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Microvascular periodontal alterations: A possible relationship between periodontitis and rheumatoid arthritis.


Abstract BACKGROUND: Microvascular involvements represent one of the first steps in many autoimmune diseases such as rheumatoid arthritis (RA). The aim of this study was to investigate the differences in periodontal microcirculation between healthy subjects and patients suffering from RA. METHODS: Thirty healthy subjects and 30 patients suffering from RA were examined. The patients who showed conditions known to compromise microcirculation, such as diabetes, hypertension, pharmacological treatments, were not included in the group of healthy patients. All the patients were non-smokers. Periodontal capillaroscopy was used to investigate the characteristics of microcirculation. Visibility, course, tortuosity, as well as the possible presence of microhemorrhages, the average caliber of the capillary loops and the number of visible capillary loops per square millimeter were evaluated for each patient. RESULTS: Microcirculation architecture in the healthy and in the RA patients was characterized by a network of capillaries in polygonal mesh with parallel orientation as regards the surface. In patients suffering from RA, it was possible to observe a reduced caliber of capillaries, as well as a greater number and elongated capillaries. No significant differences relating to oral capillaroscopic pattern were detected between RA patients that were rheumatoid factor, ANA, RANA positive and RA patients that were rheumatoid factor, ANA, RANA negative. CONCLUSIONS: This study shows that capillary alterations in patients suffering from RA occur in periodontal microcirculation; such evidence could be extremely important, suggesting that microvascular periodontal alterations may play a crucial part in the complex activity associated with periodontal disease in AR patients.