Does non-surgical periodontal treatment contribute to rheumatoid arthritis amelioration? Evidence based on an overview and meta-analysis

To perform an overview by analyzing clinical outcomes in individuals with rheumatoid arthritis (RA) who underwent non-surgical periodontal treatment (NSPT). Electronic searches were conducted across four databases and gray literature with no restriction on language or publication date. The study followed the 2020 PRISMA statement. A meta-analysis was performed comprising 18 primary studies from SRs to examine the effects of NSPT (n = 201 subjects in the non-NSPT vs. n = 199 in the NSPT group) on 28-joint Disease Activity Score (DAS28). Nine SRs were analyzed; of these, six with meta-analyses and three without meta-analyses. The main outcomes evaluated were DAS28, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR). NSPT resulted in a significant decrease in CRP, ESR and DAS28, both in studies that included a control group (without NSPT) or in those comparing individuals before and after periodontal therapy. Follow-up period after NSPT ranged from 6 to 24 weeks. Despite the heterogeneity of data related to RA and periodontitis status and antirheumatic therapy, NSPT was able to reduce the levels of systemic inflammatory markers and RA activity.