal treatment will be applied to individuals with periodontitis, clinical measurements, saliva collection and serum will be repeated 12 weeks after the treatment. ANGPTL-4 analysis will be performed by ELISA in saliva and serum of individuals. ANGPTL-4 levels will be examined to evaluate before and after treatment in periodontal health and periodontitis. Clinical measurements (Plaque index, probing depth, gingival recession, clinical attachment level, bleeding on probing) and salivary sample will be taken from all individuals at the beginning of the study.
Healthy individuals with RAELISA (Enzyme-Linked ImmunoSorbent Assay)Clinical measurements (Plaque index, probing depth, gingival recession, clinical attachment level, bleeding on probing) salivary sample and serum fluid will be taken from all individuals at the beginning of the study. ANGPTL-4 levels will be examined to evaluate before and after treatment in periodontal health and periodontitis. A pre-treatment saliva sample and serum will be collected from the healthy individuals with RA group.
Clinical HealthyELISA (Enzyme-Linked ImmunoSorbent Assay)Clinical measurements (Plaque index, probing depth, gingival recession, clinical attachment level, bleeding on probing) salivary sample and serum will be taken from all individuals at the beginning of the study. ANGPTL-4 levels will be examined to evaluate before and after treatment in periodontal health and periodontitis. A pre-treatment saliva sample and serum will be collected from the clinically healthy group.
Periodontitis with rheumatoid arthritisELISA (Enzyme-Linked ImmunoSorbent Assay)Non-surgical periodontal treatment will be applied to individuals with periodontitis, clinical measurements, saliva collection and serum will be repeated 12 weeks after the treatment. ANGPTL-4 analysis will be performed by ELISA in saliva and serum of individuals. ANGPTL-4 levels will be examined to evaluate before and after treatment in periodontitis with rheumatoid arthritis. Clinical measurements (Plaque index, probing depth, gingival recession, clinical attachment level, bleeding on probing) and salivary sample will be taken from all individuals at the beginning of the study.
Primary Outcome Measures
NameTimeMethod
Examination of ANGPTL-4 levels of periodontal disease and rheumatoid arthritisup to 1 year

Examination of ANGPTL-4 levels, which are stated to be associated with periodontal disease, in serum and saliva samples obtained from individuals with periodontitis and periodontitis individuals with RA.

Secondary Outcome Measures
NameTimeMethod
Evaluation of the effect of non-surgical periodontal treatment on changes in ANGPTL-4 level.up to 1 year

Evaluation of the effect of non-surgical periodontal treatment on changes in ANGPTL-4 level.

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