Journal of stomatology, oral and maxillofacial surgery · 2026
Periodontal Inflammatory Burden and Radiographic Bone Loss in Relation to Disease Activity in Patients with Rheumatoid Arthritis: A Cross-Sectional Analysis.
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Karaca Mustafa, Kızıltoprak Mehmet
Аннотация
OBJECTIVE: To evaluate the association of periodontal inflamed surface area (PISA) and maximum radiographic bone loss with rheumatoid arthritis (RA) disease activity.
MATERIALS AND METHODS: In this retrospective cross-sectional study, 38 patients with RA (periodontal and rheumatologic assessments ≤10 days apart) were evaluated. Periodontal inflammatory burden (PISA), maximum radiographic bone loss, and RA activity (DAS28-ESR) were assessed. Associations were examined with Spearman correlation and multivariable linear regression adjusted for age, smoking, and diabetes.
RESULTS: Patients with higher PISA had greater maximum radiographic bone loss (ρ=0.441; 95% CI 0.101-0.717; p=0.006) and higher RA disease activity (ρ=0.811; 95% CI 0.546-0.959; p<0.001); DAS28-ESR also correlated with bone loss (ρ=0.580; 95% CI 0.306-0.777; p<0.001). After adjustment for age, smoking, and diabetes, each 100-mm² increase in PISA was associated with a 0.740-unit higher DAS28-ESR (95% CI 0.363-1.118; p<0.001), and each one-unit increase in DAS28-ESR was associated with 8.27 percentage points greater bone loss (95% CI 4.26-12.29; p<0.001); age was independently associated with bone loss (0.50 points/year; 95% CI 0.18-0.83; p=0.003). Smoking and diabetes were not significant. Effect sizes were sensitive to influential observations (PISA coefficient increased to 1.468 after exclusion), and no exploratory correlation survived Holm correction.
CONCLUSION: Periodontal inflammatory burden, radiographic bone loss, and RA disease activity were mutually associated in this single-center, seropositive cohort. These findings support evaluating periodontal inflammation and structural destruction alongside RA activity; longitudinal studies are needed to establish temporal direction.
MATERIALS AND METHODS: In this retrospective cross-sectional study, 38 patients with RA (periodontal and rheumatologic assessments ≤10 days apart) were evaluated. Periodontal inflammatory burden (PISA), maximum radiographic bone loss, and RA activity (DAS28-ESR) were assessed. Associations were examined with Spearman correlation and multivariable linear regression adjusted for age, smoking, and diabetes.
RESULTS: Patients with higher PISA had greater maximum radiographic bone loss (ρ=0.441; 95% CI 0.101-0.717; p=0.006) and higher RA disease activity (ρ=0.811; 95% CI 0.546-0.959; p<0.001); DAS28-ESR also correlated with bone loss (ρ=0.580; 95% CI 0.306-0.777; p<0.001). After adjustment for age, smoking, and diabetes, each 100-mm² increase in PISA was associated with a 0.740-unit higher DAS28-ESR (95% CI 0.363-1.118; p<0.001), and each one-unit increase in DAS28-ESR was associated with 8.27 percentage points greater bone loss (95% CI 4.26-12.29; p<0.001); age was independently associated with bone loss (0.50 points/year; 95% CI 0.18-0.83; p=0.003). Smoking and diabetes were not significant. Effect sizes were sensitive to influential observations (PISA coefficient increased to 1.468 after exclusion), and no exploratory correlation survived Holm correction.
CONCLUSION: Periodontal inflammatory burden, radiographic bone loss, and RA disease activity were mutually associated in this single-center, seropositive cohort. These findings support evaluating periodontal inflammation and structural destruction alongside RA activity; longitudinal studies are needed to establish temporal direction.