Periodontal Health Status & Salivary Elements Analysis (Iron & Potassium) Among Group of Patients with Rheumatoid Arthritis & Chronic Periodontitis

Maha Sh. Al-Rubaie


Background: Periodontal diseases are common in the society & some researchers suggested an association between rheumatoid ar- thritis (RA) & periodontal diseases. The aim of the present study was to determine the periodontal health status in patient with RA & chronic periodontitis & compare it with those having chronic periodontitis only & determine the level of salivary elements; iron (Fe) & potassium (k) in both groups & compare it with control group & correlate between these salivary elements with the periodontal param- eters plaque index (PLI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD) & clinical attachment level (CAL).

Materials & Methods: The samples were recruited from patients referred to department of rheumatology at Baghdad Hospital. Seventy five (75) patients participated in this study, twenty five of them had rheumatoid arthritis with chronic periodontitis; twenty five had chronic periodontitis only without arthritis & another twenty five patients were periodontally & systemically healthy (control group). The patients were with age range 40-50 years with no other systemic disease. Periodontal parameters were measured in all groups at four surfaces which include plaque index, gingival index, bleeding on probing, probing pocket depth & clinical attachment level. Salivary samples were collected under standardized condition & then analyzed for estimation of the level of potassium by using flame atomic absorption spectrophotometry (AAS) while the iron level by using spectrophotometric analysis.

Results: Patients with RA & chronic periodontitis had higher prevalence of site presenting dental, plaque, a higher rate of gingival inflammation & bleeding on probing, greater probing depth & clinical attachment level with a significant difference from the group of patients with chronic periodontitis alone without RA the results also revealed a higher concentration of iron & potassium among the rheumatoid arthritis group than the second & control group with a statistically highly significant difference between the three groups.

Conclusion: The results suggest higher potentiality for moderate to severe periodontitis involvement among RA patients with higher levels of salivary iron & potassium. The coexistence of RA & chronic periodontitis could possibly influence the inflammatory process & the pathogenesis of one disease on the other.


Rheumatoid arthritis, Chronic periodontitis, Salivary elements.

Full Text:



Ghaliani P, Isfahanian V, Sarrafan N & Pishva S. The relationship between arthritis & periodontitis. Journal of Isfahan Dental School. 2010;6(1):44-8. (IVSL).

Bartold PM, Marshall RI, Haynes DR. Periodonti- tis & Rheumatoid Arthritis: A review. J Periodontol. 2005;76(11):2066-74.

Mercado FB, Marshall RI, Bartold PM. Inter-rela- tionships between rheumatoid arthritis & periodon- tal disease. J Clin Periodontol. 2003;30:761-72.

Rutger Persson G. Rheumatoid arthritis & peri- odontitis; inflammatory & infectious connections (Review). J Oral Micro. 2012;4:1-16. (IVSL).

Telfer JF, Brock JH (2004). Pro inflammatory cy- tokines increase iron uptake into human monocytes & synovial fibroblasts from patients with rheuma- toid arthritis. Medical Science Monitor 10, BR 91- BR95.

Ribeiro J, Leao A & Novaes AB. Periodontal in- fection as a possible severity factor for rheumatoid arthritis. J Clin Periodontol. 2005;32(4):412-6.

Eduardo de Paula I, Manoel BB, Carlos R Jr, Keih LK & Mirian AO. Periodontal condition in patients with rheumatoid arthritis. Braz Oral Res. 2008;22(1):72-7.

Katz PP, Yelin EH. Activity loss & the onset of de- pressive symptoms: do some activities matter more than others? Arthritis Rheum. 2001;44(5):1194-202.

Lieu P, HeisKala M, Peterson P & Yang Y. The roles of iron in health & disease. Molecular aspects of med- icine. 2001;22:1-87.

Cairo G, Bernuzzi F & Recakati S. A precious metal: Iron, an essential nutrient for all cells. Genes & Nutrition. 2006;1:25-40.

Al-Qenaei A. the role of Iron in Rheumatoid Ar- thritis. A thesis submitted for the degree of Doctor of Philosophy, University of Bath, Department of Pharmacy & Pharmacology; 2008.

Swaak; Editorial. Anemia of chronic disease in patients with RA: Aspects of prevalence, out- come, diagnosis & the effect of treatment on dis- ease activity. J Rheumatology. 2006;33(8):1467- 1468.

He FJ, Mac Gregor GA. Beneficial effects of potassium on human health. Physiol Plant. 2008;133(4):725-35.

Zhu k, Devine A, Prince RL. The effects of high potassium consumption on bone mineral density in a prospective cohort study of elderly postmen- opausal women. Osteoporos Int. 2009;20(2):335- 40.

Rastmanesh R. Hypothetical hormonal mecha- nism by which potassium-rich diets benefit pa- tients with RA. Med Hypotheses. 2009;73(4):564- 8.

NHANES-111, U.S. Department of health & hu- man services. Third National Health & Nutrition Examination survery, 1988-94.

Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF & Cooper NS. The American Rheu- matism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988;31(3):315-24.

Aletaha D, Neogi T, Silman AJ, Funovits J & Fel- son DT. 2010 RA classification criteria: An Amer- ican College of Rheumatology/European League Ageist Rheumatism Collaborative initiative. Ar- thritis Rheum. 2010;62(9):2569-81.

Harris ED & Firestein GS. Clinical Features of rheumatoid arthritis. In Firestein GS, Budd RC, Harris ED eds. Kelley’s text book of Rheumatol- ogy, 8th ed. Philadephia, 2008; Chapter 66.

Silness J & Loe H. Periodontal disease in preg- nancy II, Correlation between oral hygiene

& periodontal condition. Acta Odont Scand.


Loe H. The gingival Index, the plaque Index

& the Retention Index system. J periodontal.


Carranzas Clinical Periodontology, tenth edition

Page 436.

Smolik I, Robinson D &E/-Gabalawy HS. Peri-

odontitis & rheumatoid arthritis: epidemiologic, Clinical & immunologic associations. Compend Contin Educ Dent. 2009;30:188-190.

Al-Saadi Aa. Oral health condition & salivary constituents (Zinc, Copper, Calcium, iron & to- tal protein) among a selected over weight primary school children. A master thesis, 2009.

Wegner N, Wait R, Stroka A, Eick S, Nhuyen K A, Lundberg K, Kinloch A & Venables PJ. Pep- tidylarginine deiminase from porphyromonas gingivalis citrullinates human fibrinogen & al- pha-enolase: implications for autoimmunity in rheumatoid arthritis. Arthritis & Rheumatism (2010).

Mirrielees J, Crofford LJ, Lin Y, Kryscio RJ, Dawson DR 3rd, Ebersol JL & Miller CS. Rheu- matoid arthritis & salivary biomarkers of peri- odontal disease. J Clin Periodontol 2010; 37 (12): 1068-74.

Weiss G. Modification of iron regulation by the inflammatory response. Best practice & research Clinical Hematology. 2005;18:183-201.

Heeney MM & Andrews NC. Iron homeostasis & inherited iron overload disorders: an overview. Hematology-Oncology Clinics of North America. 2004;18:1379-403.

Syrjanen S & Syrjanen K. Localization of trans- ferrin in the labial salivary glands of patients with rheumatoid arthritis. Clin Rheumatol. 1984;3(3);345-50.



  • There are currently no refbacks.


Copyright by Iraqi Dental Journal

ISSN (Print): 2307-4779 | ISSN (Online): 2411-9741