Vol.:(0123456789) 1 3 Odontology https://doi.org/10.1007/s10266-020-00566-0 ORIGINAL ARTICLE Clinical and microbiological effects of non‑surgical periodontal treatment in individuals with rheumatoid arthritis: a controlled clinical trial Marcela F. Moura 1  · Luís O. M. Cota 1  · Tarcília A. Silva 1  · Sheila C. Cortelli 2  · Gilda A. Ferreira 3  · Marina M. López 1  · José R. Cortelli 2  · Fernando O. Costa 1 Received: 15 July 2020 / Accepted: 18 October 2020 © The Society of The Nippon Dental University 2020 Abstract The effect of periodontal treatment on clinical, microbiological and serological parameters of patients with rheumatoid arthritis (RA) are scarce and controversial. The aim of this study was to investigate the influence of non-surgical peri- odontal treatment on clinical periodontal status, subgingival bacterial levels of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and RA activity through a controlled clinical trial on individuals with RA and periodontitis (PE). From a convenience sample, 107 individuals were considered eligible and consecutively allocated in four groups: (1) individuals without PE and RA (− PE-RA, n = 30); (2) individuals without PE and with RA (− PE + RA, n = 23); (3) individuals with PE and RA (+ PE + RA, n = 24); and (4) individuals with PE and without RA (+ PE-RA, n = 30). Full-mouth periodontal clinical examinations, microbiological analysis and Disease Activ- ity Score (DAS-28) evaluations were performed at baseline (T1) and 45 days after non-surgical periodontal treatment (T2). At T1, individuals + PE + RA showed greater severity of PE than + PE-RA individuals. At T2, significant reductions were observed in all periodontal clinical parameters in both groups (p < 0.001) with a significant reduction in DAS-28 in + PE + RA (p = 0.011). Individuals + PE-RA and + PE-RA showed significant reductions for all bacteria (p < 0.001). Additionally, P. gingivalis demonstrated an expressively significant reduction in + PE + RA (p < 0.001). Non-surgical periodontal treatment was effective on improving the clinical periodontal condition, improving the RA clinical status and reducing the presence of periodontal pathogens. Brazilian Registry of Clinical Trials (ReBEC) protocol #RBR-8g2bc8 (https://www.ensaioscli nicos.gov.br/rg/RBR-8g2bc8/). Keywords Bacteria · Clinical trials · Nonsurgical periodontal debridements · Periodontitis · Rheumatoid arthritis Introduction Periodontitis (PE) is a chronic infectious inflammatory dis- ease caused by anaerobic bacteria, leading to the destruction of teeth supporting tissues [1]. The disease results from the disturbance of homeostasis between the subgingival micro- biota and the host’s defenses in susceptible individuals [2]. This is due to different aspects of both innate inflammatory and immune responses. In recent years, the association between immune-medi- ated inflammatory diseases and PE has been increasingly reported. Several studies point to the evidence of association between PE and several systemic conditions, including dia- betes, obesity, cardiovascular diseases, pregnancy disorders and rheumatoid arthritis (RA) [1–4]. Biological plausibility is based on the concept that inflam- mation and periodontal microbiome contribute to the global burden of systemic inflammation at a level that affects its occurrence, severity and progression of other chronic inflam- matory conditions [5]. This association does not imply causality and can be unidirectional or bidirectional, that is, * Fernando O. Costa focperio@uol.com.br 1 Department of Dental Clinics, Oral Pathology, and Oral Surgery, Department of Periodontology, Faculty of Dentistry, Federal University of Minas Gerais, Antônio Carlos Avenue, 6627, Pampulha, PO Box 359, Belo Horizonte, Minas Gerais 31270-901, Brazil 2 Faculty of Dentistry, University of Taubaté, São Paulo, Brazil 3 Faculty of Medicine Federal, University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil