Association between rheumatoid factors and proinflammatory biomarkers with implant health in rheumatoid arthritis patients with dental implants

OBJECTIVE: To evaluate the levels of crevicular fluid rheumatoid factors (RFs), and other proinflammatory cytokines including interleukin (IL)-6, and tumor necrosis factor- alpha (TNF-α) and correlate these biomarkers with the clinical peri-implant parameters among rheumatoid arthritis (RA) patients with or without concomitant connective tissue disorder (CTD). PATIENTS AND METHODS: Three groups of 14 participants each [Group-I: Healthy, Group- II: RA without CTD, and Group-III: RA with CTD] were selected. The clinical parameters observed were bleeding on probing (BOP), plaque scores (PS), pocket depth (PD) and alveolar bone loss (ABL). RFs, IL-6 and TNF-α were Enzyme-linked immunosorbent assay (ELISA) was incorporated to quantify RFs, IL-6 and TNF-α. RESULTS: BOP was significantly higher in Groups II and III as compared with Group I. Alveolar bone loss was significantly higher in Group III followed by Group II and least in Group I. Patients with RA with CTD presented with statistically higher levels of RF, IL-6 and TNF-α followed by Group II compared with Group I (p<0.05). A positive correlation existed between BOP and all the three biomarkers RF (r=0.0562; p=0.0039), IL-6 and TNF-α for Group-II patients. Similarly, a significant positive correlation existed between BOP and all the three biomarkers RF, IL-6 and TNF-α for Group-III patients. In addition, a positive correlation was also seen between ABL and RF, PD, and IL-6 in Group-III patients. CONCLUSIONS: RF might influence peri-implant inflammation in RA patients with CTD. Moreover, the increased RF levels are indicative of diagnostic marker for peri-implant complications in RA.