The Effect Of Periodontal Non-surgical Treatment On The Curative Effect Of Rheumatoid Arthritis With Periodontitis:A Meta-analysis

Objective: To systematically evaluate the effect of periodontal non-surgical treatment on patients with rheumatoid arthritis and periodontitis,and to explore the correlation between rheumatoid arthritis and periodontitis also the feasibility of controlling periodontal disease with rheumatoid arthritis through periodontal non-surgical treatment.Methods: English databases such as PubMed,Embase,Ovid,Cochrane Library,Web of science and Chinese databases such as CNKI,Wanfang Database,and Biomedical Database were searched by computer.The retrieval time was from the establishment of the database to January 2021,and clinical trial studies on the efficacy of periodontal non-surgical treatment on patients with rheumatoid arthritis and periodontitis were included.Two evaluators independently selected literature,extracted data,evaluated the quality of the trials and cross checked,and then analyzed data by Stata 15.1.The weighted mean difference(WMD)was used to measure the data of randomized controlled trials.If the difference in numerical value was large or the evaluation unit was inconsistent,the standardized mean difference(SMD)was chosen.Meta analysis of single group was used in non-randomized controlled trials.Results: Overall included 19 clinical studies,including 9 randomized controlled trials and 10 nonrandomized controlled trials.Meta analysis of randomized controlled trials showed that: the decrease of DAS28 after periodontal non-surgical treatment in patients with rheumatoid arthritis and periodontitis is statistically significant(WMD=-0.404,95%CI[-0.507,-0.301],P=0.000<0.05),the decrease of ESR is not statistically significant(WMD=-1.753,95%CI[-4.092,0.586],P=0.142>0.05),the decrease of serum CRP is not statistically significant(WMD=-0.065,95%CI[-0.193,0.064],P=0.325>0.05),the change of serum RF was not statistically significant(WMD=8.350,95%CI [-0.736,17.436],P=0.072>0.05),the decrease of VAS was not statistically significant(WMD=-0.332,95%CI[-10.195,9.530],P=0.947>0.05).Meta analysis of non-randomized controlled trials showed that:the decrease of DAS28 after periodontal non-surgical treatment in patients with rheumatoid arthritis and periodontitis was statistically significant(ES=-1.124,95%CI[-1.592,-656],P=0.000<0.05),the decrease of ESR was not statistically significant(ES=-10.352,95%CI[-22.128,1.064],P=0.075>0.05),the decrease of serum TNF-a was not statistically significant(ES=-12.707,95%CI[-31.175,-5.761],P=0.177>0.05).Conclusion: Periodontitis is related to rheumatoid arthritis.Periodontal non-surgical treatment can reduce the disease activity of patients with rheumatoid arthritis combined with periodontitis.