Periodontal therapy in chronic periodontitis lowers gingival crevicular fluid interleukin-1beta and DAS28 in rheumatoid arthritis patients

To evaluate clinical outcomes and effects of non-surgical periodontal therapy on serum, gingival crevicular fluid (GCF) interleukin-1beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) levels in chronic periodontitis patients with/without rheumatoid arthritis (RA), fifteen RA patients with chronic periodontitis (RA-P) and 15 systemically healthy non-RA chronic periodontitis patients (H-P) were recruited. Clinical periodontal recordings, GCF, and blood samples were obtained at baseline, 1, 3, and 6 months after periodontal treatment. GCF, serum IL-1 beta, TNF-alpha levels were analyzed by ELISA. Disease activity score 28 (DAS28) was used to assess RA clinical morbidity. Study groups were compared by Mann-Whitney U test. Wilcoxon test was used to compare the data at baseline, 1, 3, and 6 months after periodontal therapy within the same group. DAS28 decreased significantly after periodontal therapy in RA-P group (p < 0.01). Serum TNF-alpha concentrations of H-P group were significantly higher than those of RA-P group (p < 0.01), whereas IL-1 beta levels were similar. No significant change was observed in serum levels of these cytokines after periodontal therapy. GCF IL-1 beta amounts decreased significantly in both groups following treatment (p < 0.01). At 6-months, H-P GCF IL-1 beta concentrations were significantly lower than baseline. DAS28 and GCF IL-1 beta correlated with clinical periodontal indices (p < 0.01). Significant decreases in DAS28 and GCF IL-1 beta amounts after periodontal treatment suggest that periodontal therapy synergizes with systemic RA therapy to improve RA status.