{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T02:11:33Z","timestamp":1793412693502,"version":"4.5.0"},"reference-count":58,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2016,12,19]]},"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the association between rheumatoid arthritis (RA) and periodontitis with special emphasis on the role of antirheumatic drugs in periodontal health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Prospective follow-up study. Patients with early untreated RA and chronic active RA were examined at baseline and 16\u2005months later. Controls were examined once.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Settings and participants<\/jats:title>\n                    <jats:p>The study was conducted in Finland from September 2005 to May 2014 at the Helsinki University Hospital. Overall, 124 participants were recruited for dental and medical examinations: 53 were patients with early disease-modifying antirheumatic drug (DMARD) na\u0457ve RA (ERA), 28 were patients with chronic RA (CRA) with insufficient response to conventional DMARDs. After baseline examination, patients with ERA started treatment with synthetic DMARDs and patients with CRA with biological DMARDs. Controls were 43 age-matched, gender-matched and community-matched participants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>Degree of periodontitis (defined according to the Center for Disease Control and Prevention and the American Academy of Periodontology). Prevalence of periodontal bacteria (analysed from plaque samples), clinical rheumatological status by Disease Activity Score, 28-joint count (DAS28), function by Health Assessment Questionnaire (HAQ) and treatment response by European League Against Rheumatism (EULAR) criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Moderate periodontitis was present in 67.3% of patients with ERA, 64.3% of patients with CRA and 39.5% of control participants (p=0.001). Further, patients with RA had significantly more periodontal findings compared with controls, recorded with common periodontal indexes. In the re-examination, patients with RA still showed poor periodontal health in spite of treatment with DMARDs after baseline examination. The prevalence of\n                      <jats:italic>Porphyromonas gingivalis<\/jats:italic>\n                      was higher in patients with ERA with periodontal probing depth \u22654\u2005mm compared with patients with CRA and controls. Antirheumatic medication did not seem to affect the results.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Moderate periodontitis was more frequent in patients with RA than in controls. Patients with ERA and CRA exhibited poorer periodontal health parameters when compared with controls. There was no association between antirheumatic treatment and periodontal parameters.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-011916","type":"journal-article","created":{"date-parts":[[2017,1,31]],"date-time":"2017-01-31T20:10:38Z","timestamp":1485893438000},"page":"e011916","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":76,"title":["Periodontitis in early and chronic rheumatoid arthritis: a prospective follow-up study in Finnish population"],"prefix":"10.1136","volume":"7","author":[{"given":"Leena","family":"\u00c4yr\u00e4v\u00e4inen","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjatta","family":"Leirisalo-Repo","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antti","family":"Kuuliala","sequence":"additional","affiliation":[{"name":"Department of Bacteriology and Immunology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsi","family":"Ahola","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riitta","family":"Koivuniemi","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jukka H","family":"Meurman","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Maria","family":"Heikkinen","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,1,31]]},"reference":[{"key":"2025121402582431000_7.1.e011916.1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0757.2010.00340.x"},{"key":"2025121402582431000_7.1.e011916.2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0757.2012.00457.x"},{"key":"2025121402582431000_7.1.e011916.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752-7325.1995.tb02377.x"},{"key":"2025121402582431000_7.1.e011916.4","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1038\/sj.bdj.2014.97","article-title":"Manifesto for a paradigm shift: periodontal health for a better life","volume":"216","author":"Chapple","year":"2014","journal-title":"Br Dent J"},{"key":"2025121402582431000_7.1.e011916.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67728-8"},{"key":"2025121402582431000_7.1.e011916.6","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.090533"},{"key":"2025121402582431000_7.1.e011916.7","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780301102"},{"key":"2025121402582431000_7.1.e011916.8","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.060459"},{"key":"2025121402582431000_7.1.e011916.9","doi-asserted-by":"publisher","DOI":"10.1038\/nature05911"},{"key":"2025121402582431000_7.1.e011916.10","doi-asserted-by":"publisher","DOI":"10.1136\/ard.62.9.835"},{"key":"2025121402582431000_7.1.e011916.11","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1016\/j.molimm.2015.09.010","article-title":"Peptide motif analysis predicts alphaviruses as triggers for rheumatoid arthritis","volume":"68","author":"Hogeboom","year":"2015","journal-title":"Mol Immunol"},{"key":"2025121402582431000_7.1.e011916.12","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kes283"},{"key":"2025121402582431000_7.1.e011916.13","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204575"},{"key":"2025121402582431000_7.1.e011916.14","doi-asserted-by":"publisher","DOI":"10.1186\/ar3106"},{"key":"2025121402582431000_7.1.e011916.15","doi-asserted-by":"crossref","first-page":"259074","DOI":"10.1155\/2015\/259074","article-title":"Relationship between periodontitis and rheumatoid arthritis: review of the literature","volume":"2015","author":"Ara\u00fajo","year":"2015","journal-title":"Mediators Inflamm"},{"key":"2025121402582431000_7.1.e011916.16","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1902\/jop.1996.67.4.422","article-title":"Microbial flora in the acute phase of periodontitis and the effect of local administration of minocycline","volume":"67","author":"Umeda","year":"1996","journal-title":"J Periodontol"},{"key":"2025121402582431000_7.1.e011916.17","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.1998.tb02414.x"},{"key":"2025121402582431000_7.1.e011916.18","doi-asserted-by":"publisher","DOI":"10.1186\/ar4061"},{"key":"2025121402582431000_7.1.e011916.19","doi-asserted-by":"publisher","DOI":"10.1002\/art.34539"},{"key":"2025121402582431000_7.1.e011916.20","doi-asserted-by":"publisher","DOI":"10.1002\/art.21575"},{"key":"2025121402582431000_7.1.e011916.21","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-202254"},{"issue":"11","key":"2025121402582431000_7.1.e011916.22","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1111\/j.1600-051X.2010.01669.x","article-title":"What can the periodontal community learn from the pathophysiology of rheumatoid arthritis?","volume":"38","author":"Culshaw","year":"2011","journal-title":"J Clin Periodontol"},{"key":"2025121402582431000_7.1.e011916.23","doi-asserted-by":"publisher","DOI":"10.1007\/s10753-004-6641-z"},{"key":"2025121402582431000_7.1.e011916.24","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2008.080205"},{"key":"2025121402582431000_7.1.e011916.25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-051X.2010.01682.x"},{"key":"2025121402582431000_7.1.e011916.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2011.01.010"},{"key":"2025121402582431000_7.1.e011916.27","unstructured":"Oral Health Surveys Basic Methods. 4th edn. Geneva: World Health Organization, 1997;4\u201352."},{"key":"2025121402582431000_7.1.e011916.28","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2007.060264"},{"key":"2025121402582431000_7.1.e011916.29","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2012.110664"},{"key":"2025121402582431000_7.1.e011916.30","doi-asserted-by":"publisher","DOI":"10.1186\/1472-6831-8-16"},{"key":"2025121402582431000_7.1.e011916.31","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780380107"},{"key":"2025121402582431000_7.1.e011916.32","unstructured":"Reference and Selected Procedure for the Erythrocyte Sedimentation (ESR) Test, Approved Standard (NCCLS Document) 4th ed. Edition, 2000."},{"key":"2025121402582431000_7.1.e011916.33","doi-asserted-by":"publisher","DOI":"10.1136\/ard.60.8.744"},{"key":"2025121402582431000_7.1.e011916.34","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.tripleo.2004.06.079","article-title":"Clinical and radiographic findings of the temporomandibular joint in patients with various rheumatic diseases. A case-control study","volume":"99","author":"Helenius","year":"2005","journal-title":"Oral Surg Med Oral Pathol Oral Radiol Endod"},{"key":"2025121402582431000_7.1.e011916.35","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/ket362"},{"key":"2025121402582431000_7.1.e011916.36","doi-asserted-by":"crossref","first-page":"22","DOI":"10.4103\/0972-124X.94599","article-title":"Is there a relationship between periodontitis and rheumatoid arthritis?","volume":"16","author":"Ranade","year":"2012","journal-title":"J Indian Soc Periodontol"},{"key":"2025121402582431000_7.1.e011916.37","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1007\/s40496-014-0040-9","article-title":"The link between periodontitis and rheumatoid arthritis: a periodontist's perspective","volume":"2","author":"Payne","year":"2015","journal-title":"Curr Oral Health Rep"},{"key":"2025121402582431000_7.1.e011916.38","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.141480"},{"key":"2025121402582431000_7.1.e011916.39","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.140853"},{"key":"2025121402582431000_7.1.e011916.40","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2008.070501"},{"key":"2025121402582431000_7.1.e011916.41","first-page":"70","article-title":"Association of periodontal disease and tooth loss with rheumatoid arthritis in the US population","volume":"35","author":"de Pablo","year":"2008","journal-title":"J Rheumatol"},{"key":"2025121402582431000_7.1.e011916.42","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2009.090309"},{"key":"2025121402582431000_7.1.e011916.43","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-011-2284-1"},{"key":"2025121402582431000_7.1.e011916.44","doi-asserted-by":"publisher","DOI":"10.1002\/art.38348"},{"key":"2025121402582431000_7.1.e011916.45","doi-asserted-by":"crossref","first-page":"80","DOI":"10.3389\/fimmu.2016.00080","article-title":"Hand to mouth: a systematic review and meta-analysis of the association between rheumatoid arthritis and periodontitis","volume":"7","author":"Fuggle","year":"2016","journal-title":"Front Immunol"},{"key":"2025121402582431000_7.1.e011916.46","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0b013e32835fb8ec"},{"key":"2025121402582431000_7.1.e011916.47","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2005.76.11-S.2106"},{"key":"2025121402582431000_7.1.e011916.48","doi-asserted-by":"publisher","DOI":"10.1097\/01.bor.0000166388.47604.8b"},{"key":"2025121402582431000_7.1.e011916.49","doi-asserted-by":"publisher","DOI":"10.3402\/jom.v4i0.11829"},{"key":"2025121402582431000_7.1.e011916.50","doi-asserted-by":"publisher","DOI":"10.1002\/art.34595"},{"key":"2025121402582431000_7.1.e011916.51","first-page":"666","article-title":"Clinical and radiological assessment of effects of long-term corticosteroids therapy on oral health","volume":"10","author":"Beeraka","year":"2013","journal-title":"Dent Res J"},{"key":"2025121402582431000_7.1.e011916.52","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2008.070616"},{"key":"2025121402582431000_7.1.e011916.53","doi-asserted-by":"crossref","first-page":"3","DOI":"10.5051\/jpis.2012.42.1.3","article-title":"Effect of anti-rheumatic agents on periodontal parameters and biomarkers of inflammation: a systematic review and meta-analysis","volume":"42","author":"Han","year":"2012","journal-title":"J Periodontal Implant Sci"},{"key":"2025121402582431000_7.1.e011916.54","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2014.140194"},{"key":"2025121402582431000_7.1.e011916.55","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2013.120696"},{"key":"2025121402582431000_7.1.e011916.56","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1111\/jcpe.12433","article-title":"Anti-B lymphocyte immunotherapy is associated with improvement of periodontal status in subjects with rheumatoid arthritis","volume":"42","author":"Coat","year":"2015","journal-title":"J Clin Periodontol"},{"key":"2025121402582431000_7.1.e011916.57","first-page":"180","article-title":"Persistent periodontal disease hampers anti-tumor necrosis factor treatment response in rheumatoid arthritis","volume":"18","author":"Savioli","year":"2012","journal-title":"J Clin Rheumatol"},{"key":"2025121402582431000_7.1.e011916.58","doi-asserted-by":"publisher","DOI":"10.1093\/eurpub\/cku174"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2016-011916","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T10:58:36Z","timestamp":1765709916000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2016-011916"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1]]},"references-count":58,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2017,1,31]]},"published-print":{"date-parts":[[2017,1]]}},"alternative-id":["10.1136\/bmjopen-2016-011916"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2016-011916","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,1]]}}}