Dental News - Oral bacteria resposible for artificial joint failure

Dental Tribune International

Mon. 14 May 2012

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CLEVELAND, Ohio, USA: Study results have suggested that periodontal bacteria can migrate from the mouth to the synovial cavity, which might be the reason for the failure of artificial joints. In recent DNA tests, researchers detected the same bacterial DNA in synovial fluid and dental plaque in 14 percent of patients with arthritis and periodontitis.

The study was conducted by researchers at the Case Western Reserve University's School of Dental Medicine and the University Hospitals Case Medical Center.

"For a long time, we have suspected that these bacteria were causing problems in arthritis patients, but never had the scientific evidence to support it," said Prof. Nabil Bissada, chair of the Department of Periodontics at the dental school.

In order to prove their bacterial translocation hypothesis, the researchers investigated the presence of bacterial DNA in synovial fluid and periodontal tissue samples from 36 patients with periodontal disease and arthritis. Five of the subjects showed a direct DNA link between the bacteria in the fluid and plaque. The researchers detected identical bacterial DNA in two patients with rheumatoid arthritis and three patients with osteoarthritis who were also diagnosed with periodontitis.

"The oral–synovium translocation could be due to the periodontal disease the patients had. In the presence of periodontal disease, the quantity of oral bacteria increases dramatically. This, in combination with inflamed gums, increases the chance of oral bacteria entering the circulation, leading to systemic dissemination," the researchers said.

"On the basis of our present and previous studies, we suggest that patients with arthritis or failed prosthetic joints be examined for the presence of periodontal disease and be treated accordingly," the researchers concluded.

According to the researchers, this data is the first genetically proven evidence that oral bacteria can migrate to the synovium in humans. Nevertheless, Bissada admitted that larger studies, with control groups, are required to corroborate the findings.

The case study group consisted of nine men and 27 women, aged between 45 and 84, with a mean age of 61.6 years. Eleven of the patients were diagnosed with rheumatoid arthritis and 25 with osteoarthritis.

The study was published in the April issue of the Journal of Clinical Rheumatology.

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