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Kryukov AI, Tovmasyan AS, Kishinevskiy AE, Danilyuk LI, Mosin VV, Shvedov NV, Filina EV, Osipyan AA. [Clinical and morphological picture of chronic tonsillitis and its pathogenetic relationship with periodontal diseases: literature review]. Vestn Otorinolaringol 2022; 87:75-80. [PMID: 36404695 DOI: 10.17116/otorino20228705175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The article is devoted to the study of chronic tonsillitis from the point of view of the clinical and morphological picture of the disease, histological changes in the palatine tonsils in various forms of CT. The authors raise the question of studying the assessment of the effect of conservative therapy on the morpho-functional state of the palatine tonsils. The article focuses on the study and influence of extratonsillary oropharyngeal loci of focal infection, such as periodontopathies, on the course of chronic inflammation of the palatine tonsils. The association of periodontitis with CT and various somatic diseases has been demonstrated. The necessity of further study of the cause-and-effect relationships of CT and periodontal diseases, as well as a more in-depth study of the morphological picture in CT using immunohistochemical methods of research, which will allow us to develop new principles for the diagnosis and treatment of this disease, is justified.
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Affiliation(s)
- A I Kryukov
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A S Tovmasyan
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - A E Kishinevskiy
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - L I Danilyuk
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - V V Mosin
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - N V Shvedov
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - E V Filina
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
| | - A A Osipyan
- Sverzhevsky Research Clinical Institute of Otorhinolaryngology, Moscow, Russia
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González-Febles J, Sanz M. Periodontitis and rheumatoid arthritis: What have we learned about their connection and their treatment? Periodontol 2000 2021; 87:181-203. [PMID: 34463976 DOI: 10.1111/prd.12385] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Rheumatoid arthritis and periodontitis are chronic inflammatory diseases defined respectively by the destruction of the articular cartilage and tooth-supporting periodontal tissues. Although the epidemiologic evidence for an association between these two diseases is still scarce, there is emerging scientific information linking specific bacterial periodontal pathogens, such as Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, in the citrullination process, leading to autoantibody formation and compromised immunotolerance of the susceptible patient to rheumatoid arthritis. In this review, we update the existing information on the evidence, not only regarding the epidemiologic association, but also the biologic mechanisms linking these two diseases. Finally, we review information emerging from intervention studies evaluating whether periodontal treatment could influence the initiation and progression of rheumatoid arthritis.
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Affiliation(s)
- Jerián González-Febles
- Departament of Dental Clinical Specialties, Faculty of Odontology, University Complutense, Madrid, Spain.,Research Group on the Aetiology and Treatment of Periodontal and Periimplant Diseases (ETEP), Faculty of Odontology, University Complutense, Madrid, Spain
| | - Mariano Sanz
- Departament of Dental Clinical Specialties, Faculty of Odontology, University Complutense, Madrid, Spain.,Research Group on the Aetiology and Treatment of Periodontal and Periimplant Diseases (ETEP), Faculty of Odontology, University Complutense, Madrid, Spain
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Abstract
Historically, rheumatic diseases have not received much attention in Africa, particularly in sub-Saharan Africa, possibly owing to a focus on the overwhelming incidence of infectious diseases and the decreased life span of the general population in this region. Global attention and support, together with better health policies and planning, have improved outcomes for many infectious diseases; thus, increasing attention is being turned to chronic non-communicable diseases. Rheumatic diseases were previously considered to be rare among Africans but there is now a growing interest in these conditions, particularly as the number of rheumatologists on the continent increases. This interest has resulted in a growing number of publications from Africa on the more commonly encountered rheumatic diseases, as well as case reports of rare diseases. Despite the limited amount of available data, some aspects of the epidemiology, genetics and clinical and laboratory features of rheumatic diseases in African populations are known, as is some detail on the use of therapeutics. Similarities and differences in these conditions can be seen across the multi-ethnic and genetically diverse African continent, and it is hoped that increased awareness of rheumatic diseases in Africa will lead to earlier diagnosis and better outcomes for patients. The prevalence of rheumatic diseases is increasing in African countries, leading to an increased need for specialist rheumatologists and disease-modifying drugs. In this Review, the authors outline what is currently known about the state of rheumatic diseases in Africa. In the past, there has been an emphasis on communicable diseases in Africa, but attention has now shifted towards non-communicable diseases such as rheumatic diseases. Common rheumatic diseases are seen in Africa and are both comparable and different from presentations seen outside of Africa. Diverse genetic and environmental factors affect the presentation of common rheumatic diseases among different African nations. A shortage of appropriately trained staff, laboratory testing capacity and effective medications exists across the whole continent. Advocacy and research are needed to increase awareness of the risk factors, presentations and management of rheumatic diseases in Africa. Specialized treatment guidelines are needed for resource-poor countries in Africa.
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Bartold PM, Lopez‐Oliva I. Periodontitis and rheumatoid arthritis: An update 2012‐2017. Periodontol 2000 2020; 83:189-212. [DOI: 10.1111/prd.12300] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Peter Mark Bartold
- Department of Dentistry University of Adelaide Adelaide South Australia Australia
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Buwembo W, Munabi IG, Kaddumukasa M, Kiryowa H, Mbabali M, Nankya E, Johnson WE, Okello E, Sewankambo NK. Non-surgical oral hygiene interventions on disease activity of Rheumatoid arthritis patients with periodontitis: A randomized controlled trial. J Dent Res Dent Clin Dent Prospects 2020; 14:26-36. [PMID: 32454955 PMCID: PMC7235694 DOI: 10.34172/joddd.2020.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 12/20/2019] [Indexed: 12/15/2022] Open
Abstract
Background. Periodontitis and rheumatoid arthritis have similar epidemiology and pathophysiology. Understanding the interaction between these two diseases is vital in our settings. We set out to assess the effect of oral hygiene interventions on disease activity of rheumatoid arthritis patients with periodontitis in Kampala, Uganda. Methods. Fifty-eight patients attending an arthritis clinic with rheumatoid arthritis and periodontitis were randomly assigned to either an intervention group or a control group. Patients diagnosed with rheumatoid arthritis at least two years before, who were on the same medication, dose, or formulation for RA treatment during the preceding three months, were included. The patients were >18 years of age, would be available for all the study visits in the next six months, had at least six natural teeth, had periodontal disease classified as Dutch Periodontal Index (DPSI) >3 and provided written informed consent. Those who had a chronic disorder requiring chronic or intermittent use of antibiotics, were pregnant, were lactating, or had intent to become pregnant were excluded. The primary outcome measure was a change in Disease Activity Score of 28 Joints (DAS28 score) in two 3-month follow-up periods after the intervention. The secondary outcome measure was a change in periodontal status. Results. There was a statistically significant improvement in the DAS-28 score in both the intervention and control arms during the follow-up period (P<0.01). The participants carrying more than one bacterial species had worse DAS-28 scores. Conclusion. Oral hygiene interventions given to RA patients could drastically improve their RA treatment outcomes, especially in resource-limited settings.
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Affiliation(s)
- William Buwembo
- Department of Human Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala Uganda
| | - Ian Guyton Munabi
- Department of Human Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala Uganda
| | - Mark Kaddumukasa
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala Uganda
| | - Haruna Kiryowa
- Department of Human Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala Uganda
| | - Muhammad Mbabali
- Department of Dentistry, School of Health Sciences, Makerere University College of Health Sciences, Kampala Uganda
| | - Ethel Nankya
- Division of Computational Biomedicine, Boston University School of Medicine, Boston, MA, Boston University, USA
| | - William Evan Johnson
- Division of Computational Biomedicine, Boston University School of Medicine, Boston, MA, Boston University, USA
| | - Emmy Okello
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala Uganda
| | - Nelson K. Sewankambo
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala Uganda
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Lopez-Oliva I, de Pablo P, Dietrich T, Chapple I. Gums and joints: is there a connection? Part one: epidemiological and clinical links. Br Dent J 2019; 227:605-609. [PMID: 31605071 DOI: 10.1038/s41415-019-0722-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Rheumatoid arthritis (RA) and chronic periodontitis are common chronic inflammatory diseases that share numerous clinical and pathobiological characteristics. Due to their similarities, despite manifesting at anatomically distinct sites, the relationship between these two diseases has been investigated for many years. This review attempts to summarise the state of the field based on evidence published in the last ten years.
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Affiliation(s)
| | - Paola de Pablo
- Institute of Inflammation and Ageing, University of Birmingham, Queen Elizabeth Hospital, Birmingham, UK
| | - Thomas Dietrich
- Oral Surgery, School of Dentistry, University of Birmingham, Birmingham, UK
| | - Iain Chapple
- University of Birmingham Dental School, Periodontology, Queensway, Birmingham, UK
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Buwembo W, Munabi IG, Kaddumukasa M, Kiryowa H, Nankya E, Johnson WE, Okello E, Sewankambo N. Periodontitis and Rheumatoid Arthritis in sub-Saharan Africa, gaps and way forward: a systematic review and meta-analysis. OPEN JOURNAL OF STOMATOLOGY 2019; 9:215-226. [PMID: 31695961 PMCID: PMC6834353 DOI: 10.4236/ojst.2019.910023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND This review identified papers that described periodontitis and rheumatoid arthritis in sub-Saharan Africa. Only English language publications from January 2010 to December 2017 describing original research in sub-Saharan Africa on the association between periodontitis and rheumatoid arthritis were considered for this study. METHODS Published databases: PubMed, Science direct and Google scholar, were searched using terms "periodontitis", "rheumatoid arthritis" and "Sub-Saharan Africa" to generate a set of putative studies. Articles with data on both rheumatoid arthritis and periodontitis compared to controls were selected. Studies on the association of periodontitis with cardiovascular disease, arthritis or rheumatoid arthritis alone were excluded. Data were extracted, critically appraised, and analyzed using a random-effect Mantel-Haenszel meta-analysis on plaque index, gingival index, pocket depth and clinical attachment loss. RESULTS Three publications were selected for the systematic review and 2 for the meta-analysis. Two studies were from Sudan, and one was from Burina Faso. There was a significant increase in pocket depth (mean difference: 0.31; 95% CI: 0.21, 0.41; N= 274; (p ≤ 0.001) and clinical attachment loss (mean difference: 0.47; 95% CI: 0.22, 0.75; N= 274; (p ≤ 0.001) in participants with rheumatoid arthritis compared to normal controls. CONCLUSION Findings from these combined studies show a significant relationship between periodontal disease and rheumatoid arthritis with increased periodontal pocket depth and clinical attachment loss. They also highlight the need for additional work especially in the area of associating rheumatoid arthritis with P. gingivalis, the oral microbiome and treating periodontal diseases to help in the management of rheumatoid arthritis.
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Affiliation(s)
- William Buwembo
- Department of Human Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala Uganda
| | - Ian Guyton Munabi
- Department of Human Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala Uganda
| | - Mark Kaddumukasa
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala Uganda
| | - Haruna Kiryowa
- Department of Human Anatomy, School of Biomedical Sciences, Makerere University College of Health Sciences, Kampala Uganda
| | - Ethel Nankya
- Division of Computational Biomedicine, Boston University School of Medicine, Boston, MA, Boston University, USA
| | - William Evan Johnson
- Division of Computational Biomedicine, Boston University School of Medicine, Boston, MA, Boston University, USA
| | - Emmy Okello
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala Uganda
| | - Nelson Sewankambo
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala Uganda
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Linkage of Periodontitis and Rheumatoid Arthritis: Current Evidence and Potential Biological Interactions. Int J Mol Sci 2019; 20:ijms20184541. [PMID: 31540277 PMCID: PMC6769683 DOI: 10.3390/ijms20184541] [Citation(s) in RCA: 98] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 08/07/2019] [Accepted: 08/20/2019] [Indexed: 02/06/2023] Open
Abstract
The association between rheumatoid arthritis (RA) and periodontal disease (PD) has been the focus of numerous investigations driven by their common pathological features. RA is an autoimmune disease characterized by chronic inflammation, the production of anti-citrullinated proteins antibodies (ACPA) leading to synovial joint inflammation and destruction. PD is a chronic inflammatory condition associated with a dysbiotic microbial biofilm affecting the supporting tissues around the teeth leading to the destruction of mineralized and non-mineralized connective tissues. Chronic inflammation associated with both RA and PD is similar in the predominant adaptive immune phenotype, in the imbalance between pro- and anti-inflammatory cytokines and in the role of smoking and genetic background as risk factors. Structural damage that occurs in consequence of chronic inflammation is the ultimate cause of loss of function and disability observed with the progression of RA and PD. Interestingly, the periodontal pathogen Porphyromonas gingivalis has been implicated in the generation of ACPA in RA patients, suggesting a direct biological intersection between PD and RA. However, more studies are warranted to confirm this link, elucidate potential mechanisms involved, and ascertain temporal associations between RA and PD. This review is mainly focused on recent clinical and translational research intends to discuss and provide an overview of the relationship between RA and PD, exploring the similarities in the immune-pathological aspects and the possible mechanisms linking the development and progression of both diseases. In addition, the current available treatments targeting both RA and PD were revised.
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