ASSESSMENT OF PREDICTORS OF LONG-TERM EFFECT OF COMPLEX PERIODONTAL TREATMENT IN PATIENTS WITH RHEUMATOID ARTHRITIS
DOI:
https://doi.org/10.35220/2078-8916-2019-34-4-12-16Keywords:
periodontitis, rheumatoid arthritisAbstract
The aim of the study was to assess the effect of a complex of immunological and bacteriological indicators and markers of inflammation on the long-term effect of the treatment of chronic generalized periodontitis in patients with rheumatoid arthritis.
Materials and methods. Dental examination and treat-ment of 80 rheumatoid arthritis patients aged 24 to 66 years with chronic generalized periodontitis stage 2 was performed. We examined the patients before the start of treatment for chronic generalized periodontitis, 20 days after the onset of treatment period, and 6 months after the end of the main course of treatment. The clinical study in-cluded medical history assessment, oral cavity examina-tion, and index evaluation of the condition of periodontal tissues and hard tissues of the teeth. Additionally, samples from periodontal pockets for microbiological examination were taken. The level of SIgA in unstimulated mixed sali-va was determined by enzyme-linked immunosorbent as-say. Salivary lysozyme content was determined by the method of Motavkina NS. Multiple logistic regression analysis of the obtained data was carried out. To deter-mine the discriminatory ability of the resulting logistic model, an ROC analysis was performed.
Research results and their discussion. A model for pre-dicting the long-term positive effect of treatment of chron-ic generalized periodontitis on the background of rheu-matoid arthritis is developed. The logistic regression equation is used as a basis, which assumes that the long-term positive effect is related to the level of factors stud-ied. According to the logistic regression analysis, long-term positive prognosis for treatment depends on the level of short-term changes in SIgA levels and oral fluid lyso-zyme after treatment. An evaluation of the logistic regres-sion equation for the Chi-square value showed its ade-quacy, as its significant level χ2 = 9.02 (p = 0.029) was statistically determined. As a result of the ROC analysis of the obtained logistic model, it was determined that it has good operational characteristics: sensitivity 66.67 %, specificity 81.69%, area under the ROC curve –0.773 (95.0 % CI 0.591 - 0.955; p = 0.001)
References
Influence of periodontal treatment on rheumatoid arthritis: a systematic review and meta-analysis. Rev Bras Reumatol. / [Calderaro D.C., et al.] 2016. http://dx.doi.org/10.1016/j.rbre.2016.11.011.
Significant association of rheumatoid arthritis-related inflammatory markers with nonsurgical periodontal therapy, Journal of the Formosan Medical Association / [Yang N-Y, et al.], 2017, https://doi.org/10.1016/j.jfma.2017.11.006 3. Effects of non-surgical periodontal therapy on perio-dontal laboratory and clinical data as well as on disease activity in patients with rheumatoid arthritis. / R. Cosgarea, R. Tristiu, R.B. Dumitru [et al.] // Clin Oral Invest. – 2019. – №23. – Р. 141-151. https://doi.org/10.1007/s00784-018-2420-3
The effect of periodontal treatment on patients with rheumatoid arthritis: The ESPERA randomised controlled trial. Joint Bone Spine. / [Monsarrat P et al.] (2019), https://doi.org/10.1016/j.jbspin.2019.02.006
Мазур І. П. Оцінка факторів несприятливого перебігу генералізованого пародонтиту в пацієнтів з ревматоїдним артритом / І. П. Мазур, І. І. Білозецький // Со-временная стоматология. – 2015. – № 1. – С. 12-17.
Сміян С. І. Генералізований пародонтит і ревматоїдний артрит: імунологічні аспекти взаємообтяження / С. І. Сміян, І. П. Мазур, І. І. Білозецький // Патологія. – 2014. – № 3. – С. 16-21.
Білоклицька Г. Ф. Особливості цитокінового ста-тусу у хворих на генералізований пародонтит, асоційований зрізними формами ревматоїдного артриту / Г. Ф. Білоклицька, Г. М. Воробйова, Н. В. Цецура // Новинистоматології. – 2010. – № 3. – С. 64-67.
Gamel E.B. Salivary TNFα levels in groups of sub-jects with rheumatoid arthritis and chronic periodontitis. / E.B. Gamel, N.T. Hashim, A.A. Satti, B.G. Gismalla // BMC Re-search Notes. – 2017. – Jan 7, №10(1). – Р. 34. doi: 10.1186/s13104-016-2341-7.
Subgingival microbiome of rheumatoid arthritis pa-tients in relation to their disease status and periodontal health / K. Beyer, E. Zaura, B.W. Brandt [et al.] // PLoS ONE. – 2018. Sep 19. – №13(9). – e0202278. https: //doi.org/10.1371/journal.pone.
Мотавкина Н.С. Микрометод количественного определения лизоцима / Н.С. Мотавкина, В.М. Ковалев, А.С. Шаронов // Лабораторное дело. – 1979. – № 12. – С. 722–724.
Šimundić A. M. Measures of Diagnostic Accuracy: Basic Definitions / A. M. Šimundić // EJIFCC. eCollection – 2009 Jan 20. –№19(4). – Р. 203-11.
Ланг Т.А. Как описывать статистику в медицине / Ланг Т.А. Сесик М. Руководство для авторов, редакторов и рецензентов. 2-е издание; пер. с англ. под ред. В.П. Леонова. М.: Практическая медицина, 2016. – 480 с.
Реброва О.Ю. Статистический анализ медицинс-ких даннях / Реброва О.Ю. Применение пакета прикладных программ STATISTICA. М.: Медиа-Сфера, 2006. – 312 с.
