Relationship between rheumatoid arthritis and chronic periodontitis

Chronic periodontitis is inflammation of supporting structures of teeth caused by microorganisms, and Porphyromonas gingivalis is one of the most common organisms. Periodontitis has been associated with different systemic diseases and rheumatoid arthritis (RA) is one of them. Periodontitis and RA share several features such as inflammation and bone destruction. Enzyme peptidyl arginine deaminase (PAD) is responsible for citrullination of arginine and citrullinated antigens are generated by posttranslational modification. Anti-cyclic citrullinated peptide antibodies and citrullinated peptides (a-enolase, vimentin, fibrinogen, and Type II collagen) are associated with breakdown of self-tolerance in RA. P. gingivalis is the only periodontopathic organism to produce PAD that is responsible for citrullination of arginine. Therefore, patients of periodontitis should be evaluated for RA.