الفهرس 
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Abstract
The aim of this study is to compare the disease activity of rheumatoid arthritis with moderate chronic periodontitis before and after non-surgical periodontal therapy and to Study the correlation between serum ACPA level and RF level in relation to periodontal parameters Subjects and Methods : A total of forty patients were selected and grouped as follow : group 1 consists of twenty patients with rheumatoid arthritis and chronic periodontitis (selected from outpatients coming to the Rheumatology and Rehabilitation Department, Faculty of Medicine, Mansoura University). Those patients were sub grouped as follow : Subgroup A: Ten patients with rheumatoid arthritis without any other systemic disease Subgroup B: Ten patients with rheumatoid arthritis in association with other systemic disease group 2 consists of ten patients with rheumatoid arthritis without chronic periodontitis (selected from outpatients coming to the Rheumatology and Rehabilitation Department, Faculty of Medicine, Mansoura University) group 3 consists of Ten patients with chronic periodontitis (selected from Oral medicine and Periodontology department, Faculty of Dentistry) Study groups (group 1and 3) had undergone full mouth supra gingival and sub gingival scaling and root planning once a week for 8 weeks. During treatment, patients were instructed to establish good oral hygiene by daily tooth brushing and flossing. The periodontal parameters, Disease Activity Score 28 ESR (DAS 28 ESR) for RA activity, anti- cyclic citrullinated protein antibody (ACCPA), rheumatoid factor (RF) levels and sub gingival plaque bacterial count were measured before and after completing the treatment Results : In this study, there was a positive correlation between periodontal parameters, total sub gingival bacterial count and DAS 28 ESR in all studied groups at base line. DAS28 ESR used for measuring RA disease activity showed significantly higher levels in RA patients with chronic periodontitis regarding visual analogue scale (VAS) and ESR than group 2.ESR level declined significantly and VAS increased 8 weeks after non-surgical periodontal therapy as well as improvement of periodontal parameters in those patients. Conclusions : chronic Periodontitis and Rheumatoid Arthritis share many similarities regarding the clinical, laboratory and microbiological findings. RA patients with chronic periodontitis have more severe RA activity than RA patients without chronic periodontitis regarding the DAS28 ESR score for RA. Non- surgical periodontal therapy aids in improvement of the clinical signs and symptoms in RA patients and a decrease in ESR level.