Periodontal inflammatory burden and radiographic bone loss in relation to disease activity in patients with rheumatoid arthritis: a cross-sectional analysis

Objective To evaluate the association of periodontal inflamed surface area (PISA) and maximum radiographic bone loss with rheumatoid arthritis (RA) disease activity.Materials and methods In this retrospective cross-sectional study, 38 patients with RA (periodontal and rheumatologic assessments ≤10 days apart) were evaluated. Periodontal inflammatory burden (PISA), maximum radiographic bone loss, and RA activity (DAS28-ESR) were assessed. Associations were examined with Spearman correlation and multivariable linear regression adjusted for age, smoking, and diabetes.Results Patients with higher PISA had greater maximum radiographic bone loss (ρ=0.441; 95% CI 0.101-0.717; p=0.006) and higher RA disease activity (ρ=0.811; 95% CI 0.546-0.959; pConclusion Periodontal inflammatory burden, radiographic bone loss, and RA disease activity were mutually associated in this single-center, seropositive cohort. These findings support evaluating periodontal inflammation and structural destruction alongside RA activity; longitudinal studies are needed to establish temporal direction.