{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T14:21:11Z","timestamp":1790000471268,"version":"4.0.1"},"reference-count":50,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Currently, in the field of rheumatology, there is much attention given towards the possible causality between periodontitis and rheumatoid arthritis (RA), specifically regarding the role of <jats:italic>Porphyromonas gingivalis (Pg)<\/jats:italic>. This bacterium is unique, having a citrullinating enzyme. Antibodies against citrullinated proteins are rather specific for RA.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> Because causality is ultimately tested in longitudinal cohort studies which currently do not exist for periodontitis and RA, this commentary applied Bradford Hill criteria on the existing literature to assess causality as the most likely interpretation of this association.<\/jats:p><jats:p><jats:bold>Conclusions:<\/jats:bold> From an epidemiologic point of view, patients with RA have a higher incidence of periodontal disease than individuals without RA. In addition, there is a dose\u2010response pattern in the association between the severity of periodontitis and RA disease activity. There are indications that periodontitis precedes RA, but there is no evidence yet available to show that <jats:italic>Pg<\/jats:italic> plays a direct role in this temporal relationship. The role of the unique characteristic of citrullination by <jats:italic>Pg<\/jats:italic> remains unexplained. However, in animal models, citrullination by <jats:italic>Pg<\/jats:italic> plays a distinct role in the development and aggravation of experimental arthritis. Although the role of <jats:italic>Pg<\/jats:italic> in RA remains speculative, a causative role for periodontitis as a chronic inflammatory disease caused by infectious agents in RA seems biologically plausible.<\/jats:p>","DOI":"10.1902\/jop.2015.150088","type":"journal-article","created":{"date-parts":[[2015,5,13]],"date-time":"2015-05-13T05:23:03Z","timestamp":1431494583000},"page":"1013-1019","source":"Crossref","is-referenced-by-count":47,"title":["Commentary: Periodontitis and Rheumatoid Arthritis: What Do We Know?"],"prefix":"10.1002","volume":"86","author":[{"given":"Menke J.","family":"de Smit","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Westra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisabeth","family":"Brouwer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koen 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